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Many of you know me as SingleDad from my blog Disabled Daughter. For six years I blogged about my life as a single father with two severely disabled children. Pearlsky lived with me; David was in a residential school. I stopped blogging when life became difficult for reasons known by the followers of that blog. But here I am. No longer a single dad, and quickly becoming disabled myself.

I was diagnosed with stage 3 colorectal cancer on April 24, 2018. There have already been so many events that I want to blog about. Events with me, with Pearlsky, with Inanna, and more.

If you want to follow this blog, sign up on the right. The list is separate from SingleDad's. If you want to read from the beginning, start here.

And by the way, cancer sucks.

24 hours

Twenty four hours from now I sure as shit better be in a room on the surgical floor. It is mid-evening on Wednesday, the operating room is reserved for me from 7:30 AM to 1 PM tomorrow. For some unclear reason, I need to be at the hospital at 6:00 AM so we have a nanny coming at 5:30 AM to the house.

I made an error in my photo in the last post as to my preparations. I do not need to take any enema today! But I need to drink two bottles of magnesium citrate, one at noon and one four hours later. I need to take a lot of antibiotics today, and am into that process. The last two days, and today, I am taking a pill that relaxes the neck of my bladder. Apparently when a male has surgery in their pelvic area it is often hard to urinate for a few days. In an effort to not need a catheter, they use this pill as part of the preparation. Trust me, if I need a catheter, you will know …

I have spent the last few hours making many trips to the toilet. The inside of my colon, I am sure, is bright and shiny right now. My stomach is not so great from the antibiotics, and there are more to come. I still need to take my shower with the surgical scrub, tonight and tomorrow.

I think I am set. I have very high confidence that I will wake up from surgery, I have every time in the past. That is the next milestone, followed by getting my butt back home, hopefully by Monday. That depends on my stoma working well and my working well with the stoma. We are going to be dear friends.

Inanna is incredible. My mom traveled to here and my sister lives here. Being co-chair of an organization whose membership is overwhelmingly women caregivers is helpful! And we have some wonderful nannies (our word for the personal care attendants) working with the girls.

I am not scared, because there is nothing tomorrow to be scared about. I am anxious about the pathology report but that will be days away. I have come to terms with the stoma, and I am practicing to make a good first impression with it. I hope it likes me.

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Good thing I got my merit badge in colorectal surgery

Who says I don’t know how to prepare?

 

  • 2 Skin markers, regular tip, one sterile
  • 1 Home Skills Kit CD
  • 1 practice 2-piece ostomy bag
  • 2 saline enemas with gentle glide tip and now with 25% more lubrication
  • Hibiclens surgical scrub
  • 4 pill vials with confusing and erroneous instructions
  • 2 carbohydrate energy gels, blueberry-pomegranate
  • 6 Pedialyte electrolyte powder pre-measured packets, strawberry-lemonade
  • 4 G-2 Gatorade, lemon-lime (only 1 shown)
  • 1 ReliaMed Adjustable Ostomy Appliance Belt, 1 in., size medium, 26 in-43 in
  • 2 Boxer Briefs, black, high waist with pocket for ostomy bag,  size L (36-38″)
  • 1 Boxer Brief, gray, high waist with pocket for ostomy bag,  size XL (40-42″)
  • 1 Unisex classic wrap, tan, with pocket for ostomy bag, size L
  • 1 Unisex classic wrap, black, with pocket for ostomy bag, size XL
  • 1 Hollister m9 Odor Eliminator Drops bottle, 8 oz.
  • 1 Hollister m9 Odor Eliminator Pump Spray, 8 oz., unscented
  • 1 Hollister m9 Odor Eliminator Pump Spray, 2 oz., unscented
  • 1 EneMan stuffed toy, emotional support plushie

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“You are imperfect, permanently and inevitably flawed. And you are beautiful.” ~Amy Bloom

I was born with my grandfather’s nose. It appears that strong noses skip a generation. I was generally fine with it, but I must say that I was teased about it in my youth. One day in my senior year of high school, out of the blue, mom asked me if I wanted a nose job. I said “sure.” That was all, and then it happened.

