Ask CancerCare

A. Adjusting to a cancer diagnosis can be challenging enough; adjusting to physical challenges that might come with it can seem overwhelming. It's completely normal to wonder how you will manage. Seeking out information and support will help you to understand what to expect and how to best cope with change.

If cancer is detected in your colon or rectum, a colostomy is performed. A colostomy surgically creates a "stoma" or small opening in the lower abdomen through which stool can exit the body. Usually, the waste is captured in a small bag that is worn on the body and can be easily disposed of. While this procedure will have an obvious impact on your daily routines, keep in mind that you will still be able to do all the things you enjoy, including physical activities such as sports or gardening, and continue to live a full life with a colostomy.

To understand the impact a colostomy will have on you, talk with your doctors prior to your surgery about what you should expect before and after the procedure. It is also helpful to know the types of assistance and support available to you after your surgery. Ask to see an enterostomal therapy (ET) nurse, who specializes in ostomy care and rehabilitation.

CancerCare services can also be helpful. Speak with an oncology social worker or join a telephone or online support group specifically for colon cancer patients and survivors where you can discuss your concerns and learn how others have coped and adjusted. Connecting with others who have "been there" can be incredibly supportive and informative.

You can find additional information and support through The United Ostomy Association of America, which provides guidebooks, reference cards and brochures, as well as a message board where patients and caregivers can exchange information and answer questions. You can also find a local or virtual support group.

Remember that with any change comes loss. You may need to give yourself time to grieve as you move into this next stage of your life.

A. The numbness and reduced sensitivity in your fingers and feet is called peripheral neuropathy, which is nerve damage that often results from certain chemotherapy treatments (e.g., oxaliplatin). It is sometimes referred to as the "glove and stocking sensation," as it feels similar to wearing gloves or thick stockings on your hands or feet.

Certain medications can reduce the pain and annoying physical sensations that accompany neuropathy while the nerves repair themselves. Gabapentin relieves the pain of neuropathy by changing the way your body senses pain. It is meant to control your condition but will not cure it. Fortunately, there are several other types of medications for neuropathy, including anticonvulsants, antidepressants, local anesthetics, and opioids, that can be taken individually or in combination. Work with your doctor to find the right approach for you. Keep in mind that it can take one to two years or more for symptoms to go away completely.

Here are some tips that may help you manage and cope with the symptoms of peripheral neuropathy:

• Avoid drinking alcohol, which can damage nerves.
• Wear sneakers or shoes with "rocker bottoms" that allow the feet to roll while walking, provide better traction and can relieve some of the pressure on the soles.
• Remove throw rugs from your home to reduce the chance of slipping and falling.
• Rather than stand, sit down while doing activities such as drying your hair, applying makeup or preparing food.
• Use hand tools, kitchen utensils, and even toothbrushes and pens with wider grips, to make them easier to hold.
• If you have diabetes, manage your blood sugar level very carefully, as high levels can have a negative impact on nerves.
• Join a support group to learn how others lived with, and overcome, the challenges of neuropathy.
• Consult a psychiatrist, physical therapist, or occupational therapist who can provide guidance tailored to your specific circumstances.

CancerCare has several resources to help you learn more about living with neuropathy. Listen to our Telephone Education Workshop podcast, Understanding Peripheral Neuropathy. You can also download our Connect booklet, Understanding Peripheral Neuropathy.

For additional help and support, visit the website of The Neuropathy Association.

A. Your question is a good example of how a colorectal cancer diagnosis affects the entire family, not just the loved one who was diagnosed. Both caregivers and patients share similar challenges, although with different perspectives, and therefore the answer pertains to both caregiver and patient. Speaking with peers can often be helpful and I can suggest a few different options. Many hospitals offer support groups, so I would begin your search by speaking with a hospital social worker who can let you know about available support groups. If you are having difficulty finding local in-person support groups, CancerCare offers both telephone and online support groups for colorectal cancer patients and for caregivers. These options may be useful if there are no local groups or if traveling outside the home is difficult.

There are organizations that offer support groups, information on how to connect with a local support group, or "buddy" matching programs:

• Colon Cancer Alliance, 1-877-422-2030
• Gilda's Club, 1-888-GILDA-4-U
• American Cancer Society, 1-800-ACS-2345
• The Wellness Community, 1-888-793-WELL
• United Ostomy Associations of America, 1-800-826-0826

We know that "one size does not fit all," and it is important to determine the support services most beneficial to the person in need. A support group can be helpful, and often individual counseling may be more appropriate. Introduce this information to your mom and allow her to ask questions and share her decision with you. And don't forget to consider support for yourself. It is good to have choices, especially when it seems that cancer has affected a sense of control or choice. Our support group participants tell us they are glad they took the chance to connect with peers, and report that they now have a greater understanding of their treatment, side-effects, options, medications, and emotions.