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Living with pelvic or abdominal cancer can bring particular challenges that may affect a person’s emotional wellbeing. This page explains some of the common concerns people may experience and offers practical tips and guidance that may help.

You can also watch this short film which provides a brief overview with some key tips.

Incontinence

Urinary or faecal incontinence can significantly impact emotional wellbeing. For more information on this and managing practically follow this link Continence.

When living with incontinence, people may experience:

  • Feeling low or depressed
  • Feelings of embarrassment or shame
  • Feeling a sense of losing control
  • Anxiety about leaving home, not being close to the toilet, leaking or having an accident
  • An impact on sexual and intimate relationships

In addition to the general tips about managing your emotional wellbeing on the psychological wellbeing pages, it may be helpful to consider the following:

  • Plan ahead with incontinence pads and spare clothing, radar keys or “I need to go” cards, knowing where toilets are located and sitting in aisle seats if attending events or travelling to help you feel more comfortable with going out.
  • If you are finding it hard to leave home try to take steps to slowly challenge yourself to getting back out. This may look like initially taking a walk locally for 10 minutes near your house, and then gradually increasing the amount of time or distance from home. This is helpful as when people stay at home they may lose connection with others and their hobbies, and as a result feel more isolated and lower in mood.
  • Communicate your needs to people (e.g., if you are boarding a flight, if you are attending a group event). Some people find it helpful to have a pre-prepared statement that they will tell others, such as “I have an illness that means I sometimes need to access a toilet quickly”.
  • If you are worried about what others may think of you, sometimes it can be helpful to gently challenge your thoughts or ask yourself “what would I tell a friend in this situation”.We can often make assumptions that others may see or judge us in a certain way. You may find the following page helpful to read: Incontinence and emotions | Bladder & Bowel Community

Stomas

People who need to have a temporary or permanent stoma (or stomas) due to their cancer may be impacted emotionally. For more information on stomas and managing practically see the Stoma pages for further information.

People may experience:

  • Difficulty adjusting to having a stoma
  • Feelings of anger, frustration, embarrassment or shame about their stoma and its appearance
  • Anxiety about their stoma leaking, their appearance, smell
  • Isolating themselves/not leaving home as much
  • An impact on sex and intimate relationships

In addition to the general tips about managing your emotional wellbeing on the psychological wellbeing pages, it may be helpful to consider the following:

  • Allow yourself time to adjust to having a stoma and living with it. Over time you will likely feel more comfortable with your stoma and managing your stoma will become a part of your everyday routine.
  • Spend time talking about and explaining your feelings and experience to your loved ones to help them understand you and let them know the best way they can support you.
  • Be prepared with spare supplies for your stoma when leaving the house to help you feel more comfortable.
  • If you are finding it hard to leave the house, try to take steps to slowly challenge yourself to getting back out. This may look like initially taking a walk locally for 10 minutes near your house, and then gradually increasing the amount of time or distance from home. This is helpful as when people stay at home, they may lose connection with others and their hobbies, and as a result feel more isolated and lower in mood.
  • If you are worried about what others may think of you, sometimes it can be helpful to gently challenge your thoughts or ask yourself “what would I tell a friend in this situation”. We can often make assumptions that others may see or judge us in a certain way.
  • If you are worried about your appearance spend time thinking about other parts of your body that you like or are grateful for. You can do this by thinking about it, or by looking at a mirror and working downwards from your head and saying what you like and appreciate out loud.
  • Thinking about the positives alongside the difficulties of having a stoma, for example “it saved my life”.
  • You may find the following helpful to read through: Managing Emotions Post-Stoma Surgery | Dansac UK
  • For more information on sex and intimacy see sex & intimacy

Body image concerns

Treatment for cancer can change what a person’s body looks like, including the removal of body parts (such as your penis, vagina or clitoris), or lead to a change in colour or shape of body parts.

This can impact how someone thinks and feels about their body and how they feel others may view them. It can also affect a person’s self-worth and confidence, and cause difficulties such as depression and anxiety if they find it hard to adjust to these changes. These changes may also make a person feel more/less masculine or feminine.

