Bowel cancer

Cancer of the colon and rectum (often referred to bowel cancer) is one of the most common cancers in the Western world. More than 40,000 people in the UK are diagnosed with bowel cancer every year.

Although the majority of bowel cancers can be successfully treated, getting a diagnosis can be a difficult and distressing process for some patients. At CRSC we’ll be at your side at every step of your journey.

Typical symptoms for bowel cancer include: 

• Persistent changes in bowel habits (loose stools, going to the toilet more or less often)
• Persistent tummy ache or bloating
• Rectal bleeding (blood passing when going to the toilet)

These symptoms are quite unspecific and may be caused by other, less troubling conditions. It’s also possible that you won’t experience any symptoms at all, especially during the early stages of a cancer.

In the UK, the NHS offers the Bowel Cancer Screening programme to all people aged between 50 and 75 (depending on location). People are contacted every two years to take a voluntary stool test (called a FIT test) which is a reliable way to detect even very small quantities of blood in the stool.

Those whose results are positive are invited to undergo a colonoscopy. While restricted by available resources, the purpose of this screening programme is to detect early cancers or cancer precursors (polyps), as the chances of a cure are highest in those stages.

The gold standard tool in bowel cancer diagnosis is a camera test (colonoscopy).

During this procedure, a flexible endoscope is inserted through the anus, allowing us to see the whole of the rectum and colon. If we detect any tumours, we’ll conduct a biopsy there and then. We’ll take tissue samples through the scope and we can also remove small tumours (polyps) at the same session, which saves both time and repeat procedures.

Alternatively, we can carry out a CT scan (computed tomography) or virtual colonoscopy, which allows us to reliably detect any tumours larger than 5mm. While this process is less invasive and easier for the patient, if something is detected, a colonoscopy for further inspection and biopsy will still be necessary.

If the results are positive for bowel cancer, we’ll carry out a further CT scan of the chest and abdomen in order to make sure it hasn’t spread, and correctly stage the tumour.

Should you need further tests, such as MRI scans (magnetic resonance imaging) or PET scans (positron emission tomography), we are able to carry these out to give you a quick diagnosis and a fast-track to onward treatment.

We do this by discussing each case at our regular multidisciplinary team (MDT) meetings. This is where specialists, including  oncologists, radiologists, surgeons and cancer nurse specialists bring their unique knowledge and skillsets to your particular case.

We’ll discuss the suggested plan with you, going through it to make sure it’s a strategy you’re comfortable with and that suits you best. In most cases, there’s not just one solution, but rather several possible ways we can proceed.

Typically, surgery will be the mainstay of your treatment. This can often be combined with chemotherapy or radiotherapy before or after surgery. In some rare situations, cancers can be so responsive to those treatments, that we can avoid surgery altogether.

Our standard approach to all cancer surgery is robotic surgery. You can find out more here on how robotic surgery works. We believe the unmatched precision this gives us, along with the image quality from the abdomen, has a positive impact on patient outcomes.

We’ve seen first-hand faster recoveries with minimal scarring and little to no pain after surgery.  In our personal experience, 87% of all cancer patients have a textbook outcome (no complication , complete removal of the tumour, less than 10 days in hospital, no conversion to open surgery, no mortality and no hospital readmission).

Click here to learn more about our outcomes. These are significantly higher than many published series using other methods. There is also an increasing body of evidence that robotic surgery is particularly advantageous for bowel cancer outcomes. 

Table of outcomes: Robotic vs laparoscopic surgery

Most of our patients stay in hospital for anywhere between 3 to 5 days. Occasionally, patients are discharged even earlier, but our priority is making sure you, and the people around you, are comfortable when you return home. If you experience any problems, we will keep you in the hospital until everything is fully resolved.

Once at home, you’ll continue with your recovery process. We encourage regular, light exercise, a healthy diet and appropriate pain management where necessary. We’ll stay in touch during this period to offer advice and check on your progress.

We’ll also go through the outcomes of the operation (your pathology results) with you in detail and discuss your case again at our MDT meeting to determine if you need any further adjuvant treatment (typically chemotherapy).

Over the longer term, we’ll stay in touch and see you at regular intervals for at least 5 years. This will include regular scans, camera tests (colonoscopy) and blood tests to make sure the cancer hasn’t returned.

As we said, every step of the way.