Answers to Your Most Common Questions – CORUM FAQ

Yes. Talking to survivors who have gone through similar experiences can bring comfort, understanding, and hope. Peer mentors can share coping tips and inspire confidence in recovery. Many cancer patients are reported to become ‘lost’ in this transition from patient to survivor (Hewitt et al, 2005).

Colorectal cancer can affect body image, bowel control, and sexual health. These issues can lead to embarrassment and loss of confidence. Counselling helps address these sensitive concerns.

Yes. Counselling plays an important role in strengthening self-efficacy. It helps survivors set realistic goals, reframe setbacks and encourages them with affirming words and guides them in managing emotional states. In this safe and supportive space, survivors learn to believe in their ability to manage challenges and embrace life with renewed purpose. When stress and anxiety are managed, patients often sleep better, eat well, follow treatment plans, and recover more smoothly

Mental health support is as important as physical care for cancer survivors. It helps you feel understood, supported, and motivated to continue your recovery journey.

Good mental health helps patients cope with treatment, make clear decisions, and maintain hope. It also improves quality of life and emotional strength.

• Counselling and therapy: For emotional support and coping skills.
• Psychiatric care:  For medication and medical management.
• Peer support groups:  For sharing experiences and encouragement.
• Crisis support: For immediate help in emergencies.

Counselling, mindfulness, relaxation exercises, medication (if needed), and social support can reduce anxiety and depression. Regular follow-up with healthcare providers is also important.

Counselling helps individuals calm their emotions, think clearly, and find ways to manage their situation. It supports emotional healing and better decision-making.

The best treatment depends on each person’s needs. It may include counselling, medication, support groups, lifestyle changes, or a mix of these approaches guided by professionals.

Counselling helps people understand their feelings, change negative thinking patterns, and learn healthy ways to cope with stress, anxiety, and sadness.

Counselling can address body image concerns, fear of recurrence, and relationship changes. It helps patients and caregivers express emotions, strengthen resilience, and live with greater peace and purpose. You don’t have to go through this alone. Reaching out to friends, family, or a support group can bring comfort. Sometimes, just talking can bring relief. Healing often begins with one honest conversation

Counselling is a safe space where you can share your thoughts and feelings with someone who is professionally trained to listen and support you. It’s confidential and non-judgmental. It helps you explore your challenges, talk about fears, pain and emotions. It helps patients manage stress, discover ways to cope, find hope and meaning during treatment and recovery. Counselling and support can help manage these emotions and rebuild confidence. It’s not about being broken, it’s about being supported.

Listen with care. Offer help with daily tasks. Be patient with their emotions. Encourage them to attend medical appointments and join support groups. Avoid giving advice unless asked.

Cancer is a physical disease, but it can significantly affect your emotional health. Cancer doesn’t just affect the body. It shakes emotions, relationships, and identity. Healing involves caring for body, mind and spiritual. Survivorship differs with each person; yet, many survivors share these common emotions overwhelmed, fear and worry, stress and anxiety, anger, sadness and depression, guilt and loneliness.

Caregivers often feel tired, stressed, worried, grief and lonely. They may struggle to balance caregiving, work, and family. Counselling, support groups, and talking to other caregivers can help them cope and feel less alone.

• Learn to manage your own stoma care whenever possible
• Cleanse the skin properly to reduce risk of skin excoriation, be gentle when cleansing the stoma. Dry the skin before applying the skin barrier
• Empty the bag when it is 1/3 full to avoid the weight pulling off the adhesive
• Avoid skin care products that contain alcohol. These can make your skin too dry.
• Do not use products that contain oil on the skin around your stoma which interferes with the adhesives
• Always replenish the skin barrier & bag when you have 2-3 pieces left
• Take balance diet and eat everything in moderation, keep a food diary in relation to output.
• Change the appliances once they are leaking and do not wait

Seek consultation if any abnormality observed

1. Skin excoriation due to leakage problems
2. Stoma prolapsed due to weakened abdominal muscles in older age.  To prevent that avoid carrying heavy things during early stage after operation and seek treatment for prolonged cough which exert pressure onto the abdominal muscles
3. Hernia due to weakened abdominal muscles in older age.  To prevent that avoid carrying heavy things during early stage after operation and seek treatment for prolonged cough which exert pressure onto the abdominal muscles

Yes, you need to empty the bag first and tug in the stoma bag before swimming.  Make sure that the skin barrier still has reasonably good adhesiveness.

