Ostomy

Ostomies in Cancer treatment

An Ostomy is a surgical opening from an organ inside the body to the outside of the body. It helps waste to be drained into a pocket, out of the body, or for passing nutrients inside. Some survivors need to continue living with an Ostomy. Understanding how to manage everyday life with an Ostomy will help you confidently live your life.

A relatively small number of cancer survivors require an ostomy, thanks to surgical advances. However, for those who do, it can be life-saving Surgery. Ostomies may be temporary or permanent. A temporary Ostomy allows the healing of an area under the Ostomy in the bowel or bladder. A permanent Ostomy may be needed if the treatment requires removal of the end of the colon or rectum, the entire colon, or the entire bladder.

Common Ostomy types in cancer survivors:

    • Colostomy: A surgical opening from the large intestine or colon to the abdomen, to allow faecal matter to pass to the outside of the body.
    • Ileostomy: An opening in the ileum, a part of the small bowel, to the abdomen. Small intestine contents can pass through to the outside of the body.
    • Urostomy: An opening in the urinary system where urine can pass to the outside.

Less common Ostomy types in cancer survivors:

  • Jejunostomy: Opening into the jejunum, a part of the small bowel, to allow feeding.
  • Gastrostomy: Opening from the stomach to the outside of the body, to allow feeding.
  • Tracheostomy: Opening from the trachea to protect the airway.
  • Internal ostomies: A surgical opening between two internal organs rather than making an opening out to the surface of the body.

Cancers that Can Require an Ostomy

Ostomy Surgery may take place on people of all ages, including children. Two ostomies may be required by a small number of patients: one in the bowel and one in the urinary system. If cancer spreads out to the bladder or rectum, an Ostomy may be required. This is more likely to occur in cancers near the bladder and rectum, such as cervical and Prostate Cancer. Here are some cancers which could lead to an Ostomy operation:

  • Ovarian cancer: Cancer of the ovaries may spread in the abdominal cavity, obstructing either the small or large intestine and could require an ileostomy or colostomy.
  • Small bowel cancer or ovarian cancer: If cancer has spread to the small bowel an ileostomy may be required.
  • Rectal cancer: If the rectum is removed by surgery, a colostomy is required.
  • Cervical cancer: Because the cervix and the uterus are between the bladder and the rectum, there may be a urostomy or colostomy.
  • Bladder and urethra cancer: If either the bladder or urethra is removed, a urostomy is required.
  • Small intestine cancer: If cancer affects the small intestine, an ileostomy may be required.
  • Colon cancer: Depending on the location of cancer in the colon, a colostomy may be required.
  • Prostate cancer: Because the prostate lies just above the rectum, Surgery or radiation to the area may require a colostomy.
  • Uterine cancer: As the uterus lies below the bladder and above the rectum, Surgery or radiation to the area may require a colostomy or a urostomy.

An Ostomy may also be required due to the side effects of Radiation therapy or Surgery. Below are some side effects from treatment that may require an ostomy:

  • Radiation to the prostate or cervix may cause a change in the bowel or bladder that interferes with eliminating waste.
  • Severe bladder or bowel irritation.
  • Chronic bleeding after radiation to the uterus, bowel, or prostate gland.
  • Bowel obstruction after Surgery.

What are the Risks and Side Effects of having an ostomy?

    • Skin irritation. This is a common problem that is caused by the adhesive on your Ostomy pouch. Try using a different pouch or changing the adhesive you use.
    • Dehydration. Dehydration may be caused as a lot of waste leaves your body. You will have to rehydrate yourself by drinking fluids. If dehydration persists, you may require hospitalization.
    • Leakage. Leakage may happen in case your stoma pouch does not fit properly. If this happens, you probably need a new pouch that fits better.
    • Bowel obstruction. If your food is not chewed or properly digested, it can cause a blockage in your intestines. Symptoms of a blockage include cramps, stomach pain, and a sudden decrease in waste. It may clear up on its own. Sometimes blockages may require additional treatment.
    • Retraction. Sometimes the stoma may move inward, generally due to weight gain, scar tissue, or improper placement. Retraction makes it hard to attach your appliance and can also cause irritation and leakage.
    • Parastomal hernia. This frequent problem happens when your intestine starts to press outward through the opening. Such cases are very common and often go away on their own. In some cases, you may need Surgery to repair it.
    • Necrosis. Necrosis means tissue death. This happens when blood flow to your stoma is reduced or stopped. It usually happens within the first few days after Surgery and can be treated with medical help.

Most complications associated with stomas are minor, but some, especially necrosis and dehydration, can turn into medical emergencies. Call your doctor immediately if:

  • you’re Vomiting and not seeing any waste in your pouch
  • the skin around your stoma is turning blue, purple, or very dark red
  • you’re dizzy, lightheaded, and always thirsty