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Dear Aunt Vadge,
I have a vaginal fistula that is too large and the surrounding skin in too poor a condition to stitch, all a result of cervical cancer six years ago – the radiation damage has evolved into the condition I’m in now. I’ve seen a good doctor and he has suggested I get a colostomy bag.
In the meantime, while waiting for surgery, I can’t keep the area clean and dry. I soak in hot water several times a day, but the relief only lasts as long as I’m in the water. I’m 65 and from the US.
Do you have any suggestions for me until my surgery? Thanks for your time and help.
Sincerely,
Split
Dear Split,
I’m so sorry you’re dealing with this. The long-term fallout of cancer treatment is one of the least-talked-about things in medicine – everyone is so relieved you survived that the damage left behind, and what it does to daily life, often goes unspoken. Radiation injury to delicate vaginal and vulval tissue, on top of low post-menopausal oestrogen, is a cruel combination, and none of what you’re going through is a failing on your part.
I’ll be straight about scope: a radiation fistula and badly damaged tissue are beyond what a naturopathic column can safely manage, so the heart of your care has to sit with your medical team. But there are real comfort measures and the right specialists to lean on while you wait for surgery, so that’s where I’ll point you.
Get the right specialists around you
- Ask your doctor to refer you to a stoma/ostomy nurse and a wound or continence specialist now, ahead of the surgery. They manage exactly this, and they have skin-barrier products (barrier creams, films and pastes) made to protect broken skin from moisture and leakage far better than soaking alone.
- Many places now have pelvic radiation disease services or cancer late-effects clinics – ask whether one is available to you, as they specialise in radiation damage like yours.
Skin comfort until surgery
- Protect the skin with a barrier ointment (zinc-based, or a proper skin protectant your nurse recommends) rather than leaving it wet – constant moisture breaks fragile skin down further.
- Warm-water soaks are soothing, so keep them up, but pat dry gently afterwards and let air get to the area; skip soap and anything fragranced.
- Soft, breathable materials, changed often.
- Keep stools soft and easy to pass with fibre and plenty of water so nothing aggravates the area – your team can advise on stool softeners.
Oestrogen and nourishing the tissue
Low oestrogen makes the tissue thinner and more fragile, and local vaginal oestrogen can sometimes help suppleness. Whether it’s suitable for you depends entirely on your cancer history, so this is a conversation for your oncology team, not a decision to make on your own. Our pages on vaginal atrophy, atrophy in cancer survivors and radiation-induced vaginal stenosis lay out the longer-term radiation changes and the options you could raise with them.
What tissue you have heals better with enough protein, zinc, iron and vitamin C. Eating as well as you can, and getting advice from a dietitian or a well-trained naturopath who understands wound healing, can really support the tissue you’ve got.
Look after your heart, too
Please don’t underestimate the emotional weight of this. Living with your body breaking down this way, and facing a stoma, is an enormous amount to carry. Make sure you have someone to talk to – a counsellor, a cancer support service, or a group of others who’ve been through pelvic radiation. Your wellbeing matters every bit as much as the physical care.
This is general information, not a substitute for personalised medical advice.
I’m thinking of you, and you’re welcome to write anytime.
Warmest regards,
Aunt Vadge
