A stoma is a surgically created opening in the body that replaces a normal opening. It is needed when the normal opening is blocked by tumor or has been altered as part of cancer treatment. Stomas serve as new sites for basic bodily functions.

There are different types of stomas. Three are commonly seen in people with cancer:

• tracheostomy (pronounced tray-key-oss-tuh-mee, or trach for short) in the trachea, or windpipe
• urostomy in the bladder or urinary system
• colostomy in the colon

What the patient can do

Tracheostomy:

• Use pad and paper for "speaking" with others.
• Do not remove the outer tube of the tracheostomy unless your doctor or nurse tells you to.
• Clean your tracheostomy tube at least once a day as instructed by your nurse or doctor.
• Suction the tube as needed or as directed by nurse or doctor.
• Wash your hands carefully before and after handling your tracheostomy to help prevent infections.
• Be careful to keep water out of the trach while bathing. A child's bib with the plastic side facing outward can be used to keep water out and allow breathing while you shower.
• Do not swim. Being around water that may get close to your neck will be risky for you because water can get into your lungs.
• Wear a scarf or shirt that covers the opening but is made of thin fabric (such as cotton) that allows air to get through. This helps protect the stoma from dust and loose fibers.
• Ask to meet with a respiratory therapist or ostomy nurse if you need more information.
• You may want to visit www.theial.com or call 1-866-425-3678 to learn about the International Association of Laryngectomees.

Urostomy and colostomy:

• Every day gently clean the skin around your stoma with warm water only. (You may see a small amount of blood while cleaning. This is OK.)
• Gently pat dry or allow to air dry.
• Showers or baths can be taken with pouch on or off.
• Apply barriers, borders, or pastes to the skin around the stoma before putting on the pouch.
• Empty the pouch when it is one-third full.
• Change the colostomy pouch before there is a leak; if possible, not more than once a day and not less than once every 3 or 4 days.
• Change the urostomy pouch every 3 to 5 days.
• Irrigate stoma as instructed by a nurse or doctor.
• Ask your enterostomal therapy nurse or therapist any questions you may have.
• If you live in a large community, consider joining a support group. Visit www.uoaa.org or call 1-800-826-0826 for information from United Ostomy Associations of America, Inc.
• See section on sexuality for tips on managing the stoma during sex.

What caregivers can do

Tracheostomy:

• Learn how to care for the tracheostomy.
• Learn to suction out mucus from the upper airway.
• Moist air helps keep mucus from being too thick and sticky. A humidifier, especially in the bedroom, may be helpful. Check with the doctor or nurse on how to clean the humidifier.

Urostomy and colostomy:

• Learn how to care for the stoma, including the skin around the opening.
• Offer help if the patient is having trouble. Often the patient feels embarrassed and will not ask for help.
• Encourage the patient to join an ostomy club for support and practical tips.

Revised: 04/07/08