Supportive care helps people meet the physical, practical, emotional and spiritual challenges of cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.
Recovering from colorectal cancer and adjusting to life after treatment is different for each person, depending on the extent of the disease, the type of treatment and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A person who has been treated for colorectal cancer may have the following concerns.
Living with a colostomy
A colostomy is a surgical procedure in which an opening, called a stoma, is created in the colon through the abdominal wall. Living with an ostomy may be frightening at first. However, most people are able to adapt to and live normally with an ostomy.
It takes time and patience to learn the new skills needed to care for the colostomy. Specially trained healthcare professionals, called enterostomal therapists, teach ostomy care after surgery. They also offer support and advice after the person is discharged from the hospital.
Local or national ostomy groups and associations are available to provide support and information.
Body image and self-esteem
Colorectal cancer and its treatments can affect a person's body image and self-esteem. Body image is a person's perception of their own body. How a person feels about or sees themselves is called self-esteem.
Those who have a colostomy may feel uncomfortable around others. These feelings may cause distress for some people.
Urinary incontinence is a problem for some people following treatment. Embarrassment and fear of being made fun of may cause some people to isolate themselves from others.
Women may feel differently about their bodies and themselves as women, especially after having a pelvic exenteration. They may feel less like a woman or less feminine because they no longer have a uterus.
Changes in sexual function following surgery or radiation therapy may change body image and self-esteem in many people.
Sexuality
Many people continue to have strong, supportive relationships and a satisfying sex life after colorectal cancer. If sexual problems occur because of colorectal cancer treatment, there may be some ways to manage them.
Some people may feel uncomfortable with their bodies after colorectal cancer treatment, especially if they have a colostomy. A person and their partner may be uncertain, afraid or nervous about their first sexual experience after treatment. They may avoid intimacy, touching and sexual activity. All of these reactions are normal and are to be expected.
Being aware of these reactions can help a person with cancer and their partner understand and cope with the changes to their lives and relationship. Talking openly can help them overcome sexual concerns. While it may be awkward at first, the person and their partner should ask questions and discuss worries about sexuality with their doctor, other healthcare team members, or an ostomy support organization.
Sexual dysfunction
Treatment for colorectal cancer – surgery, chemotherapy and radiation therapy – may cause sexual problems in both men and women.
Sexual side effects from surgery include:
- fertility problems in women if the uterus was removed during pelvic exenteration
- painful intercourse in women if part of the vagina was removed or reconstructed as a result of pelvic exenteration
- erectile dysfunction (impotence) or ejaculation problems in men if the nerves that control erection and ejaculation are damaged during surgery (for example, abdominal perineal resection, pelvic exenteration or total mesorectal excision)
Sexual side effects from radiation include:
Chemotherapy may cause nausea, weakness, depression, tiredness and lack of energy. All these side effects can reduce the desire for sex. Once chemotherapy is stopped, the desire should eventually return.
See a list of questions to ask your doctor about supportive care after treatment.