Figuring Out Sex in a Reconfigured Body: Experiences of Female Colorectal Cancer Survivors with Ostomies

Abstract

Colorectal cancer (CRC) survivors with ostomies can face complex concerns regarding sexuality. We used an anthropological perspective to examine the experiences of 30 female CRC survivors with ostomies to shed light on the sexual challenges and adaptations made in the wake of cancer surgery and treatment. Participants fell into four categories with regard to their sexual experience post surgery; however, not all women found their altered sexuality to be particularly problematic. This type of phenomenological examination can inform a more patient centered, less biomedically focused paradigm for assessing and improving the sexual health of cancer survivors.

Cancer survivorship: Advancing the concept in the context of colorectal cancer

“…Survivors spoke of unpredictability when describing the loss of control over the body that came about as a result of the ostomy. Ostomy function varied daily, causing embarrassment and loss of confidence as leakage, incontinence or flatulence from the ostomy were anticipated (Desnoo and Faithfull, 2006;Grant et al, 2011;McMullen et al, 2008;Ramirez et al, 2009). Living with an ostomy and the chronic effects of CRC becomes a careful balancing act between competing priorities for survivors, as they attempt to resolve the joy of having survived with the sadness of living with the unpredictable, sometimes humiliating consequences of CRC (McMullen et al, 2008).…”

“…The process of survivorship occurs parallel to the normal aging process (McCaughan et al, 2012;Phipps et al, 2008;Ramirez et al, 2009). Up to four-fifths of CRC survivors experience co-morbid health conditions, which may be more limiting than living with an ostomy or CRC in some circumstances (Anderson et al, 2013;McMullen et al, 2008;Palmer et al, 2013;Phipps et al, 2008;Soerjomataram et al, 2012).…”

“…Up to four-fifths of CRC survivors experience co-morbid health conditions, which may be more limiting than living with an ostomy or CRC in some circumstances (Anderson et al, 2013;McMullen et al, 2008;Palmer et al, 2013;Phipps et al, 2008;Soerjomataram et al, 2012). As a result, some CRC survivors describe difficulties attributing physical and psychosocial symptoms to the experience of cancer, rather blaming age or comorbidity (McCaughan et al, 2012;Ramirez et al, 2009). …”

“…Although some survivors struggle to come to terms with bodily changes and chronic treatment effects, many are capable of remarkable resilience, reframing the experience of symptoms or presence of an ostomy over time (McCaughan et al, 2012;McMullen et al, 2008;Palmer et al, 2013). Survivors may identify positive consequences of cancer, including appreciation for life, gratitude, strengthening of relationships, changing priorities and hope for the future (Appleton et al, 2013;Grant et al, 2011;McMullen et al, 2008;Nikoletti et al, 2008;Ramirez et al, 2009). For many, the new normal of the body and bodily function were things to adapt to and live with, and were better than possible alternatives to their situation, such as more aggressive types of cancer, treatment, or death (Appleton et al, 2013;Desnoo and Faithfull, 2006;McCaughan et al, 2012;McMullen et al, 2008;Ramirez et al, 2009).…”

“…Aside from dietary changes, CRC survivors felt the presence of an ostomy impacted upon their ability to engage in physical and social activities, and significantly impacted upon their body image Loi, 2011;McCaughan et al, 2012;McMullen et al, 2008;Mols et al, 2014). Hiding away involved a process of concealing the ostomy or avoiding situations where their ostomy may be seen by others (McMullen et al, 2008;Ramirez et al, 2009). …”