The relationship between body image disturbance and distress in colorectal cancer patients with and without stomas

Objective: This study aimed to investigate the effect of having a stoma on body image in patients with colorectal cancer and to determine whether disturbances in body image predicted distress. Methods: A prospective analysis of 79 colorectal cancer patients. Patients were assessed within 9 weeks of surgery and followed up at the end of adjuvant treatment. Body image disturbance, depressive symptoms, anxiety, and general distress were measured at baseline and follow-up. Results: Patients who received stomas had poorer body image, which worsened over time. Although there were no differences between stoma groups on anxiety, or depressive symptoms, those with a late stoma were most depressed. Body image was a strong predictor of initial levels of anxiety, depression, and distress and subsequent anxiety and distress. Conclusions: These results confirm that stomas negatively impact on the body image of patients with colorectal cancer. Importantly, those whose body image is most disturbed are at risk for experiencing more anxiety and depression. These results underscore the importance of assessing and treating body image disturbance in colorectal patients who receive a stoma. (c) 2010 Elsevier Inc. All rights reserved.