Navigating Vaginal Fistula Post-Cancer: Expert Advice

Dear Aunt Vadge,

I have a vaginal fistula that is too large and the surrounding skin in too poor of condition to stitch, which all was a result of having cervical cancer six years ago, and eventually the damage from the radiation has evolved into the condition I am in now. I have seen a good doctor and he has suggested that I get a colonoscopy bag.

In the meantime, while waiting for surgery I am unable to keep the area clean and dry. I soak in hot water several times a day, but the soothing only lasts as long as I’m in the hot water. I am 65 years old and from the U.S.

Do you have any suggestions for me until my surgery? Thanks for your time and help.

Sincerely,
Split
_______

Dear Split,

Sorry to hear you are in such dire straights. It sounds miserable. The fallout from cancer treatments rarely gets discussed, since everyone is so focused on you being lucky to be alive, but the outcomes can be very severe for your quality of life. Your extensive vaginal damage combined with low oestrogen from post-menopause is a great example of that.

The damage from radiation can be quite severe unfortunately, especially on the delicate vaginal tissues. Minor cuts and tears can be encouraged to heal well with a moisturising vulva and vagina-friendly cuts cream.

You sound like you are doing everything you can to keep the area clean and dry, and unfortunately there isn’t much else I can suggest without knowing the precise details of the problem as it applies specifically to your body.

Things that could help might include:

1. Diet

Making sure you have a suitable diet for the kinds of stools that make this less messy and traumatising than it needs to be. I’m sure you have that covered by now, but some people aren’t sure how to get the stools of their dreams, whatever that may be. If they need to be firmer, softer, whatever, then choose foods that achieve this end. Fibre and plenty of water will make your stools soft and pliable, so they don’t further aggravate any wounds that remain. You have no doubt been schooled in stool softeners, water intake and bowel care.

2. Oestrogen for skin strength and suppleness

You may want to see if you are able to speak to your doctor about some form of oestrogen therapy to help improve the elasticity of your skin somewhat. It depends on your cancer profile, and if you are able to take oestrogens in certain forms. Have a look at the vaginal atrophy page, since the same things are likely to apply to you. If you are unable to take oestrogen, see the breast cancer survivors’ vaginal atrophy page. Talk to your doctor about whether he thinks it would be helpful.

3. Nutrients for tissue repair and wound healing

Keeping your flesh in good working order is hard as you grow older, but especially after serious damage by radiation has occurred. Making sure your digestion is optimal will also help, since the better you can support your flesh with the right nutrients, the stronger what’s left will be. You can’t afford to lose much more. This means plenty of zinc and protein, but in highly-absorbable forms. Ensure iron is at optimal levels to increase oxygenation of tissues. Not everyone knows what you need and how you need to take it, and it’s a big topic, so eat as well as you possibly can, and get some nutritional advice by someone who knows digestive systems and food inside out.

4. Don’t overdo it

Be gentle. When flesh is trying to heal itself constantly, it can be easily torn. Getting a colonoscopy bag will stop the leaking, but your problem of having shredded flesh remains, and the care will be lifelong.

5. Find an alternative medicine practitioner who can help you with emotions, diet, digestion and herbal medicine

I would recommend that you find a herbal medicine practitioner in your area who is well trained and respected to pay visit to. There are a number of herbal medicines and dietary/lifestyle advice that could really promote healing and skin strength.

Some other changes or additions could assist with specific functions of your body like optimising digestion of certain nutrients, promoting healthy blood supply to damaged tissues, and ensuring you have everything you need to make your life as comfortable as possible, while keeping your skin as strong as it needs to be.

If your doctor has deemed your fistula inoperable, you do have options to strengthen your tissues, so investigate them even after your colonoscopy bag is installed. The medical profession can only do so much; the rest you have to learn about yourself.

6. Make sure you are getting emotional support

Do not underestimate the impact of having your vagina falling apart and needing a colonoscopy bag. You have been dealing with this for some time now, but it can’t be easy or fun, so make sure you have someone you can talk to, express your anger and grief with, and cry and laugh if you need to. Your emotional wellbeing is of critical importance. Please keep in touch with us – we’d love to know more about your experiences with radiation and cancer, if you care to write and tell us your story.

Warmest regards,
Aunt Vadge