Patient discussions

Patients undergoing bowel resection where a stoma is the intended or possible outcome should have an early appointment with a specialist stoma nurse for fitting and education on how to manage the stoma postoperatively. Anastomotic leakage and local or distant recurrences may increase the risk of permanent stoma in patients with a temporary stoma.[402]​ Older patients, patients with advanced tumor stages, patients with American Society of Anesthesiologists score of ≥3, and patients who undergo neoadjuvant therapy are at risk for permanent stoma and should be informed about the risks before surgery.[402] 

American Society of Clinical Oncology guidelines advise that patients undergoing active treatment with curative intent should be advised to undertake aerobic and resistance exercise; evidence suggests that exercise interventions during active treatment reduce fatigue, preserve cardiorespiratory fitness, physical functioning, and strength, and in some populations, improve disease-free survival, improve quality of life and reduce anxiety and depression.[378][403][404][405]

There is currently insufficient evidence to recommend specific diets, intentional weight loss, or avoidance of weight gain during cancer treatment to improve outcomes related to quality of life, treatment toxicity, or cancer control. Neutropenic diets (specifically diets that exclude raw fruits and vegetables) are not recommended, as the harms are likely to outweigh the benefits. Further research is needed to look into the impact of diet and weight management interventions in patients undergoing cancer treatment.[378]

Use of this content is subject to our disclaimer