Your treatment

• Specialist Colorectal Cancer surgeons, trained to perform operations to manage cancer
• Specialist Oncologists, (cancer doctors), trained to prescribe therapies such as chemotherapy and radiotherapy
• Clinical Nurse Specialist, (CNS), specialist trained nurses will have a key role in coordinating your care with different members of the multidisciplinary team to ensure you have the guidance and support you require.
• Radiologists, who will have special expertise interpreting scans in relation to bowel, rectal and anal cancers
• Histopathologist, a specialist doctor who analyses tissue under the microscope
• Multi-disciplinary team coordinators, who ensures your care pathway is smooth and timely.

Surgery to treat colorectal cancer aims to remove the tumour, as well as part of the colon or rectum that it may be attached to.

The extent of your surgery will depend on which part of your bowel is affected and how far your cancer has spread. If you have surgery for colorectal cancer, you may need to have a stoma.

A stoma is an opening in the stomach that’s connected to the digestive system. It allows poo and other waste to leave your body and into a pouch. A stoma may be temporary or permanent, depending on the surgery you’ve had.

Our clinical nurse specialists will support you after your surgery and teach you how to manage your stoma and adapt to changes in your bowel habit.

If you’re diagnosed with colorectal cancer, you may receive chemotherapy to kill cancer cells and reduce the risk of the cancer coming back.

Radiotherapy uses high-energy rays (radiation) to treat cancer. Our experts use specialist machines to precisely deliver high-energy x-ray radiation to colorectal tumours to destroy cancer cells and stop them from spreading.

Radiotherapy may be used:

• Before surgery to shrink the cancer and increase the chances of complete removal.
• Instead of surgery to cure or stop the spread of early-stage cancer, if you cannot have surgery.
• As palliative radiotherapy to control symptoms and slow the spread of cancer in advanced cases.

Targeted medicines kill cancer cells.

Immunotherapy is where medicines are used to help your immune system kill cancer.

Targeted medicines or immunotherapy are sometimes used to treat advanced bowel cancer that has spread to other parts of the body.

Clinical trials are a type of medical research involving people. They can include people with different illnesses and conditions. Or sometimes, they include healthy people who volunteer. Trials are done in all areas of medicine. Cancer clinical trials only involve people affected by cancer.

This type of research is important because it shows which treatments are most effective and safe. This helps healthcare teams plan the best treatment for the people they care for.

Some patients may require specialist treatment and may be referred to another NHS organisation.

If you’ve been diagnosed with advanced bowel cancer, it may be hard to treat and not possible to cure. The aim of treatment will be to slow down the growth and spread of the cancer, to help with the symptoms, and help you live longer.

Finding out cancer cannot be cured can be very hard news to take in.

You’ll be referred to a team of doctors and nurses called a palliative care team.

They will help you to manage your symptoms and make you feel more comfortable.

The palliative care team can also help you and your loved ones get any other support you need.

Following completion of treatment, you will usually meet your consultant and specialist nurse.

This may be an in-person appointment at the hospital or a phone call. The team will explain what your follow up will look like.

Patients are usually then followed up for 3 to 5 years after completing their treatment. This may involve some phone call appointments or face to face appointments at the hospital.

Tests during follow up

After you have finished your treatment, you need to have 3 main tests over 5 years.

• A blood test to check your carcinoembryonic antigen (CEA) levels. CEA is a type of protein in the body. Some colorectal cancers produce CEA.
• A colonoscopy to check the inside of your bowel. You do not need this test if all of your large bowel has been removed.
• A CT scan to create detailed pictures of the inside of the body.

Test results

You get your test results in a letter through the post if everything is normal. If there are any concerns, your colorectal care team will phone you.

The effects of treatment, such as surgery or radiotherapy, can sometimes make it difficult for us to read the results. We might ask you to come back to the hospital to have more tests or scans. If this happens, we will phone you.

It’s important to make sure we have your correct address and telephone number.

If you do not get your results 4 weeks after having your tests, please call the colorectal clinical nurse specialist (CNS) helpline.