Bleeding can occur when we wipe too hard on the stoma, or the cotton is too dry. Granuloma – a small, raised tissue surrounding the stoma also bleed easily.  If the bleeding is at the stoma surface, you can use a cotton to apply pressure on the bleeding point, and it will stop within seconds.  Sometimes the bleeding comes from interior of the intestine, which is more than 10ml, then you need to consult the doctor.

Stoma is full of small blood vessels, so it bleeds easily although it stops quite fast too, try avoid usage of dry cotton or gauze to wipe the stoma.  Do not rub too hard on the stoma to avoid bleeding.  Clean the skin surrounding the stoma thoroughly to avoid residues of fecal matter stays on the skin which can cause skin soreness (excoriation).  Keep fingernails short to avoid injury to the stoma and use gloves.

You can use normal water from the tap or filter.  During cold days you can use warm water otherwise just go with your own preference.

Empty the stoma bag when it’s one third full, For 1 pc system, you can flush in some water to clean the stoma and bag, after that just wipe dry the bag and the tail end before fastening it back.  For 2 pc system, it is easier to maintain hygiene – just remove the stoma bag from the skin barrier, use moisten cotton or wet wipes to clean the stoma and surrounding area at the skin barrier.  Replace a clean bag before bringing the soiled bag to wash in the toilet, 2 pc system bag is reusable for 5-7 days.  Observe for any change in color, healthy stoma is red, shiny and moist.  Consult doctor if the stoma changes to purple or blue color, also if the stoma becomes longer (prolapsed).

All stoma appliances (1 pc or 2 pc system) have a skin barrier which is made of hydrocolloid which not only provide the adhesive but it also protects the skin from contacting the feces which may cause skin excoriation.  Hydrocolloid skin barrier is also a material that heals the skin. 

Stoma bag acts as a temporary collection device which allows the users to go on with their daily activities and work.  The odor proof material and carbon filter allow the users to be able to socialize with others confidently

1 pc system stoma bag normally needs changes 3-4 day once

2 pc system stoma wafer and bag users normally change 4-5 days once

For new users, it may take about 45mins to 1 hour.  After 2-3 weeks, when you are more familiar with the procedure it will only take about 20-30 minutes

You may not need to use the accessories, the Stoma Nurse will show you what you need and how to use them effectively.

Stoma Nurse will assess the stoma and surrounding skin before recommending suitable types of stoma appliances.  He/she will inform you of the type and size that you are using, it could be 1 pc system or 2 pc system and the accessories that you may need.  Besides, you also need to prepare cotton, gauze, bowl of water, wet wipes (optional), dry tissue, scissors, marker pen, bed liner and clinical waste or plastic bag. Please be reminded that the stoma size will shrink during the first 2-3 months after operation, you need to measure the size and shape of stoma each changes and cut the skin barrier according to the stoma size to prevent skin excoriation due to contact with fecal matter.

For patients after stoma surgery, the nurse in the ward will help to empty and change the stoma bag during the first 2-3 days.  Each time the nurse empties the bag, she will explain how to do it so that you have an idea how to do it yourself when you feel better on 3 or 4^th day.  Before discharge, the nurse will demonstrate to you and caregiver the full procedure from removal of the soiled bag, cleansing the stoma plus surrounding skin to applying a new bag with skin protective accessories.  Normally you will be given an appointment to see the Stoma Nurse during the next change and you or caregiver will be expected to change it under supervision.

Proper stoma care helps to protect users from accidental leakage, skin soreness (excoriation) and infection.   A well applied stoma bag gives users the confidence to socialize, resuming work and activities like before.  It also reduces wastage and unnecessary embarrassment if it’s done properly.

Function of the stoma is to divert feces or urine for elimination in a new location on the abdomen which is collected into a stoma bag.  Stoma care involves several times in a day emptying the bag, cleansing the stoma plus surrounding skin to maintain hygiene, protect the skin and prevent infection.  Stoma care also includes selecting the appropriate stoma appliances and accessories, removing and reapplying a new set of stoma appliances 4-5 days once.

There are 3 common types of stomas:

Ileostomy – stoma created at small intestine (ileum)

Colostomy – stoma created at large intestine (colon)

Urostomy – stoma created to divert urine after bladder removal

A stoma is an opening on the abdomen that can be connected to either your digestive or urinary system to allow waste (urine or feces) to be diverted out of your body. It looks like a small, pinkish, circular piece of flesh that is sewn to your body (Bladder and Bowel Community).

Stage 4 colorectal cancer means the cancer has spread (metastasis) to other organs; commonly to                                             Liver and lungs

Major factors that increase the risk include age over 50, a family history of CRC or polyps, and lifestyle factors like a diet high in processed meats, obesity, physical inactivity, and smoking. Chronic inflammatory bowel diseases also raise the risk.