About a month later I was in a dressing room somewhere and stepped into one of those three-segment mirrors where you can see yourself at various angles. It was the first time I really saw my new nose.

And I freaked out. I can picture it like it was yesterday. I looked deformed; I thought it was horrible.

When you look at something now, you have three fields of view. You see what your left eye sees, then in the middle you see what both eyes see, and you see what your right eye sees. It is obvious if you move your eyes all the way to the left, then to the right. What you don’t think about, is you also see the shape of your nose. In my case it became vastly different. The entire shape of my visual world changed.

My profile was completely mangled. My nose went from sort of out then down to sloping down and out. Shaping my face like a muzzle. Or so it seemed.

Here is the only picture known to exist of my previous profile:

And today-ish (that’s me on the left):

I have never given my looks all that much thought. I did not ask for the nose job, although I agreed right away. I absolutely am not vain now. But then when you are a gorgeous 59 year-old Adonis you don’t need to be.

Body image is a person’s perception of the aesthetics or sexual attractiveness of their own body. The phrase body image was first coined by the Austrian neurologist and psychoanalyst Paul Schilder in his book The Image and Appearance of the Human Body (1935). Human society has at all times placed great value on beauty of the human body, but a person’s perception of their own body may not correspond to society’s standards.

The concept of body image is used in a number of disciplines, including psychology, medicine, psychiatry, psychoanalysis, philosophy and cultural and feminist studies. The term is also often used in the media. Across these disciplines and media there is no consensus definition, but body image may be expressed as how one views themselves in the mirror, or in their minds. It incorporates the memories, experiences, assumptions, and comparisons of one’s own appearance, and overall attitudes towards their height, shape, and weight. An individual’s impression of their body is also assumed to be a product of ideals cultivated by various social and cultural ideals. ~Wikipedia

My point?

I don’t want a stoma. I don’t like my tatoos, three small dark blue dots that no one can really see (radiation targets). I don’t like the “X” currently on my belly. I’m not even happy with the four or five other tattoos I have, and they are on the inside of my rectum. No one sees them, except me when I have my head up my ass. Which lately may be a tad more often than I prefer.

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Don’t f–k up with Mr. Smith’s son

When my son David went to live in a residential facility he had a rough few months. There were many errors in his care, one or two of them were major. All this, and he was at one of the best facilities available. Needless to say I was rather vocal and dealing with the top level administration there.

Things were then quiet for a few months and on a visit I was talking with one of those administrators. I asked what changed … with a wink he said:

We put a sign over his bed that said ‘Don’t fuck up with Mr. Smith’s son’


As I am sure you remember, a bit ago I got an email addressed to “Mary” and I assured you my name is not Mary. Maybe there is something about the letter ‘M’ but my name is also not Michael. Really. My name is neither Mary nor Michael.

Today, September 5, 2018, I received an email. Here is a screen shot, simply redacting identifying information. I did not need to redact my name because, alas, it is not there.

All good information. I hope Michael knows that he has appointments on August 28, eight days ago.

I then got another email about 5 minutes later, identical other than it had the correct salutation, and this was followed by a phone apology about 90 minutes later.

Oh, the surgery prep instructions that were attached, simply a photocopy of these.

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“… the only thing we have to fear is fear itself” ~FDR

Franklin Roosevelt is often grouped in as one of the top three presidents ever, along with Washington and Lincoln, he ran the country from a wheelchair, and was played by Robin Williams in two movies. Barring the issue of the St. Louis, I would agree with his greatness. Roosevelt’s first inaugural address (remember, he was elected to four terms as president) (isn’t that thought scary as hell right now?), an address of 1883 words, contained in part:

the only thing we have to fear is fear itself

and that became his 10 most famous words. The problem is fake news. Lack of context*. I argue that those words are completely out of context* so how do we know what they mean? Here is the the context, as I remember it from primary school:

The only thing we have to fear is fear itself. And this fucking tumor up my ass. And surgery. And a stoma. And surgery by a computerized robot named after a guy who has been dead for 500 years (as of next May 2).

