Colostomy: Challenges, Rehabilitation, and Support for Rectal Cancer Survivors

Artificial anus

I was diagnosed with rectal cancer in April, and the cancer cells were removed without affecting the lymph nodes.
The doctor created a colostomy at the site of the normal anus.
Is this more inconvenient? If the urinary system is affected and causes urinary incontinence, how can I rehabilitate? In the future, if I need to consult about the urinary system, should I see a colorectal specialist or a urologist? Since my surgery in November, my weight has not increased, and I have not undergone radiation therapy; is there a connection? Additionally, are there any support groups for rectal cancer patients? I would like the opportunity to hear about the experiences and sharing from other patients.

Xiao Jin, 60~69 year old female. Ask Date: 2000/11/03

Dr. Wang Qichao reply Surgery

Based on your description, it seems that you underwent a relatively low anterior resection surgery, as very few physicians would place a colostomy in the perineal area due to the considerable care difficulties.
Although your pathology report indicates that the lymph nodes are not involved, it is still important to monitor the depth of tumor invasion.
If the entire thickness of the bowel wall is invaded, adjuvant radiochemotherapy is still recommended post-surgery.
Total rectal excision surgery often comes with sexual function and urinary abnormalities; therefore, it is advisable for you to consult with a urologist and consider rehabilitation.
Additionally, there is no specific rectal cancer support group, but there is an organization called "Friends of the Rose" that provides care and support.
If you are interested, you can contact them at 02-23757010 for more information.

Reply Date: 2000/11/03

More Info

Understanding colostomy and the challenges faced by rectal cancer survivors is crucial for improving quality of life and facilitating rehabilitation. A colostomy is a surgical procedure that creates an opening (stoma) in the abdominal wall, allowing waste to exit the body into a colostomy bag. This procedure is often necessary for patients with rectal cancer, especially when the cancer is located in a part of the rectum that cannot be preserved.

Challenges of Living with a Colostomy
1. Physical Adjustments: After surgery, patients may experience discomfort and need time to adjust to the presence of a stoma. This includes learning how to care for the stoma, manage the colostomy bag, and deal with potential skin irritation around the stoma site.

2. Psychological Impact: Many patients experience anxiety, depression, or body image issues after undergoing a colostomy. It is essential to address these feelings through counseling or support groups.

3. Dietary Changes: Patients may need to modify their diets to avoid foods that can cause gas or blockages. It’s important to work with a dietitian to develop a suitable eating plan.

4. Urinary Issues: If the colostomy affects the urinary system, leading to incontinence, it can be particularly distressing. Rehabilitation may involve pelvic floor exercises, bladder training, or medications to help manage these symptoms.

Rehabilitation and Support
Rehabilitation after a colostomy involves both physical and emotional support. Here are some strategies:
- Pelvic Floor Rehabilitation: If urinary incontinence is a concern, pelvic floor exercises can strengthen the muscles that control urination. A physical therapist specializing in pelvic health can provide guidance.

- Support Groups: Connecting with others who have undergone similar experiences can be incredibly beneficial. Organizations such as the United Ostomy Associations of America (UOAA) provide resources and support for individuals living with a colostomy.

- Professional Guidance: Regular follow-ups with healthcare providers, including colorectal surgeons and dietitians, can help manage any complications and ensure proper care.

Medical Follow-Up
Regarding your question about whether to see a colorectal or urology specialist, it depends on the specific issues you are facing. If your primary concern is related to the colostomy and its management, a colorectal surgeon or a specialized nurse in ostomy care would be appropriate. However, if urinary incontinence is a significant issue, consulting a urologist may be necessary.

Weight Management
It’s concerning that your weight has not increased since your surgery in April. Weight loss can be attributed to several factors, including dietary changes, malabsorption, or stress. It’s crucial to discuss this with your healthcare team to identify the underlying cause and develop a plan to address it. Nutritional support, possibly including supplements or a tailored diet, may be necessary to help you regain weight and strength.

Resources for Support
To find support groups or associations for rectal cancer survivors, consider the following resources:
- American Cancer Society: They offer support groups and resources for cancer patients and survivors.

- Cancer Support Community: This organization provides free support services, including online support groups.

- Local Hospitals or Cancer Centers: Many have support groups for patients undergoing treatment for specific types of cancer.

In conclusion, living with a colostomy after rectal cancer surgery presents unique challenges, but with the right support and rehabilitation strategies, patients can lead fulfilling lives. It’s essential to maintain open communication with your healthcare providers and seek out resources that can help you navigate this journey.

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