Satish, a small-business owner hailing from rural northern India came to the general surgery clinic of a tertiary care hospital. He was in his early thirties, married, and with two children. Satish was diagnosed with cancer of his rectum and had finished the first part of the treatment which is a combination of chemo and radiation therapy.
He now required surgery for the removal of the rectum. The surgery would take away his ability to pass stools from the natural passage and instead, the stools would come out of the intestine through an opening in the abdominal wall known as a stoma. Not doing the operation would mean that the tumor would soon increase in size and spread to the other organs making it incurable.
“I am a panchayat member of my village. My work involves a lot of traveling and I need to be out almost the entire day. How will I be able to do my work with a stoma? The people in my village will never want to meet or talk to me. My family will not accept me. My friends will not support me. I will die but never have a stoma”- said Satish as he walked out of the OPD, never to be seen again.
Colorectal cancer is among the top three most common cancers in the world and it is becoming more and more common. Surgical treatment remains the cornerstone of management. Patients who have the tumor in the lower part of the rectum require removal of the entire rectum and anal canal which results in them having a permanent stoma. The management of rectal cancers has considerably advanced over the past years. However, there is still a subset of patients who cannot get away without a stoma.
When first explained about the need for a stoma, patients often feel that they will be incapacitated and their work-life would come to a standstill.
Rahul, an auto driver, was extremely worried if he will be able to work long hours after getting a stoma. Nearly everyone has the same query be it manual laborers, homemakers, officer workers, or drivers.
However, being incapacitated after a stoma is only a misconception according to experts. “A person with a stoma can do every single activity like traveling by air, working in fields, lifting heavy objects, and even swimming,” says a colorectal surgeon working in a tertiary care hospital dealing with 50-100 patients with stomas every month.
Just like every other disease, gender-related issues can be noticed even in patients with a stoma. Women with stomas tend to have worse quality of life compared to men which reflects inadequate family support in our predominantly patriarchal society. “Ever since I had a stoma, my husband stopped having intimate contact with me. He says he feels disgusted with the site of the stoma. He wants to leave me and remarry,” said Meena, a 28-year-old woman.
