Bowel and Rectal cancer

This is a general term applied to cancers occurring anywhere within the colon (large bowel or intestine) or the rectum (back passage).

What to expect from your appointments with us

You have been referred to a specialist team because tests or symptoms suggest you may have colorectal (bowel) cancer.

This first appointment allows your care team to understand your situation, explain your diagnosis, and plan the next steps in your treatment and support.

This first appointment is an opportunity to meet your care team, understand your diagnosis, and discuss what happens next.

• We will discuss your medical history - The doctor or nurse will talk with you about your general health, symptoms, and any tests you have already had
• Physical Examination- The doctor may carry out a gentle examination of your abdomen and, if needed, a rectal examination. You’ll be given privacy, and everything will be explained beforehand.
• Review of Test Results - Any previous scans, colonoscopies, biopsies, or reports will be reviewed. If further information is needed, your team will arrange additional tests.

What to expect from your diagnostic tests and investigations

Bowel cancer is diagnosed following various tests. Your medical team may request some of the following tests and investigations:

• Examination of your rectum: this will be carried out by a doctor.
• Biopsy: A biopsy is a minor surgical procedure where a small part of your tissue is removed so that it can be examined under a microscope.
• CT Scan: Computerised tomography (CT) scans take pictures of your body to find out where the cancer is and whether it has spread to other parts of the body. Before having a CT scan, you’ll be given an injection containing a special dye, which helps improve the quality of the image.
• MRI Scan: Magnetic resonance imaging (MRI) uses magnetism and radio waves to create a cross sectional picture of the body. You will have an MRI scan to see if your cancer has spread.
• PET Scan: A positron emission tomography (PET) scan produces a detailed three dimensional image inside of the body.
• Ultrasound: An ultrasound scan is a procedure that uses high frequency sound waves to create a picture of the inside of your body. During the scan a small thin ultrasound probe is put in to your back passage
• Colonoscopy: A colonoscopy is a test doctors use to look inside your large intestine (colon) and rectum. A thin, flexible tube with a tiny camera on the end (called a colonoscope) is gently guided into your colon. The camera sends pictures to a screen so the medical professional can see clearly.
• Flexi-sigmoidoscopy: A flexible sigmoidoscopy is a test that lets doctors look at the lower part of your large intestine (called the sigmoid colon and rectum). It’s like a “mini‑colonoscopy” that focuses only on the last section of your bowel.
• CT Colonoscopy: A CT colonoscopy is a special type of scan that lets doctors look inside your large intestine (colon) without using a camera tube. Instead, it uses a CT scanner (a kind of advanced X‑ray machine) to take detailed pictures of your bowel.

Treatment options and what to expect

Your specialist team will advise which, if any, of the below are suitable for you:

Surgery- Surgery may be your primary treatment if you have a very small tumour; or may be used before or after other treatments.

Chemotherapy - If your cancer has spread to other parts of the body, chemotherapy can be used to help to control it and relieve symptoms

You may hear the chemotherapy treatment being described as SACT, which means systemic anti-cancer therapies. This is a treatment that work throughout the entire body.

Radiotherapy - You may have radiotherapy on its own if you cannot have chemo-radiotherapy as a combination.

Our Radiotherapy pages have more detailed information.

Contacts

Colorectal Clinical Nurse Specialist (CNS) Team – 0300 4225617