What is cancer?
The tissues and organs of the body are made up of cells. Cells age and become damaged and need to repair and reproduce themselves continually. When this process gets out of control, the cells reproduce and multiply to form an abnormal mass (or tumour). Tumours can be benign (not cancerous) or malignant (cancer). A malignant tumour consists of cancer cells that can spread (metastasise) to other organs in the body. Doctors (pathologists) can tell whether a tumour is benign or malignant by examining a small sample (biopsy) of cells under a microscope.
Can bowel cancer be cured?
Cancer is a frightening word and many people immediately think it means they are going to die. It is important to remember that, if caught early enough, cancer can be cured. Even if the disease is not completely curable, surgery and modern treatments mean that it can be controlled, often for years. If you are a patient of the Colorectal Clinic, it is important to discuss your fears and worries with the doctors or specialist nurses. There are many people both in and outside Addenbrooke's who can help you through a difficult time.
What are the causes of bowel cancer?
Generally, bowel cancer develops in the colon or rectum. In most people, the cause of cancer of the bowel is still unknown, although there is some evidence to suggest it is linked with our diet. People who have a family history of bowel cancer have a slightly increased risk of developing the disease. In rare instances, cancer predisposition can be inherited genetically.
What treatment is available for bowel cancer?
Surgery is the main treatment for colon and rectal cancer, which is discussed on a separate webpage:
What is adjuvant therapy?
Some patients benefit from other treatments in addition to surgery, and this is referred to as adjuvant therapy. This might be in the form of either radiotherapy or chemotherapy. Adjuvant therapy is given when the cancer has been removed but the appearance under the microscope suggests that there is a chance that it might recur. Adjuvant therapy can improve the outcome.
All aspects of adjuvant therapy will be discussed in detail with you as soon as we have confirmation that you might benefit from it. This is usually about 10 days after your operation, when we have the histology result (microscope report on your cancer). If you require adjuvant therapy, you will be informed by letter or telephone shortly after discharge from hospital and will be sent an appointment to see an oncologist (cancer specialist). He or she will discuss in more detail with you the benefits of further treatment and the possible side effects of these therapies.
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Radiotherapy
Radiotherapy involves using invisible rays that destroy cancer cells, and is usually given to selected patients who have cancer of the rectum. It can be given before surgery or afterwards, depending on the circumstances. Radiotherapy itself is painless.
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Chemotherapy
Chemotherapy involves using drugs to attack the cancer, and is usually given in the form of an injection into the bloodstream; it is given over a period of months rather than weeks.
Both radiotherapy and chemotherapy are usually given as outpatient treatments.
Nowdays, neither radiotherapy nor chemotherapy causes many unpleasant side effects, and many people lead a normal life – for example they might feel able to go to work throughout the treatment.
Who are the colorectal specialist nurses?
The colorectal specialist nurses will be responsible for co-ordinating your care following any operations and/or treatment for bowel cancer. These nurses are highly qualified, having specialised training in caring for patients who have bowel disease, and many years of experience in this field. As well as supporting you and your family through your operation and treatment, the nurse will provide you with clear written and verbal information; the nurses can also examine you and arrange any tests you might need.
What kind of follow-up will I get after my operation?
It is our aim to improve the quality of services provided for the follow-up of bowel cancer; for this reason, there is a clinic dedicated to patients who have had bowel cancer, and this is run by the colorectal specialist nurses. The clinic has several advantages:
(1) You will see the same person each time you attend. You will see the colorectal specialist nurse while you are in hospital, before and after your surgery, and then in the clinic afterwards.
(2) You will be given a contact telephone number: if you have any worries or concerns regarding your operation or treatment, please ring this number for advice. If necessary, you can be seen urgently in the clinic; thus you have quick and easy access to the clinic.
(3) The nurses have direct access to the colorectal surgeons and their clinics should they need to consult with them about any aspect of your care and treatment.
You might not be given appointments for regular checkups in the surgical clinic after a bowel operation; however, we would like to reassure you that you will periodically receive appointments for X-rays or scans and colonoscopy. This is what we call surveillance, and it is co-ordinated by the colorectal specialist nurses. You will receive these appointments even if you are not visiting the clinic regularly, and may ring a nurse at any time if you are worried.
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