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Survivors Cancer’s impact on work and strategies Changes in bowel and bladder function

Changes in bowel and bladder function

Dr. Christine Maheu, RN, PhD

Dr. Christine Maheu is an Associate Professor in the Ingram School of Nursing, Faculty of Medicine, McGill University. Dr. Maheu is also an Affiliate Scientist at the University Health Network and the University of Toronto. At McGill University, she teaches research methods, supervises graduate students (masters, doctoral, post-doctoral), mentors practicing nurses and students in research, and conducts research in English and French. She has held research awards with the Canadian Institutes of Health Research, the Canadian Cancer Society, and the Canadian Partnership Against Cancer. These awards funded her research in psychosocial oncology, which focuses on developing and testing psychosocial interventions or measurements tools for various cancer populations. Additionally, in partnership with Ipsos Canada and funded by the Canadian Partnership Against Cancer, she is co-leading a nationwide survey of the needs of cancer patients for transition care from the end of their treatment to three years after their diagnosis. Dr. Maheu received awards for excellence in nursing research (2013, 2015, 2016) from Ovarian Cancer Canada, the Canadian Association of Nurses in Oncology, and the Quebec Association of Nurses in Oncology.

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Ms. Rosemary Cashman

Ms. Rosemary Cashman is a nurse practitioner at the BC Cancer Agency and an Adjunct Professor in the Faculty of Nursing at the University of British Columbia. Her professional experience includes the care of lymphoma, lung cancer and brain cancer patients. She co-chairs the Patient and Family Advisory Council, which guides the brain tumour care program at the BC Cancer Agency. She has authored book chapters and articles related to the care of brain tumour patients and their families. Ms. Cashman was involved in developing and implementing a rapid-access radiotherapy clinic for the palliative treatment of lung cancer and she continues to work in this clinic.

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Kyla Johnson, Occupational Therapist, Segal Cancer Centre, Jewish General Hospital

Ms. Kyla Johnson, M.Sc.A., originally from Edmonton, Alberta, Kyla Johnson works as an Occupational Therapist at the Segal Cancer Center of the Jewish General Hospital. She holds a Master of Science in Occupational Therapy from McGill University. Her goal as a rehabilitation professional in Oncology is to enable people with cancer to be able to do what they want and need to do, in all stages of their cancer experience. Kyla helps develop strategies and accommodations to facilitate a return to meaningful life roles, including work. She is specialized in cancer-related cognitive dysfunction and runs a weekly group teaching strategies to improve daily cognitive functioning. Kyla also leads a volunteer yoga class for young adults with cancer. She lives in Montreal, Quebec.

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Ms. Maureen Parkinson, Vocational Rehabilitation Counsellor, M.Ed. C.C.R.C, BC Cancer

Ms. Maureen Parkinson is the province-wide vocational rehabilitation counsellor at the BC Cancer Agency. She has also been vocational rehabilitation counsellor at a public rehabilitation hospital and vocational rehabilitation consultant to insurance companies and the court system. She has instructed and facilitated Service-Canada-funded programs on job searching and career exploration. Ms. Parkinson has a Masters in Counselling Psychology, is a Canadian Certified Rehabilitation Counsellor, and completed the Certified Return to Work Coordinator Program through the National Institute for Disability Management and Research. She has developed return-to-work and job-search seminars for cancer patients and created the guidebook “Cancer and Returning to Work: A Practical Guide for Cancer Patients” as well as on-line articles about returning to work and school. She also co-authored a paper commissioned by the Canadian Association of Psychosocial Oncology, “Cancer and Work: A Canadian Perspective”.

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Cancer and cancer treatment may cause changes in the usual patterns of elimination.1 2 Some treatments cause constipation or loose stool. Urinary tract infections may occur as the result of immune system suppression. In some cases, surgical procedures related to cancer treatment result in the creation of new outlets for stool and urine in the form of a colostomy, ileostomy, ileal conduit or other urinary diversions. All of these conditions have the potential to cause physical and psychological distress and may impose restrictions or challenges in your work life.3

Vocational implications

Changes in bowel and bladder function may provoke concerns about elimination. A work environment that provides easy and regular access to a private bathroom is desirable. The care of ostomies requires some education and practice so that you feel comfortable in preventing and troubleshooting any problems that might occur.

What you can do

Understand the factors that contribute to irregularities in bowel and bladder function so that these can be prevented or managed quickly. Monitor for signs of problems such as infections and speak to your healthcare team for advice.

Some other tips include:

  • Aim for regular elimination habits, especially if you are on medications that may cause constipation or diarrhea. Diet and fluid intake may help this.
  • Know the warning signs that indicate you should seek medical attention.
  • If you have a surgical opening for the passage of urine or stool, speak to your healthcare team or to an ostomy care specialist for advice on managing your ostomy and preventing problems. For more information, see the Ostomy Canada Society website.

Job accommodations

  • Relocate your workstation closer to the washroom.
  • Ask for access to a private washroom that has a sink and toilet together.
  • Request a private place to store wet wipes, extra ostomy supplies and a change of clothing.
  • Identify tasks that would be problematic to interrupt with an emergency bathroom visit.
  • Explore if there is a way to modify these tasks to allow for unforeseen interruptions.


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