GYNECOLOGICAL CANCER: COLOSTOMY BAGS AND THE IMPACT ON RECOVERY
Colostomy: The term colostomy is when the bowel, through surgery, opens onto the outside of the abdomen.
Surgery for most gynecological cancers does not require a colostomy except for the most advanced cases, or where bowel obstruction occurs as it can in advanced ovarian malignancy.
Sometimes surgery for ovarian cancer results in the need for a temporary colostomy with less than ten percent (10%) of surgical patients needing a permanent colostomy. A colostomy is needed when the surgeon has no option but to remove or divert part of the digestive system, which may be damaged due to the spread of the cancer beyond the ovaries. This means the body cannot rid itself of waste in the natural way, and needs a surgical opening (a stoma) to help do this. One of the greatest fears for women undergoing surgery for gynecological cancer is the thought of being left with a permanent colostomy that requires a bag. This means that the woman will no longer be able to pass faeces (‘pooh’) through her anus as normally happens. The faeces are now excreted via the colostomy (or stoma). The contents are collected in a colostomy bag that is attached to the outside of her abdomen.
A colostomy bag is seen by many women as having a devastating impact on lifestyle, self-image and intimate relationships.
However, this need not be the case.
Colostomies are temporary when the bowel needs time to heal effectively. Once everything is returned to normal, the bowel is reconnected and the colostomy is removed. No more bag! A marvelous feat of human plumbing! In some cases, however, the damage is so extensive to the digestive organs or bowel that the colostomy may be permanent.
It is important that you discuss with your doctor what all your options are.
The colostomy bags are cleverly designed and come in a range of sizes, and each with its own clamp to prevent leakage, and charcoal filters to reduce any smell.
Your stomal therapist (colostomy expert) will ‘fit’ your correct size and teach you how to manage the bag.
However, despite all these marvelous advances in bag technology, it is perfectly normal that women needing colostomy bags will experience a range of emotions. There will be a feeling of grief at the loss of normal bodily function, the change to body image, a feeling of being ‘ugly’ and loss of self as an active, sexual being. It is quite common for a woman to feel depressed in the early phases of adjusting to life with a colostomy, and before the realization that life (a good life) will continue. It is really important to communicate your feelings to your stomal therapist, partner or close friends about this. If the depression is severe, psychological counseling may be recommended. Some women go through a temporary phase of not eating to avoid the bag filling. In severe cases, this may lead to the onset of anorexia.
It is really important to discuss all your feelings, especially issues around intimacy and sexuality, with your partner. To discuss what feels most comfortable in intimate moments. If you do not feel like sex immediately, (and for some women this may take days, weeks or months to resume) hugging and kissing can still give enormous pleasure. Make your partner an active part of your management team. Include them in formal meetings, and encourage participation in managing your bag. Blocking them out of your feelings and other needs will only create fear and anxiety in them . . . and inevitably damage the relationship.
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