Bowel (colorectal) cancer surgery: decision-making and information needs
Surgery is usually the main form of treatment for bowel (colorectal) cancer. There are several types of surgery for colorectal cancer, depending on where the...
Surgery is the main form of treatment for bowel (colorectal) cancer. The part of the bowel containing the cancer is removed and the two ends of the bowel are then joined together. If it is not possible to rejoin the two ends then a colostomy or ileostomy may be required. (For more on this see Stoma.)
The period immediately after surgery was a shock to many as they woke up connected to machines, drains, tubes, and intravenous drips. One woman recalls being frightened when she awoke after surgery. Many people were upset at finding themselves unable to walk, stand, sit up or even move in bed. This was usually followed by rapid improvement and many were able to start walking and looking after themselves within a day or two.
Post-operative routines have changed a lot in the past few years and more hospitals now use a programme called enhanced recovery where people are encouraged to get out of bed, start walking, eating and drinking as soon as possible. This helps to shorten the recovery time needed.
In a few cases recovery was disrupted by a major setback. Usually this was a medical complication but one woman had an unfortunate experience when her wound broke down and hospital staff failed to respond promptly.
The speed of recovery varied greatly from person to person. One man’s GP said he was “like Rasputin – stick a knife in him and he jumps up again”. A woman described her consultant’s amazement at finding her “sitting bolt upright in bed with her heated rollers in and her makeup on” 2 or 3 days after surgery. For another woman, however, recovery was a slow and painful process.
The recovery period in hospital is normally between a week and 10 days. With the enhanced recovery programme, most people are well enough to go home within a week of their operation. The recovery period for this type of major surgery can be long although some people are able to resume many normal activities as soon as 6 to 8 weeks after their operation.
After effects of surgery may be experienced in the medium to long term. These include adhesions, (a build-up of scar tissue that can cause episodes of severe abdominal pain or blockage of the bowel), sexual dysfunction, and emotional distress. Post-operative infections, DVTs (blood clots), and other complications may require further treatment and delay recovery. Restoring eating and bowel habit can also be a long and difficult process. (For more see Eating and bowel habits after bowel cancer surgery.)
Several people experienced depression, panic attacks or flashbacks after surgery which sometimes lasted for months or even years. One woman felt that the lack of opportunity to discuss her feelings after surgery contributed to an emotional decline. Another woman became depressed more than a year after her operation.
A man describes the panic attacks he suffered for nearly a year after coming out of hospital, while another man, who had a history of depression and became depressed while in hospital, found that staff in the surgical ward did not know how to deal with him.
The woman who did not receive prompt attention when her wound broke down after surgery had flashbacks of the experience for months afterwards.
A number of people developed adhesions after surgery and experienced extreme distress in addition to physical pain because they did not understand what was happening to them. One man’s adhesions caused a blockage of the bowel which required emergency surgery. One woman had learned to detect the signs of an attack in its early stages and used steroids to prevent it coming on. The majority of people who discussed adhesions felt they should have been warned about them in advance. One woman felt that her consultant had downplayed discussion of adhesions and that this had been unhelpful to her.
One man experienced sexual dysfunction as a result of his surgery and had to seek counselling to help him deal with it. He felt strongly that this risk should have been discussed with him before surgery.
Surgery is usually the main form of treatment for bowel (colorectal) cancer. There are several types of surgery for colorectal cancer, depending on where the...
It is normal to experience some pain or discomfort for a few days after surgery, but with the variety of drugs and drug delivery systems...