Patients with colorectal cancer expressed a loss of adulthood related to a loss of professional and sexual identity, dignity, privacy, independence, and ability to socialise

摘要

The study by Rozmovits and Ziebland reveals the potential impact of pelvic cancers on the physical, social, and interpersonal dimensions of human embodiment. The data are drawn from the stories of people with both temporary and permanent ileostomies and colostomies, and the narratives will resonate for professionals who have worked with patients with ostomies. The participants, of whom 22 had ostomies, emphasised that colorectal cancer challenges personal identity and disrupts the trust that we learn to place in our bodies. The inherent vulnerability introduced by a diagnosis of colorectal cancer is given powerful voice in this study. For example, life after bowel surgery can mean having to cope with the everyday risk of others noticing a leaking, smelly, or noisy stoma. In addition to adapting to such fundamental changes in body image, patients need to bear the existential threat associated with a cancer diagnosis. These findings support those of other recent studies of patients with gynaecological or prostate cancers.It is now accepted that rehabilitation should be an integral phase of effective cancer care, and studies such as the one by Rozmovits and Ziebland provide evidence to help guide service development in this area. For practitioners, this study emphasises the need to speak openly with patients about the impact of colorectal cancer and its treatment on their sense of identity, including their sexual identity. Practitioners also have key roles in providing education and support related to living with a stoma. Finally, connecting patients with peer supports (eg, individuals, groups, or the DIPEx bowel cancer module, an internet resource based on illness narrative interviews2) may help them to recognise that they are not alone in their experiences and to identify new ways of living with colorectal cancer and maintaining a positive self identity.