I know I will have a stoma, a hole in my belly where the contents of my small intestine will exit my body instead of continuing through my large intestine and out my butt. This type of stoma is, quiet frankly, a bit gross. They are pinkish red since basically the lining of the intestine, the lumen, is similar to the inside of one’s mouth. It would not be so bad if it was flat along my skin, but no, it typically sticks out. Seeing that the surgery may cause erectile function issues, this may be the only thing sticking out from my body, albeit not nearly as far. I find those pictures difficult to look at but it will soon be my view and I will be dealing quite a bit with the stoma. As of today, I really don’t want to see it. How I wish I had big boobs.

It is fascinating to me that medical people say what to them is a minor thing, or a quick piece of information, without specifically discussing that topic and it can make a huge difference, both positive at times and negative at times to the patient. For instance, the surgeon mentioned that I would have an MRI before surgery. When I said “oh?” he said, as an aside, “to see if the cancer is elsewhere and if surgery is still warranted.” That simple sentence made me anxious for over two months. Seriously. (No, this paragraph was not a non-sequitur.)

The other day I was speaking with a random woman, well, not so random, as I have known her for 47 years. Anyway, I was talking with her, not that she knows much about this topic other than the fact that she has been a nurse for 40 of those years years, and a wound and ostomy care clinical specialist. She works in a big city university teaching hospital and happens to live walking distance from me. We had not had a discussion of stomas, mine nor anyone else’s. She absolutely did not know of my concerns or feelings about it. And she happened to write:

Remember that right after surgery your stoma will be swollen as will be your abdomen a little bit. Because of this, think that you could have a stoma that has a base of between one and 1/2 and one and 3/4 inches initially. Protruding is good though. That really helps keep the perfect seal since the stool bypasses your skin and goes right into the pouch.

That last sentence, the advantage of a stoma that sticks out, and the reason for it, has totally changed my attitude and feeling about it. No, I still don’t want to see it, and if it is the size of whatever I have now that sometimes sticks out I will never find a bag to fit, but simply understanding the reasons and advantages, I really feel much better about it. I did text her that …

I may wear one of those dog cone collars so I can’t see it …

Which is always a possibility I guess.


I am not really fearful of the surgery itself. I have full confidence I will wake up afterwards; I have had surgery without problems in the past. I am not fearful of what the surgeon will see or find, between the CT, MRI, and flex sig I think we have a pretty good picture of what is in there. Although I am not fearful of the recovery, I really prefer it be pain free. Somehow I think that ain’t happening.

Sometimes it is hard to understand one’s feelings. During the chemo-radiation I never really knew if I had to poop, pee, or what. All the physical feelings in my pelvis were mixed up; thankfully that has gone back to normal. Similarly, right now I don’t know what my primary stressors are. What am I afraid of? Why do I feel stressed? Is it this fucking waiting? Is it that every ache and pain I have is now thought to be a rouge tumor? Do I have a touch of diarrhea because of my being nervous or that street peddler’s sushi last night? Or am I simply being a wuss?

*Real context:

So, first of all, let me assert my firm belief that the only thing we have to fear is fear itself — nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance. In every dark hour of our national life a leadership of frankness and of vigor has met with that understanding and support of the people themselves which is essential to victory. And I am convinced that you will again give that support to leadership in these critical days. ~Franklin D. Roosevelt

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“If I haven’t any talent for writing books or newspaper articles, well, then I can always write for myself.” ~Anne Frank

I know some people that do not want to know anything about what will happen to them. They go into surgery, etc. not knowing what to expect but that is how they roll. I know others who you cannot keep away from researching (is it really researching if you only use the Internet?) whatever the issue is and must know everything.

