Supportive care for anal cancer
Supportive care helps people meet the physical, practical, emotional and spiritual challenges of anal cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.
Recovering from anal cancer and adjusting to life after treatment is different for each person. It will depend on the stage, the type of treatments you had and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects.
You may want to talk to your healthcare team about the following.
Diarrhea is a common problem for people treated for anal cancer. This is because the anal area and intestine are very sensitive to treatments like radiation therapy and chemotherapy. An abdominoperineal resection may also cause diarrhea. Diarrhea usually goes away after treatment is finished, but sometimes it can last several months or years after treatment.
You can help manage diarrhea by making changes to your diet. You can try limiting certain foods and drinks, such as greasy foods, high-fibre foods, coffee, tea and alcohol. Ask your doctor for a referral to a registered dietitian if you have questions or concerns about your diet. Your healthcare team may also recommend medicines to help manage diarrhea.
In addition to diarrhea, some people may not be able to control their bowel movements (called incontinence). This often happens if the anal sphincter is damaged by treatments. Tell your healthcare team if you have incontinence. Special pads or undergarments can be used to collect stool. In some cases, surgery may be used to repair the anal sphincter. A colostomy is done when the anal sphincter can’t be fixed.
Find out more about diarrhea.
Some treatments for anal cancer can cause sexual problems or make sex difficult. For example, it is common for people to lose interest in sex around the time of diagnosis and during treatment. Some people may not be able to have anal sex because of cancer or its treatments.
Men who have radiation therapy or an abdominoperineal resection may not be able to have or keep an erection (called erectile dysfunction). These treatments can also lead to ejaculation problems, including dry orgasm (no semen is ejaculated).
Women may have pain and discomfort during sex if scar tissue or adhesions develop in the abdomen from an abdominoperineal resection. Radiation therapy may cause the vagina to become irritated and dry, which can also make sex painful or uncomfortable.
Talk to your doctor or healthcare team if sexual problems occur because of anal cancer or its treatments. They can suggest ways to help you manage these problems, such as medicines or special devices. Some people find that counselling helps them cope with the effects that anal cancer and its treatments have on their sexual relationships.
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A colostomy creates an artificial opening (called a stoma) from the colon to the outside of the body through the abdominal wall. People who have an abdominoperineal resection need a permanent colostomy because the anal sphincter is removed.
Specially trained healthcare professionals, called enterostomal therapists, will help you adapt to having a colostomy. They will teach you how to live with a colostomy and care for the stoma. Local or national ostomy groups and associations can also give you support and information.
Find out more about colostomy.
American Cancer Society. Anal Cancer. 2014: http://www.cancer.org/acs/groups/cid/documents/webcontent/003083-pdf.pdf.
Krebs, LU . Altered Body Image and Sexual Health. Yarbro CH, Wujcik D, & Holmes Gobel B (eds.). Cancer Symptom Management. 4th ed. Jones & Bartlett Learning; 2014: 24:507-540.
Muehlbauer PM, Lopez RC . Diarrhea. Yarbro CH, Wujcik D, & Holmes Gobel B (eds.). Cancer Symptom Management. 4th ed. Jones & Bartlett Learning; 2014: 10:185-212.
The Canadian Association for Enterostomal Therapy. A Guide to Living with a Colostomy. Ottawa, ON: The Canadian Association for Enterostomal Therapy; 2007.