Colorectal Cancer

Colorectal cancer surgery can have an intense effect on your body and body image, whether or not a colostomy or ileostomy has been created. Whether or not there is an ostomy, men may have difficulty with erection problems and dry orgasm (no semen for ejaculation). This is because nerves may be cut that assist in erection and in the control of semen ejaculation. Sometimes "retrograde" ejaculation can also happen (sperm are propelled into the bladder rather than out of the penis). Your surgeon can usually tell you whether any of these effects are likely to occur. If retrograde ejaculation occurs and the patient is still interested in having children, sperm can be harvested from the urine and used to assist in a pregnancy. (For more information about fertility, see the reference in the reading list entitled, Sexuality and Fertility After Cancer, by Leslie Schover).

If an ostomy has been placed, this may only be temporary, and your bowel can be put back together a few months later. However, if your ostomy is permanent, you may have many responses such as, 1) you have more fatigue and weakness than you expect, 2) you feel fragile, vulnerable, or depressed 3) you feel sadness and disgust when you first look at your stoma, 4) you are disgusted with stool eliminated into a bag taped to your abdomen, 5) you fear accidents and leakage, 6) there may be extreme emotional meaning for you in the stoma, 7) you may feel violated or mutilated, 8) you may have a sense of loss of control. All of these feelings, although upsetting, are completely normal!

Self-esteem and body image disturbances are the greatest within the first year after surgery. Because bowel control may be lost and society has always placed such emphasis on the control of waste material as early as we can remember, your self-image may be disturbed. Learning as much as possible about the stoma and its care can be reassuring and a real confidence builder. As well, a visit from a member of the ostomy association can also bring a reassurance that you are not alone in this situation and there are many people who have overcome this obstacle who are willing to assist you (See web resources and references). Ask your physician, nurse, or social worker to help you locate someone to talk to about his or her own personal experiences overcoming this challenge. You may be surprised at the strength that you already have within you!