you've gotten some great advice here. All i wanna throw out there is my kpouch situation.
i truly feel it's a really good option that doesn't often get brought up by surgeons, so i'm taking it upon myself to be a kpouch cheerleader.
Cuca, at age 25 i learned i had stage III rectal cancer, and after doing chemo and radiation, they told me the tumor was too low in the rectum, and they wouldn't be able to save the sphincter muscle.
as you'll see if you search my past posts...i was pretty devastated at this news.
i really felt hopeless. BUT i researched alot, and finally settled on having a Kock pouch.
you have to be seen by a doc who really specializes in em (i like to refer people to the amazing Dr. Fazio at Cleveland Clinic. An absolutey FANTASTIC place for this stuff...and a very good place for a second opinion).
And they can determine if you're a good candidate of the surgery.
so please, read some of my past posts, especially things like the pictures i've posted (to give your fiance an idea that it's not as horrid and offensive as it may seem...like my comparison shot here: http://www.cancer-sucks.com/rebecca/sto ... 20shot.jpg
just know that there are options out there, and to make sure he is as informed and educated as he can be going into this decision, since it is such a life altering surgery.
but as others have said...compared to the alternative (cancer is not gonna spontaneously go away. as much as we wish and wish it would), a colostomy doesn't have to be the end of the world.
the uoaa board is an excellent resource (although, i must admit, when i was looking into all this, it was a bit intimidating to me at first. and overwhelming reading about all these people. but the people on those message boards, many of whom i've met in person, have become an infallible resource for me now)
also, try the j-pouch.org board. they have a kpouch section of it now, you can get a better idea of how it works, etc.
good luck, and please do keep us updated. feel free to PM me if you have any questions i didn't address...