Colorectal cancer

Colorectal cancer

Colorectal cancer is the most common tumor in the Spanish population. The main risk factor is age, as 90% of cases occur in patients over 50 years of age.

There are several types of treatments: surgery, radiation therapy and chemotherapy. In addition, their combination is possible.

Surgery involves removing the affected part of the colon. Once extracted, the ends are fused together to restore the continuity of the gastrointestinal tract. When this is not possible, a temporary or permanent ostomy may be performed.

What is an ostomy? a surgical opening that allows intestinal contents to pass through the abdominal wall. You’ll need to wear a pouch connected to your abdomen to collect that waste.

I am scheduled for an ostomy, now what? “Pee and pooh” remain taboo subjects. With this article we hope to squash that stigma NOW! You can lead a “normal life” (if a normal life even exists) with an ostomy.

The process that makes it easier to recover that normality is as follows:

Pre-operative information and marking:

It is essential that you visit (before your surgery) with the Stomal Therapy Nurse (STN, a nurse specializing in ostomies). The visit will give you information on:

  • What an ostomy is
  • The devices and how to handle them
  • Getting your questions answered
  • Reducing your anxiety and fear
  • Marking on your abdomen where the bowel outlet will be located
  • Information on support groups and associations.

The STN will accompany you throughout the acceptance process and subsequent follow-up.

What are the support groups for?

These are spaces where people who are ostomized or who are going to be ostomized can share their experiences with the intention of improving their situation, learn as a group and provide reciprocal support. They are founded on the grounds of mutual respect and confidentiality. There are no hierarchies or distinct roles.

Participating in these support groups helps you not feel alone in the process and to see more people leading a “normal life” with an ostomy. The purpose is to move forward from “Why me” to “For what”. These groups facilitate the acceptance process and being able to continue with normal life.

Bag&Wings is a group of ostomized people that meets monthly in an online/face-to-face format with the participation of various associations at the national level. In addition, the group welcomes all companions/relatives to experience the process positively.

Good Clinical Practice guidelines (https://rnao.ca/bpg/guidelines/ostomy) recommend participating in these groups.

Surgery and post-op:

Being at the Hospital after surgery can be an emotionally complicated stage as it will be your first contact with the ostomy. The care team, the STN and family are important to help you cope and know how to manage the new situation.

Since the Hospital stay is usually only a few days, your family can provide support, motivation and help in the care of your ostomy until you become autonomous.

Over time, you will regain your usual pace of life. The ostomy becomes just another part of being able to lead a quality life.

At this point is when support groups also offer tricks and tips for activities of daily living (showering, eating, gas…) and specifically for when you want to play sports, or go to the beach, or to the pool.

There are a number of accessories that can make you feel more comfortable and “sexier”.

The ostomy or “pouch” are not impediments to your daily life. Your limitations come more from the sequelae of cancer.

When these sequelae appear, you have a multidisciplinary team of expert professionals who can treat them, improve them and even make them disappear.

Social stigma causes ostomized people to isolate themselves because of their embarrassment or fear of what others might think. There is a social media movement that fights for awareness about the “pouch” and wearing it with pride. Even so, it won’t be until a celebrity goes out in public talking about his or her “pouch” that this visibility will be attained.

Bibliographie :
1.RNAO. Registered Nurses Association of Ontario. Supporting adults who anticipate or live with an ostomy. International Affairs and Best Practice Guidelines.  2019. Disponible sur : https://rnao.ca/bpg/guidelines/ostomy
2.Folguera Arnau M, Gutiérrez VilaplanaJM, González María E, Moreno Casbas MT, Obarrio Fernandez S, Loente Granados G, Viñoly Torres E, Rodriguez Soberado MP. Mise en œuvre du guide des bonnes pratiques pour les soins et la prise en charge des stomies : résultats des soins. Soins infirmiers cliniques, Vol30, pages 176-184. May-June 2020. Disponible sur : Mise en œuvre du guide des bonnes pratiques pour les soins et la prise en charge des stomies : résultats des soins – ScienceDirect
3.WOCN, Wound Ostomy Continence Nurs. Society clinical guideline. Management of the adult patient with a fecal or urinary ostomy. Vol 45, pag 50-58.Jan-Feb 2018 Disponible sur : WOCN Society Clinical Guideline: Management of the Adult Pat… : Journal of Wound Ostomy & Continence Nursing (lww.com)
4. Salvadalena G, Hendren S, McKenna L, Muldoon R, Netsch D, Paquette I, Pittman J, Ramundo J, Streinberg G. WOCN, Wound Ostomy Continence Nurs. Position statement on preoperative stoma site marjeting for patients undergoing colostomy or ileostomy surgery. Vol 42, pag 249-252. May-Jun 2015. Disponible sur : WOCN Society and ASCRS Position Statement on Preoperative Stoma Site Marking for Patients Undergoing Colostomy or Ileostomy Surgery – PubMed (nih.gov)

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