The "Four Pillars" of colorectal cancer treatment generally refer to the main modalities used: Surgery, Chemotherapy, Radiation Therapy (especially for rectal cancer), and Targeted Therapy/Immunotherapy.

Colorectal cancer is staged from I to IV, where Stage I and II is localized to the bowel, Stage III involves nearby lymph nodes, and Stage IV indicates the cancer has metastasized to distant organs.

Colorectal cancer typically progresses slowly, often taking around 5 to 10 years for small precancerous polyps to develop into invasive cancer, which is why screening is so effective. Once invasive, the rate of progression varies significantly by stage and biological subtype.

A critical symptom to report immediately is any change in bowel habits that lasts more than 2 weeks such as new-onset constipation, diarrhoea, or rectal bleeding or blood in the stool. These can be early signs of colorectal cancer.

the strongest risk factor are strong family history and inherited genetic syndrome like Familial Adenomatous Polyposis (FAP) or Lynch Syndrome

Major factors that increase the risk include age over 50, a family history of CRC or polyps, and lifestyle factors like a diet high in processed meats, obesity, physical inactivity, and smoking. Chronic inflammatory bowel diseases also raise the risk.

The number one food component to limit to reduce colon cancer risk is processed meats (like sausage, bacon, and hot dogs), as high intake of these and red meat is strongly linked to an increased risk

Colorectal cancer cells are killed by various treatments, including surgery (removing the tumour), chemotherapy (chemical agents), radiation therapy (high-energy beams), and targeted therapies (drugs that exploit specific weaknesses in the cancer cells)

Chemotherapy is stopped when a patient completes the planned treatment cycles, if the cancer progresses despite treatment, or if the side effects become unmanageable and outweigh the benefits. The decision is highly personalized and made in consultation with the oncology team.

For early-stage (I-III) colorectal cancer, the first line of treatment is typically surgery to remove the tumour and surrounding lymph nodes, sometimes followed by chemotherapy for higher-risk cases.

For rectal cancer, sometimes chemotherapy and radiotherapy is given prior to surgery ( neoadjuvant therapy)

The primary way to stop colon cancer from spreading (metastasizing) is through curative-intent treatment, which involves surgical removal of the tumour often followed by chemotherapy to eliminate microscopic cancer cells.

The latest treatments often involve precision medicine, using targeted therapies and for tumours with specific genetic markers.  Advances in minimally invasive surgery, like laparoscopic and robotic surgery, are also continually improving recovery and patient outcomes.

   There is no single "miracle" treatment for colon cancer; instead, a personalized approach combining    surgery, chemotherapy, radiation, and targeted therapy offers the best cure for colon cancer

No. Colorectal cancers are only categorised according to the TNM classification of 4 stages. These stages depend on the size of the tumour and any other nearby organs involved, the presence of cancer cells in the lymph nodes or whether the tumour has spread to other distant organs.

No food can help prevent colon cancer but there are foods that can help reduce the risk of developing colon cancer. These include food with a high fibre content and dairy products.

The 3-2-1 rule refers to the Amsterdam II criteria for identifying families with a high risk of hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome. The rule is a mnemonic for the three criteria that must all be met: three or more relatives with Lynch syndrome-related cancers (like colorectal or endometrial), two successive generations with affected family members, and at least one relative diagnosed before age 50. 

Eating well with a healthy diet, regular exercise, stop smoking and getting yourself screened regularly.

Only about 10-30% of colorectal cancer patients have a family history of colorectal cancer

Survival depends on the stage of the cancer and how quickly it is treated. Patients who have early stage tumours can have a normal lifespan. However, patients with tumours that present later or has spread to other organs generally have a lower rate of survival ranging from a few months to a few years.

Cancer don’t happen overnight. They take many months or years to develop. The rate of cancer growth depends on the tumour biology and the individual.

Yes, colorectal cancer can be cured if detected early.

The rectum is the continuation of the colon and together there are known as the lower gastrointestinal tract. Cancers can develop anywhere along this tract. However, treatment strategies such as the method of surgery or the use of radiotherapy may differ depending on the location of the tumour.

Yes, colorectal cancer can be cured if detected early.

Unhealthy dietary habits including high consumption of processed food, high fat content, red meat, reduced fibre intake, smoking and a leading a sedentary life with inadequate physical exercise can all contribute to the formation of colorectal cancer.

Leading a healthy lifestyle reduces the risk of cancer. However, early screening with regular stool tests or a colonoscopy is the only way to avoid getting colon cancer by detecting pre-cancerous growth early.