For more information, tips, resources and sources of further support see the Body Image pages.

Pain

If cancer has led to pelvic pain this can impact on your emotional wellbeing in a variety of ways. Pain can lead to low mood, anxiety, feelings of frustration and anger, feelings of isolation or loss of identity, or it may impact sex and intimate relationships.

In addition to the general tips about managing your emotional wellbeing at psychological wellbeing, it may be helpful to consider the following:

  • When in pain this can often impact how much someone is able to do and may mean that you can no longer engage in the same activities as you used to. When you stop doing activities that bring joy, although this helps manage pain in the short term, it can lead to longer term problems with your mood and may lead you to becoming deconditioned.It can be helpful where possible to make adjustments to the activities you do by thinking about alternative ways to engage with them or something that brings you a similar level of joy.
  • If pelvic pain is impacting your sex life, it is important to speak with your cancer team or GP about this to see if anything can be done medically. For further information on sex and intimacy see sex&intimacy.
  • Keeping a pain diary can help you to better understand when your pain is worse and better, which you can then take to explain to your cancer team or GP to see what may help. This may also help you think about any changes you can make personally to help manage the pain

For more information please see the Pelvic Pain pages.

Sex and intimacy

Difficulties with sex and intimacy can cause emotional difficulties such as depression and anxiety. Emotional difficulties can make someone not want to have sex or be intimate.

For further information, follow this link sex and intimacy

Changes to fertility

If cancer has impacted your fertility, this can lead to feelings of sadness and anger. You may also be feeling unsure about decisions regarding fertility preservation or options moving forward.

You may find the general tips about managing your emotional wellbeing at psychological wellbeing helpful. But if you are struggling, you may want to consider accessing therapy as a space to talk about this. If you are under a fertility clinic do speak to them regarding this, as they may have in-house support or can recommend where you can access more specific help.

The Fertility Network UK also has some helpful information and resources that you may want to investigate: Access support | Fertility Network

For further information about fertility follow this link.

Further information

This page contains a few thoughts and ideas on psychological wellbeing. For further information you can go to:

Macmillan: How cancer may affect you emotionally | Macmillan Cancer Support

Maggies: Managing emotions | Maggie’s

Who can help:

Trying the tips on this page can be an excellent starting point and may help you live with the emotional impact of pelvic and abdominal consequence of cancer. Some people may need more support, and there are different options available. Remember you are not alone.

Peer support

Peer support can often be helpful, especially when people feel alone in their experience. There are a range of support groups available, you can speak to your cancer team about this for advice or look online

Cancer self-help and support groups | Macmillan Cancer Support

Psychological therapy

Psychological therapy can be useful, and usually involves meeting with someone one to one or in a group. Therapists may use a variety of techniques to support you including (but not limited to) ideas from cognitive behavioural therapy, acceptance and commitment therapy and compassion focused therapy.

You can ask your cancer team for a referral to the Macmillan Cancer Psychological Support Team (CaPS) at St George’s Hospital if you are a patient under their care. Alternatively, you can speak to your GP about psychological therapy available, including your local Talking Therapies service.

You can find information about the CaPS team at: Macmillan Cancer Psychological Support (CaPS) Team – St George’s University Hospitals NHS Foundation Trust

You can find your local talking therapies service at: Find NHS talking therapies for anxiety and depression – NHS

Support from cancer charities

Maggie’s Centres offer a range of psychological support including support groups, drop-in services, workshops and courses, and one to one psychological therapy: Our centres – Maggie’s. You can either drop in, email or call them.

Macmillan offer a free support line on 0808 808 00 00, or you can email them for support: Emotional, financial and physical help for people with cancer | Macmillan Cancer Support

Community Mental Health Teams:

If you are already receiving support for your mental health, tell your team or therapist about your cancer diagnosis and how this is impacting you. For more information on this you can go to MH teams webpage.