Psychological consequences of functional sequelae after rectal cancer treatment: a narrative review

Rectal cancer treatment relies on multimodal approaches including surgery, radiotherapy, and chemotherapy, which are frequently associated with persistent functional sequelae such as bowel dysfunction, stoma formation, and sexual or urinary impairments. These long-term complications are increasingly recognized as key determinants of patients’ quality of life. This narrative review aims to synthesize current evidence on the psychological consequences associated with functional sequelae following rectal cancer treatment. A targeted literature search was conducted across PubMed, PsycINFO, Embase, and Scopus to identify relevant studies published between 2015 and 2025, focusing on patient-reported outcomes and psychosocial dimensions. The findings indicate that bowel dysfunction, particularly Low Anterior Resection Syndrome (LARS), is consistently associated with psychological distress, including anxiety, depressive symptoms, and social withdrawal. Stoma formation is associated with body image disturbances, reduced self-esteem, and impaired sexual functioning. Across studies, these functional impairments appear to interact with psychological and social factors, contributing to multidimensional experiences of isolation. Socioeconomic difficulties and reduced participation in daily activities are also associated with increased psychological burden. Functional sequelae following rectal cancer treatment are closely associated with substantial psychological burden and multidimensional disruptions in patients’ lives. A biopsychosocial perspective may help better understand these complex interactions and guide more comprehensive survivorship care. Greater integration of psychological support into routine care pathways may improve adaptation, reduce distress, and enhance long-term quality of life for rectal cancer survivors. Tailored interventions addressing both functional and psychosocial needs appear essential for optimizing survivorship outcomes.