An evaluation of a ScarWork service for cancer survivors experiencing adverse effects of surgery and/or radiotherapy

Introduction: In the UK, 68% of early stage cancer patients undergo surgical resection, which may result in troublesome physiological and psychosocial symptoms from scars associated with this curative-intent surgery. We evaluated a 12-month service offering ScarWork, a light-touch manual therapy, to improve our understanding of this novel intervention.Methods: A National Health Service (NHS) cancer centre offered eight ScarWork treatments to survivors who had undergone surgery (and/or radiotherapy) for breast, colorectal, gynaecological, head and neck cancers or melanoma. Outcome measures administered at beginning and end-of-treatment included the Patient Scar Assessment Questionnaire (PSAQ) and Measure Yourself Medical Outcome Profile (MYMOP). Patients could specify one or more scars. A semi-structured questionnaire administered at end-of-treatment collected patients' impressions of ScarWork.Results: Nineteen patients, reporting 25 scars with a mean scar age of 4.2 years (range: 0.5-17 years) received a median of six ScarWork treatments (range: 0-12). PSAQ showed significant improvements for subscales Appearance, Consciousness, Satisfaction with Appearance, and Satisfaction with Symptoms; symptom improvements included itching, frequency of discomfort, sensations of numbness and overall troublesomeness. Mean MYMOP profile score showed 1.8 (SE = 0.3) points improvement on a 7-point scale, where change of >= 0.5-1.0 points is clinically significant. In written feedback, patients reported benefits including improved appearance, texture, mobility, wellbeing and acceptance of scars. No serious adverse events were reported.Conclusions: Feedback from this service assured funding for continued clinical activity. Valuable experience in administering outcome measures, especially PSAQ, was gained. This will facilitate improved data collection and analysis for future service development.