Practical Advice for Living With Colorectal Cancer

From the WebMD Archives

Colorectal cancer is the fourth most common type of cancer in the U.S. Thanks to increased awareness about the importance of regular screening tests, many cases are being caught early, when it’s most curable.

Still, going through treatment for colorectal cancer can be life-changing. But with some adjustments you can live a full life.

Learn to Accept Your Ostomy

It doesn’t happen all the time, but some colorectal cancer surgeries require a procedure called a colostomy or ileostomy to move waste out of your body. Your surgeon will create a small hole, called a stoma, in your belly and attach the end of your colon or small intestine to it. Stool moves out through the hole and into a special pouch you wear.

Most often, the ostomy is temporary to allow your bowel to heal. The doctor will reverse it in a few months. In some cases, it’s permanent.

You’ll meet with a certified ostomy nurse before surgery to make your first step toward living with this change.

“There are many accessories available today to help conceal pouches,” says Kelly Jaszarowski, RN, president-elect of the Wound, Ostomy and Continence Nurses Society. “Pouch covers and clothing designed for patients with ostomies are also available.”

She says that some patients may be concerned about the odor of stool and gas in the pouch. But, she says, you can manage it with gas filters and special pouch deodorants. You can also avoid foods that cause gas.

Take care of the stoma: If you have a colostomy or ileostomy after surgery, it’s crucial to keep the opening in your belly clean and free from irritation and infection.

Gently wipe the opening, or stoma, off with a cloth and water each time you change the pouch, Jaszarowski says. You don’t need to use soap, but if you do, choose one that’s mild and doesn’t leave any residue.

Stay hydrated: Dehydration is a very common complication with ileostomies.  Normally your colon pulls water from your waste and returns it to your body. With an ileostomy, that water doesn’t go back into your body.

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This can be real problem in warmer weather, Jaszarowski says. She suggests you get more sodium and potassium through fluids and foods like broth, tomato juice, bananas, and spinach.

Take pain medicine with laxatives: Your doctor will prescribed pain meds after surgery. But watch out. Some of them can make you constipated.

Don’t try to tough it out, says Kathryn Walker, PharmD, senior clinical director for palliative care at MedStar Health. “You’ll be stronger and better able to recover if your pain is controlled.”

She suggests that every time you take your pain medication, you also take an over-the-counter laxative. 

Pay attention to what you eat: Your bowels need to rest after surgery, so your doctor or nutritionist may suggest a low-fiber diet. You’ll need to stay away from:

  • Peas
  • Beans
  • Nuts
  • Legumes
  • Lentils
  • Processed meats
  • Whole grains
  • Berries
  • Prunes
  • Broccoli
  • Cauliflower and other raw vegetables

Instead, you can eat:

  • Strained, canned, or well-cooked vegetables
  • Tofu
  • Eggs
  • Tender cuts of meat, ground meat, and fish

Talk to a nutritionist to find out what’s best for you.

Keep moving: After surgery, it may seem like the best strategy is to stay in bed to rest and recover, but the opposite is true. You need to be up and moving within 24 hours of surgery. Doctors often recommend patients get out of bed the first morning after surgery. By that evening or the next morning, you’ll likely be walking the halls a few times per day.

You’ll speed up recovery and keep your muscles in good shape.

Make lifestyle changes: The best way to make sure your cancer doesn’t come back is to maintain a healthy weight. Eat lots of fruits and vegetables and stay away from red meat. Get regular exercise, and if you smoke, quit.

The best strategy is to make these lifestyle changes before you go through surgery, says Mark Welton, MD, chief of colorectal surgery at Stanford Health Care.

“If you start getting your body into shape by eating better and exercising before treatment begins, you will recover more rapidly, tolerate chemo better, and have a better quality of life,” he says.

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Get regular follow-ups: As a colorectal cancer survivor, you’ll need to stay vigilant to make sure your cancer doesn’t come back. Part of that is checking in with your doctor so they can check you out.

“The recommendation is to have a colonoscopy within 1 year after diagnosis,” Welton says. If the results are normal, you can wait another 3 years for your next one, and then have one every 5 years. Depending on your age and other medical conditions, your doctor may also recommend regular blood tests and CT scans to check for signs of cancer.

WebMD Feature Reviewed by Lisa Bernstein, MD on July 25, 2016

Sources

SOURCES:

National Cancer Institute: “Colorectal Cancer,” "SEER Stat Fact Sheets: Cancer of Any Site."

American Cancer Society: “What is a colostomy?” “What is an ileostomy?” “Low-Fiber Foods: What is a low-fiber diet?” “Living as a Colorectal Cancer Survivor.”

Allen Kamrava, MD, colorectal cancer surgeon, Cedars-Sinai Medical Center, Los Angeles.

Kelly Jaszarowski, RN, president-elect, Wound, Ostomy and Continence Nurses Society.

Kathryn Walker, PharmD, senior clinical director for palliative care, MedStar.

Mark Welton, MD, chief of colorectal surgery, Stanford Health Care.

Sanjay Goel, MD, medical oncologist, Montefiore Einstein Center for Cancer Care.

University of Utah Huntsman Cancer Institute: “Preventing Dehydration After Your Ileostomy.”

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