Strangely, I find myself somewhere on that spectrum. I have not, and will not, research my actual cancer. I don’t really see a point. I did read two papers at the National Institutes of Health (NIH) about the chemo-radiation protocol since I had never heard of such. I did a minor bit of research on my three doctors. That is about all. Until a few days ago.

I am in need of understanding more of what will happen the next few weeks and months. I am not looking into anything pertaining to my body per se (the actual type of cancer, etc.) but rather the procedures. The surgeon, when I asked how long the various protocols that will happen the day of surgery take (take me in -> pre-surgery set up -> surgery -> recovery, etc.) mentioned setting up the robot and kept talking. That was all I ever heard about the surgery other than it is laparoscopic. I was given some information on the stoma but not all I would have liked.

The last two posts showed you some of what my research found. Yesterday’s post with the videos and information on da Vinci took me longer than any other post here. I probably watched 20 videos looking for the most informative (first for me, then for you) and then those that I felt would not gross anyone out. But I learned. A lot. Hell, give me the controls – at this point I could probably do a decent surgical job at it myself. Well, maybe. Ok, maybe not, but you get the point.

This is the last of this three part series, mainly because things still suck and get harder every day and I want to talk about that. I am ending this short series with published papers and their abstracts. If the full text was available without a subscription I included it here. I purposely put the ones about sex at the end, my way to get you to at least read the titles! The formatting of the abstracts may be a bit funky, the links you see were in the original, I simply cut and pasted (shouldn’t it be cutted and pasted?) and didn’t want to spend the time to make it look perfect. Sorry. But you see, I have cancer …

CLICK HERE to see the papers!
 2013 Oct;60(10):B4732.

Life after stoma creation.

Surgical Department, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark. anne.k.danielsen@gmail.com.

Abstract

BACKGROUND:

Stoma creation is a surgical operation where the surgeon makes an artificial opening on the abdomen from where the bowel is taken out. It is a radical treatment with permanent physical signs of bodily change. In general, it leads to loss of a central and personal physical function, as well as an alteration in the bodily design. Research in the field may provide additional information about central elements when adapting to life with a stoma. There are currently no studies that adequately focus on the relationship between health-related quality of life and stoma construction in a Danish context, neither for temporary or permanent construction, nor in relation to the importance of stoma handling.

PURPOSE:

The overall objective of the study was to investigate health-related quality of life related to stoma creation and patient education. Methodologically, the project was implemented as a mixed methods study in which qualitative interview studies and two systematic literature reviews identified interventions, which were subsequently tested in a clinical case/control study. Finally the case/control study was made subject to an economic analysis. The project is based on 6 papers reporting the results.

ARTICLE 1: Impact of a temporary stoma on patients everyday-lives: feelings of uncertainty while waiting for closure of the stoma. The study included 7 participants who were interviewed in focus groups. The results indicated that patients experienced a high degree of uncertainty in connection with the stoma being temporary. At the same time, participants had a strong need to control both their physical appearance and their changed bodily functions. Participants opted for education programs involving teachers with a stoma.

ARTICLE 2: Learning to live with a Permanent Intestinal Ostomy: Impact on everyday life and Educational Needs. The study included 15 participants who were interviewed in groups related to whether they were treated for cancer or non-cancer. The results showed that participants often experienced the stoma as a taboo, and emotions related to stigma were identified. In addition, participants were influenced by the stoma in various ways, and the stoma imposed some restrictions on the participants. Participants pointed at group-based education, as well as the involvement of teachers who had a stoma.

ARTICLE 3: Spouses of patients with a stoma lack information and support and are restricted in their social and sexual life: a systematic review. The study included 6 articles based on quantitative and qualitative data showing that spouses were affected in several ways by the construction of the stoma. The results pointed at spouses not being informed and supported sufficiently by neither enterostoma therapists or surgeons.