Yes. Like any other cancer, the earlier detected and treated, the better the chance for cure.

Colon cancer can present in many ways. Some symptoms are more alarming than others including rectal bleeding, abdominal pain and abdominal belatedness. However, patients can also have subtle changes in their bowel habits which they must not ignore.

There is no one main cause of colorectal cancer. No one really knows the exact cause but doctors and researchers believe it is a combination of environmental, dietary, lifestyle and genetic factors.

There are many “recommended diets” or dietary practices on the Internet,
such as the ketogenic diet, Atkins diet, Alkaline diet, and intermittent fasting.
Some diets are “recommended” for weight loss or blood sugar control.
However, it is not recommended for cancer patients to engage in any dietary
plan without consulting with a dietitian. These diets often lack specific food
groups that may lead to malnutrition in the long term. Currently, there is no
scientific evidence that an alternative diet can cure cancer.

Generally, there’s no specific diet plan just for cancer survivors. It will be a
balanced diet with complete nutrition and good physical activity. However,
dietary adjustments can be made based on different conditions which require
further assessment and intervention by a dietitian.

Added sugar should be limited to 10% of total daily energy intake as excessive
sugar leads to weight gain and possible other non-communicable diseases
such as diabetes. Hence, it should be enjoyed in a controllable amount.

Unauthorized supplements are generally not recommended, especially for
patients undergoing active chemotherapy treatment. Micronutrient
supplements such as multivitamins and minerals are only recommended
based on the patient’s needs and condition. Patients are advised to discuss
with an oncologist before any commencement of traditional medicine

Protein intake is generally important for preserving muscle mass, as muscle
wasting is one of the undesirable side effects of chemotherapy. Muscle
wasting leads to poor quality of life and increases the risk of falling. One hand
size of protein is recommended per meal, 2-3 meals per day.

Under the Malaysian Dietary Guideline, two servings of fruits and three
servings of vegetables are recommended daily to meet the requirements of
micronutrients (minerals and vitamins). However, patients with a stoma
should seek more detailed advice from a dietitian regarding the
recommended servings.

Xeloda is commonly known for its negative effects, such as causing nausea
and vomiting, which leads to impairing adequate oral intake. A similar
approach to managing nausea includes consuming small, frequent meals and
avoiding foods high in fat and strong in odour. Patients are also recommended
to separate solid and fluid intake.

Processed/canned foods are higher in sodium, and excessive sodium intake
may contribute to NCD such as hypertension.
Not to mention that some processed foods such as sausages and burger patties
are classified as Group 1 carcinogens by the World Health Organization (WHO),
which comes with strong evidence of increased risk of bowel and stomach
cancer.

Food intake generally doesn't significantly raise white blood cell counts as
they depend on the body's defense system; common dietary suggestions
include consuming fruits high in Vitamin C to improve immunity in general.

If the taste buds are affected, flavored water is suggested, such as fruit-infused
water and lemongrass/pandan-infused water. Cordial can be used minimally to
address the adverse taste.
Aside from that, spices and herbs can be used in cooking for flavor
enhancement.

An average adult requires 2.5L fluid intake daily for basic function.
Chemotherapy can be dehydrating for the body, hence is recommended to
take enough fluid daily.

Tips for increasing energy intake include pan frying to increase calories, adding
sesame oil for fragrance, or using unsalted margarine in cooking. Don’t forget
to include protein sources such as eggs, tofu, chicken, fish to increase the
nutrient value of the meal. Homemade gravy can be helpful to get the calories
in without changing the food volume as tolerated by patient.
Oral Nutrition Supplements can also be used in recipes for calorie-dense
food/drinks such as milkshakes and puddings. This can help patients who are
having trouble meeting an adequate volume of food intake but also assist in
meeting calories in smaller food amounts as tolerated.

Suggestions include using complete and balanced nutritional products
available in the current market to supplement additional calories and protein
intake, especially for patients struggling with adequate daily intake orally and
to help increase or maintain weight during treatment programs.

Maintaining a good diet and exercise regimen is essential for recovery from
cancer. Physical activity should not be hindered; many studies show active
patients have experienced fewer side effects of chemotherapy and a better
quality of life. The recommended guidelines are 150 minutes per week for
cardiovascular exercise and 2-3 days of strength training exercises.

CORUM Peer Support Groups provide platforms for patients to seek tips for
dietary management, information about stoma care, managing side effects of
chemo and radiotherapy, and encouraging participation in CORUM activities
to enhance bonding between survivors and caregivers.