Sixty-five-year-old Robert had no idea he was seriously ill with bladder cancer until he was admitted to hospital as an emergency in the summer.
Robert had an aggressive form of bladder cancer and he needed a cystectomy operation to remove the bladder and create a stoma on his abdomen.
He has now successfully had surgery, has embarked on a course of chemotherapy and is looking forward to entering 2009 with, quite literally, a new lease of life.
He said: “I’m very thankful that I was still well enough to have this surgery and I was relieved when it was over. It was a big operation, but once my digestive system started working properly that was when my recovery started to speed-up. And, of course, the physiotherapist played a big part in getting my confidence back and getting me steady on my feet.
“I think I’ve recovered reasonably well and am fighting a good battle. I’m eating normal food, going for short road walks and driving short distances. Now we’ll see how the chemo works!”
In the cystectomy operation his bladder was removed and a stoma was created from a small piece of his bowel. Urine could then flow from the kidneys directly to the stoma, which protrudes slightly from his abdomen like a short spout. This enables urine to pass through the stoma into a disposable bag.
Said Robert: “The stoma bag has been the least of my problems! The stoma nurse talked me through everything before I was discharged and I had plenty of practising with bag changes daily. When I left hospital I left with good advice and confidence.”
Senior Sister Barbara Doyle knows from experience that patients’ perspective the pre-surgery preparation is very important.
Said Barbara: “This is a major operation, and recovery is a long-haul. Patients have the cancer side of the illness to deal with as well as the physical changes. We reassure them about what they can expect when they come round after surgery. Most patients are on the ward for 7-10 days, including a short time in the Surgical Dependency Unit (SDU).”
“This kind of stoma is not like one replacing bowl functions, which fills once or twice a day. These bags are continually filling up and they are designed to hold a few hours worth of urine. Our patients leave the ward with the knowledge of how to empty the bag into a toilet, how to deal with possible leakages, how to change and dispose safely of old bags and how to get their supplies.”
Said Specialist Stoma Nurse Carol Katte: “We receive a referral from the Consultant or his secretary and we then make contact with the patient. As we are the Regional Centre for bladder cancer surgery the patient may come from outside St Peter’s catchment area – if so, we ask the Stoma Nurse from that area to see the patient before admission. This allows the patient to meet their Stoma Nurse before being referred back following their discharge from hospital.
“At this first visit the patient, and hopefully their partner, will have their surgery explained to them. They receive information booklets and are offered a DVD showing patients dealing with their stomas; they are shown urostomy equipment and have the aftercare explained to them.
“Our patients are given the opportunity to speak to somebody who has undergone similar surgery, which they usually find very helpful and reassuring. They are also introduced to the Urostomy Association – a voluntary organisation run by patients for the support of this group of patients. The UA has a website, produces a quarterly magazine and holds local support meetings. Also, at this pre-operative appointment, the patient has the site for their stoma marked – this is chosen by the Stoma Nurse together with the patient taking into consideration things like body shape, type of clothing worn, previous surgery scars etc – in order to place the stoma in the best position to enable the patient to care for it.
“We can explain in detail how passing urine through a stoma for the rest of their life can be manageable, and can be the means to leading a nearly normal life once more.
“Each person is individual and will adapt to their change in lifestyle differently, and thus the care and support – both physical and psychological – that they require will be provided according to their own needs. Their Stoma Nurse will see them at home or in clinics for as long as they require support, and after that they know they can always contact us if they have a question or a problem – there is no time limit or end point to our involvement.”
- 10,000 UK people in the UK are diagnosed with bladder cancer.
- Cigarette smoking is the biggest risk factor for bladder cancer.
- Second biggest risk is exposure to industrial chemicals banned in the UK in 1967 but can take up to 25 years to develop.
- Patients can bath/shower/swim without any risk of leakage.
- Some female patients can have children following this surgery.