ARTICLE 4: Patient education has a positive effect in patients with a stoma – a systematic review The study included 7 studies, all with quantitative results. They showed that patient education had a positive impact in several areas including shorter hospital stay, less time until proficiency in stoma management is reached, an increase in quality of life, increased knowledge about the stoma, and increased self-efficacy.

ARTICLE 5: Health-related quality of life increases when patients with a stoma attend patient education – a case/control study. The study included 50 participants shortly after stoma creation. The results showed that the disease-specific quality of life was significantly increased in the intervention group, while generic health-related quality of life was positively affected in different dimensions in both groups.

ARTICLE 6: Decreased costs with patient education after stoma creation. The study was an economic analysis based on participants in Article 5. The results indicated that there were fewer unplanned re-admissions related to the stoma, and that patients in the intervention group did not visit the general practitioner as much as patients in the control group. Furthermore, we found that the average cost per patient did not increase when establishing a patient education program.

CONCLUSION:

The thesis concludes that patient education has a positive impact on patients’ quality of life, and that costs are reduced. At the same time, it is concluded that living with a stoma is a complex situation, which also involves spouses and close relatives, and that patient education must be based on multiple interventions that are not all explored in this project.

PMID: 24083536
[Indexed for MEDLINE]

Full paper not available (to me).


. 2017; 25: e2961.

Published online 2017 Dec 11. doi:  10.1590/1518-8345.2059.2961
PMCID: PMC5738856
PMID: 29236839

Ostomy patients’ perception of the health care received

ABSTRACT

Aim:

to describe ostomy patient’s perception about health care received, as well as their needs and suggestions for healthcare system improvement.

Method:

qualitative phenomenological study was conducted, involving individual and semi-structured interviews on the life experiences of 21 adults who had a digestive stoma. Participants were selected following a purposive sampling approach. The analysis was based on the constant comparison of the data, the progressive incorporation of subjects and triangulation among researchers and stoma therapy nurses. The software Atlas.ti was used.

Results:

perception of health care received is closely related to the information process, as well as training for caring the stoma from peristomal skin to diet. It is worthy to point out the work performed by stoma care nurses ensuring support during all stages of the process.

Conclusion:

findings contribute to address the main patients’ needs (better prepared nurses, shorter waiting lists, information about sexual relation, inclusion of family members all along the process) and recommendations for improving health care to facilitate their adaptation to a new status of having a digestive stoma.

Descriptors: Colostomy, Ileostomy, Qualitative Research, Health Services, Patient Satisfaction, Health Personnel

Click here to read the entire paper Ostomy-patients-perception

 2016 Dec 8;24:e2840. doi: 10.1590/1518-8345.1276.2840.

Experiences and coping with the altered body image in digestive stoma patients.

[Article in English, Portuguese, Spanish; Abstract available in Portuguese and Spanish from the publisher]

Abstract

OBJECTIVE:

to describe the coping of stoma patients with the news about the ostomy, as well as to analyze the meaning and the experience of their new bodily reality.

METHOD:

qualitative phenomenological study undertaken through semistructured interviews with 21 stoma patients. The analysis was based on the constant comparison of the data, the progressive incorporation of subjects and triangulation among researchers and stomal therapy nurses. The software Atlas.ti was used.

RESULTS:

two main categories emerge: “Coping with the news about receiving a stoma” and “Meaning and experience of the new bodily reality”. The informants’ answer varies, showing situations that range from the natural acceptance of the process to resignation and rejection. The previous experiences of other family members, the possible reconstruction of the stoma or the type of illness act as conditioning factors.

CONCLUSIONS:

the coping with the news about the stoma is conditioned by the type of illness, although the normalization of the process is the trend observed in most informants. Nursing plays a fundamental role in the implementation of cognitive-behavioral interventions and other resources to promote the patients’ autonomy in everything related to care for the stoma.

