Longevity in people with learning disabilities has increased substantially over recent years and as life expectancy increases for this population so does the risk of colorectal cancer. Today, with the transition from institution to the community for people with learning disabilities, conscientious and competent medical and nursing care is a necessity. This article examines autonomy, consent, treatment, palliative care and death relating to people with profound learning disabilities and challenging behaviour, who also have colorectal cancer and stomas. Lack of written information, knowledge, and organizational planning need to be addressed to bring cancer services for the patient with learning disabilities to the level that it is for the general population.

Whatever the age of the child, there is no easy way for a parent to explain serious, life-threatening illness. For children to hear that their parent is ill is devastating, especially if the parent has cancer and needs a permanent colostomy. The diagnosis of cancer can produce feelings of fear, confusion and uncertainty in patients and their close relatives. How difficult does this then become for the child battling to understand long medical words, alien hospital environments and an ill parent? The social taboos that surround body matter elimination are legion and therefore the surgical outcome of having a permanent stoma changes the individual's body image perception long-term. The two case studies presented in this article highlight this problem as well as the lack of suitable available literature.