Managing Nutrition After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS-HIPEC): A Qualitative Study of Colorectal Cancer Survivors' and Caregivers' Experiences.

BACKGROUND

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is a potentially curative treatment for peritoneal metastasis in colorectal cancer. The procedure is extensive, and colorectal cancer survivors experience prolonged nutrition-impact symptoms and significant weight loss.

OBJECTIVE

The aim of this study was to explore colorectal cancer survivors' and caregivers' experiences with managing nutrition after the CRS-HIPEC procedure.

DESIGN

A qualitative descriptive design was used to gain insight into colorectal cancer survivors' and caregivers' experiences with nutrition.

PARTICIPANTS/

SETTING

Participants included 20 colorectal cancer survivors who underwent CRS-HIPEC in the past 3-12 months and 10 colorectal cancer caregivers at a single cancer center. Semi-structured interviews were conducted in 2024 and 2025 by videoconference.

ANALYSIS: Interviews were recorded, transcribed verbatim, and analyzed using rapid qualitative analysis.

RESULTS

Four key themes were observed: (1) Nutrition-impact symptoms, such as diarrhea, early satiety, and pain, were more severe and lasted longer after the CRS-HIPEC procedure than anticipated; (2) After the procedure, survivors had difficulty purchasing, preparing, and eating food, which led to anxiety and frustration; (3) Caregivers struggled to implement nutrition guidance from the care team and expressed a desire for more tailored resources, such as recipes and meal plans tailored based on the surgical procedure (eg, presence of colostomy); and (4) The timing and continuity of registered dietitian nutritionist support affected readiness for self-managing nutrition after the procedure.

CONCLUSIONS

Early and proactive registered dietitian nutritionist support may help colorectal cancer survivors and caregivers cope with nutrition challenges after CRS-HIPEC. Future interventions are needed to test early and proactive delivery of nutrition counseling and tailored nutrition education based on the surgical procedure (eg, colostomy).