PMID:  27982309
PMCID: PMC5171781
DOI: 10.1590/1518-8345.1276.2840

Click here to read the entire paper body-image-stoma

 2017 Jan/Feb;44(1):63-68. doi: 10.1097/WON.0000000000000271.

Perceived Barriers and Home Care Needs When Adapting to a Fecal Ostomy: A Phenomenological Study.

Burcu Cengiz, MSc, RA, Department of Public Health Nursing, Dokuz Eylul University Faculty of Nursing, Izmir, Turkey. Zuhal Bahar, PhD, Department of Public Health Nursing, Koc University School of Nursing, Istanbul, Turkey.

Abstract

PURPOSE:

The aim of this study was to determine perceived barriers to adaptation to life with a fecal ostomy based on the Health Belief Model and to reveal home care needs related to these perceptions.

DESIGN:

Phenomenological study.

SUBJECTS AND SETTING:

Twelve participants undergoing ileostomy or colostomy within 3 months of data collection participated in the study. The participants were recruited from Stomatherapy Outpatient Clinic of Dokuz Eylül University Hospital. Their mean age was 54.41 ± 19.14 years (mean ± SD). Eight (67%) underwent ostomy surgery 2 to 3 months prior to study participation; 9 (75%) underwent stoma surgery for the treatment of colorectal cancer, 5 (42%) had a temporary stoma, and 8 also received chemotherapy for the management of an underlying malignancy.

METHODS:

A semistructured interview form was used to collect data, and obtained data were analyzed with inductive content analysis. The questions were based on the Health Belief Model and were directed at identifying challenges to adaptation to life at home and home care needs in patients with stoma.

RESULTS:

Inductive content analysis identified 4 main themes: “restriction of daily life activities”; “factors affecting adaptation to stoma”; “need for health professionals”; and “emotional effects.” The theme, need for health professionals, was expressed by the highest number of the participants. The respondents explained that services from ostomy nurse specialists should begin in the hospital and continue into the home. Participants suggested that ostomy nurses are needed to improve self-care skills via telephone contact and home visits. They also expressed the need for nursing interventions for the management of adverse effects associated with chemotherapy.

CONCLUSIONS:

Individuals experience physical, mental, and social barriers when adapting to live with a new stoma and when receiving chemotherapy for underlying cancer. Additional services from ostomy nurses are needed to aid patients when adapting to these challenges.

PMID: 27564927
DOI: 10.1097/WON.0000000000000271

Full paper not available (to me).


 2013 May;22(9-10):1343-52. doi: 10.1111/jocn.12011. Epub 2013 Jan 2.

Impact of a temporary stoma on patients’ everyday lives: feelings of uncertainty while waiting for closure of the stoma.

Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark. anne.kjaergaard.danielsen@regionh.dk

Abstract

AIMS AND OBJECTIVES:

To examine patients’ experiences of impact of a temporary stoma on their everyday life. Furthermore, we wanted to generate new knowledge and comprehension of learning how to live with a temporary stoma.

BACKGROUND:

There are many aspects, largely unexplored, that may influence patients’ adaptation to life with a stoma. Amongst these, being in a temporary state is relatively unexplored and may have a restrictive impact on patients’ adaptation.

DESIGN:

Focus group interviews conducted with seven patients with temporary stoma were set up with a hermeneutic phenomenological perspective.

METHODS:

Data were processed using qualitative content analysis.

RESULTS:

The creation of a temporary stoma led to feelings of uncertainty related to being in an undecided situation. Stoma creation led to feelings of stigma and worries about disclosure. Patients proposed group-based patient education with lay educators with a stoma to make sure that information about the stoma was based on real-life experiences.

CONCLUSIONS:

Creation of a temporary stoma was linked to uncontrollable feelings of uncertainty. Professionals should assist patients with focus on coping strategies, as they are associated with positive re-evaluation of the situation. Introducing a coherent and structured learning environment involving both lay educators with a stoma and group-based learning would be useful.

