Expressions of Loss of Adulthood in the Narratives of People with Colorectal Cancer

Abstract

The diagnosis and treatment of colorectal cancer entail detailed discussions of bodily functions, invasive procedures, and a reorientation of life around bowel habit. Furthermore, people with stomas undergo a second experience of toilet training in adulthood. For these reasons, colorectal cancer is sometimes considered an embarrassing disease. Narrative interviews with colorectal cancer patients indicate the inadequacy of the concept of embarrassment in describing the loss of dignity, privacy, independence, and sexual confidence as well as a compromised ability to work, travel, and socialize. The link between bowel control and the constitution of adult identity must be acknowledged if health professionals and carers are to offer the most appropriate forms of information and support to people affected by colorectal cancer.

Adjusting to bodily change following stoma formation: a phenomenological study

“…and feeling in control of the body following stoma formation as promoting adaptation to a new stoma [31,5,14,18]. Only Kelly [9,22] and McVey et al [17] investigate the relationship between bodily mastery and social functioning that was evident in the present study.…”

“…Although previous studies highlight ways in which stoma formation can create an alienation from the body [10,16,18,14], this is only 19 fully examined by Kelly [9]. White and Unwin [5] identified a feeling of being a complete person as the single most important factor in determining psychological morbidity following stoma formation, but they did not investigate what 'being a complete person' might mean.…”

“…Specifically, awareness of a changed body [9], living with bodily changes [10], alienation from the body [10,11] and altered body image [11]). In other studies the experience of bodily change has been described in broad themes relating to loss of wholeness [12], practical stoma management [9,13,14], self-care [15], adapting to change [16], personal control [17,18] and feeling different [19]. Profound feelings of self-deprecation and self-hatred, with reactions of shock, disgust and repulsion are not uncommon among people after undergoing stoma-forming surgery [20,21,15,10,13,11].…”

“…Sutherland et al [20], Kelly [90], McVey et al [17], Rozmovits and Ziebland [14] and Annells [18] all identify a feeling of loss of control related to the particular problems caused by unprompted and unexpected faecal or flatus output from a stoma and the experience of appliance leakage.…”

Living and dying with metastatic bowel cancer: Serial in-depth interviews with patients

“…Fluctuations in psycho‐social and spiritual wellbeing also occur as patients suffer gradual social decline and seek meaning and purpose in their distress (Murray et al., 2007). Patients may also reflect on life's value as the illness progresses (Houldin & Lewis, 2006; Sjovall, Gunnars, Olsson, & Thome, 2011) and their sense of self is compromised, which can result in social isolation and existential distress (Hubbard, Kidd, & Kearney, 2010; Kidd, Kearney, O'Carroll, & Hubbard, 2008; Little, Jordens, Paul, Montgomery, & Philipson, 1998; Rozmovits & Ziebland, 2004; Taylor, 2001). …”