Living with a Permanent Colostomy Following Treatment for Rectal Cancer: Understanding Couple Adjustment

Background:   It is estimated that in 2015, 13.9 % of men and 11.5% of women will develop colorectal cancer in Canada. (Canadian Cancer Society, 2015) Individuals presenting with locally advanced, low lying or recurrent rectal cancer may require a permanent colostomy. While there is some literature that has explored the impact of a permanent stoma on spouses, the processes which underlie couples’ successful adjustment to rectal cancer and living with a permanent colostomy are not yet well understood.  Purpose: The current study aims to better understand the adjustment of couples to life with a permanent colostomy following an abdominal perineal resection for locally advanced or recurrent rectal cancer. Specifically, what types of challenges do these patients and their partners face and how do they attempt to overcome them. Methodology:  Eleven patients and their partners (10 heterosexual, 1 same-sex couple) were interviewed about their adjustment experience.  Each dyad’s interview was transcribed verbatim and the text was analyzed using the grounded theory method (Glaser & Strauss, 1967; Graneheim & Lundman, 2004). Results:  Several themes emerged through the analysis of data including “Acute Embarrassment”, “Controlling What’s Controllable”, “Marred Body Image and Sexuality” and “It’s a Foreign Land”.  Given the depth and breadth of the information collected, the focus of this presentation will address body image and sexuality, an area not often addressed by clinicians.   Conclusions: These results are important in elucidating common practical and psychosocial challenges faced by couples adjusting to a permanent colostomy after treatment for rectal cancer.  The results provide insight into the ways couples cope with these concerns and also reveals areas where couples have a lack of support, wherein clinicians may help to support couples’ adjustment.