RELEVANCE TO CLINICAL PRACTICE:

Nurses and other health professionals should support patients in problem-focused coping strategies. These strategies may be supported when patients have a high sense of coherence. Furthermore, patients’ disclosure of the stoma as a way to master feelings of stigma should be facilitated. Stoma education is central for patients, and group-based learning that involves lay educators with a stoma is seen as a way to empower patients with temporary stomas.

PMID: 23279240
DOI: 10.1111/jocn.12011

Full paper not available (to me).


 2013 Dec;28(12):1603-12. doi: 10.1007/s00384-013-1749-y. Epub 2013 Jul 31.

Spouses of patients with a stoma lack information and support and are restricted in their social and sexual life: a systematic review.

Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark, anne.k.danielsen@gmail.com.

Abstract

PURPOSE:

A permanent stoma has a large impact on everyday life with several physical, mental, and social impairments for the individual. It seems obvious that if persons with stomas are affected socially by the stoma creation, it is likely that the family and/or relatives will be affected as well. The objective of this systematic review was to explore how stoma creation may affect spouses of patients with stomas.

METHODS:

A systematic review was undertaken based on database searches including studies published from 1950 to 2012. We applied a method of synthesis based on narrative summaries of both qualitative and quantitative results being assessed in parallel processes and finally included in a joint synthesis of results on a study level.

RESULTS:

We identified 17 studies and included 6 studies. Spouses wanted to be more involved in the stoma education and specifically wanted more focus on the psychosocial aspects of stoma creation. Furthermore, spouses’ sexual life was seriously affected, and their social life was restricted. In general, spouses wished for more support from the health care sector as well as from family and friends.

CONCLUSIONS:

There is a need for further research focusing on spouses or relatives. Talking about worries and concerns regarding the new life situation may alleviate suffering and reduce uncertainty. Stoma nurses and other health professionals play an important role in the care of patients as well as spouses, and a greater insight into the worries and concerns affecting spouses is warranted to improve postoperative counseling and education.

PMID: 23900653
DOI: 10.1007/s00384-013-1749-y
[Indexed for MEDLINE]

Full paper not available (to me).


Sexual (dys)function and the quality of sexual life in patients with colorectal cancer: a systematic review

M. J. Traa J. De VriesJ. A. Roukema B. L. Den Oudsten
Annals of Oncology, Volume 23, Issue 1, 1 January 2012, Pages 19–27, https://doi.org/10.1093/annonc/mdr133

Published:  20 April 2011

Abstract

Background:

To determine (i) the prevalence of sexual (dys)function in patients with colorectal cancer and (ii) treatment-related and sociodemographic aspects in relation to sexual (dys)function and the quality of sexual life. Recommendations for future studies are provided.

Methods:

A systematic search was conducted during the period 1990 to July 2010 that used the databases PubMed, PsychINFO, The Cochrane Library, EMBASE, and OVID Medline.

Results:

Eighty-two studies were included. The mean quality score was 7.2. The percentage of preoperatively potent men that experienced sexual dysfunction postoperatively varied from 5% to 88%. Approximately half of the women reported sexual dysfunction. Preoperative radiotherapy, a stoma, complications during or after surgery, and a higher age predicted more sexual dysfunction with a strong level of evidence. Type of surgery and a lower tumor location predicted more sexual dysfunction with a moderate level of evidence. Insufficient evidence existed for predictors of the quality of sexual life. Current studies mainly focus on biological aspects of sexual (dys)function. Furthermore, existing studies suffer from methodological shortcomings such as a cross-sectional design, a small sample size, and the use of nonstandardized measurements.

Conclusion:

Sexuality should be investigated prospectively from a biopsychosocial model, hereby including the quality of sexual life.

Click here to read the entire paper sexual-dys-function
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