What is bowel cancer? back to top of page
Bowel (or colorectal) cancer is the development of a malignant growth in the large bowel or back passage. It occurs when the cells that line the bowel wall change in the way in which they divide.

Bowel cancer is the second most common cause of death from cancer in the UK. It can affect both men and women and every year around 36,000 people are diagnosed with bowel cancer in the UK.

Bowel cancer is one of the most curable forms of cancer if it is treated early.

Click here to view a diagram of the bowel and internal organs.

What do we do? back to top of page
The colorectal cancer service at Manchester Royal Infirmary treats between 120 and 150 patients with colorectal cancer each year.
The colorectal unit at the MRI is a recognised colorectal cancer unit.

Who are we? back to top of page
Key members of the team

What if I think I might have colorectal cancer? back to top of page
If you are worried that you might have colorectal cancer, you should go and see your family doctor (GP) as soon as possible.

However, the symptoms listed below are also found in other bowel disorders (e.g. irritable bowel syndrome, ulcerative colitis, Crohn's disease, diverticular disease and piles.)

• A recent or persistent change in your bowel habit (such as going to the toilet more frequently, or having looser stools, especially with rectal bleeding.)
  
  
• Bleeding from the back passage (bright or dark red blood on the toilet paper, in the toilet pan or mixed in with the stool.)
  
  
• Unexplained weight loss.
  
  
• Unexplained anaemia, (which sometimes takes the form of extreme tiredness or fatigue) and/or severe gut pain.
  
  
• You can feel a lump in your abdomen (tummy)
  
  
• Family history of colorectal cancer (someone in your immediate family such as your mother, father, brother or sister who has been diagnosed under the age of 45yrs with colorectal cancer, or when there is bowel cancer in several close members of the same family)

Inherited faulty genes

There are two rare genetic conditions in which people have a high risk of developing bowel cancer.  In Familial Adenomatous Polyposis (FAP), many benign tumours called polyps are found in the lining of the colon.  People with FAP have a high risk of developing bowel cancer. In another inherited genetic condition known as Hereditary Non-Polyposis Colon Cancer (HNPCC), bowel cancers develop at an early age, sometimes in more than one place in the bowel.

Only about 5% (5 in every 100) of bowel cancers are caused by an inherited faulty gene.

Experiencing one or a combination of these symptoms does not necessarily mean that you have colorectal cancer

The National Institute for Health and Clinical Excellence has produced information for the public about the guidelines for suspected cancers. The guidelines are for doctors, to help ensure that the patient is seen quickly if the doctor thinks he or she may have cancer. Information about the guidelines can be seen by clicking here

For information about tests you may have for anal problems click here

Referral criteria and contact procedures back to top of page
All urgent referrals should be faxed to the booking centre by the patient's GP on 0161 443 0632 using the urgent referral form.

If your family doctor (GP) is concerned that you may have colorectal cancer he/she will refer you to the hospital and you will be seen by a specialist in the outpatient department within two weeks, further tests will then be carried out.

Clinic days and times back to top of page

Cancer follow-up clinic,

M Parker, Colorectal Nurse Practitioner
Suite A, MRI

Miss K Telford, Suite A, MRI

Miss K Telford, Suite A, MRI

Treatment back to top of page
Treatment for colorectal cancer will depend on the type and extent of the bowel cancer. The treatment for bowel cancer is decided on an individual basis, so the treatment may not be the same for everyone. In some cases treatment such as radiotherapy (x Ray treatment) or chemotherapy (drug treatment) is given before surgery to help shrink the cancer.

Depending on the type and degree of bowel cancer treatment may include:

• Bowel resection (part of the bowel removed)
  
  
• TEMS procedure (Trans Anal Endoscopic Microsurgery) for early staged cancers that are found in the rectum (back passage)
  
  
• Palliative treatment for advanced colorectal cancer (relieving the symptoms without curing the cancer)

For information about different types of bowel surgery, produced by the Association of Coloproctology of Great Britain and Ireland, click below:

Abdomino-Perineal excision of the rectum
Treatment for bowel polyps
Left Hemicolectomy
Right Hemicolectomy
Anterior Resection of the Rectum

How treatment is planned

back to top of page

A team of specialists will discuss the treatment that is best.  This multidisciplinary team (MDT) will include:

• a surgeon who specialises in bowel cancers
• a medical oncologist (chemotherapy specialist)
• a clinical oncologist (radiotherapy and chemotherapy specialist)
• a radiologist (who analyses x-rays)
• a pathologist (who advises on the type and grade of the cancer, and how far it has spread)

The team may also include a:

• nurse specialist
• dietician
• physiotherapist
• occupational therapist
• psychologist or counsellor

Together, the MDT will be able to advise on the best course of action and plan of treatment, taking into account a number of factors.  These include your general health, age, the type and size of the tumour, and whether it has begun to spread.

Surgery is done at Manchester Royal Infirmary. Patients are admitted to ward 12 the colorectal ward. The ward is situated on the second floor next to ward 11. The telephone number for ward 12 is 0161 276 4053.

Following surgery some patients will need additional treatment, as sometimes surgery alone is not enough to treat the cancer. This additional treatment may be Radiotherapy (X Ray treatment) or chemotherapy (drug treatment).

Those patients, who may require additional treatment before or after surgery, will be seen by the Cancer specialist (Oncologist) in the outpatient department at the MRI. This clinic is held every two weeks. Treatment discussed at this clinic will be carried out at the Christie Hospital.

A lot of people with cancer worry that if they go to the Christie Hospital for treatment it means their cancer must be worse. This is not true. Many of the teams at Central Manchester work closely with the doctors at the Christie Hospital. This means that some people go to the Christie Hospital for treatment not because their cancer is worse but because that is where the doctors are based. All patients needing radiotherapy go to the Christie Hospital. This is because that is where the radiotherapy machines are.

Follow Up Treatment
Following discharge from hospital patients will be reviewed in the outpatient clinic within six to eight weeks. You will be seen by one of the surgical team. Following cancer treatment, patients continue to have investigations to monitor the cancer or to check that the cancer has not returned. (See above for clinic days and times).

Support for Patients
All patients who have treatment for bowel cancer at Manchester Royal Infirmary will be given a contact number for the colorectal nurse specialist.

The Palliative Care Team is also available to support patients and their families. Click here for more information about the Palliative Care Team.

Support contacts Back to top of page
The authors of this site do not endorse any particular groups, and anyone looking for a support group is advised to find out more about the group, including who runs it, what it offers and what its aims are.

Cancerbackup
3 Bath Place
Rivington Street
London
EC2A 3JR
www.cancerbackup.org.uk
Freephone helpline 0808 800 1234
Support and information for people affected by cancer, including over 50 booklets and 134 factsheets on cancer, treatment and living with cancer
Helpline staffed by nurse specialists

Macmillan Cancer Support
89 Albert Embankment
London
SE1 7EQ
Macmillan CancerLine freephone helpline 0808 808 2020
Textphone: 0808 808 0121
www.macmillan.org.uk
Support and information for people affected by cancer, including information on cancer support and care charities in the UK, and leaflets/booklets about different cancers and living with cancer. Also information about Macmillan services, from nursing to grants.
Link to Language Line to help callers in up to 150 languages.

NHS Direct
Telephone service: 0845 46 47
Textphone 0845 606 46 47
NHS Direct Online www.nhsdirect.nhs.uk

24 hour confidential nurse advice and health information telephone service with access to interpreters
Online information

Cancer Aid and Listening Line
Tel: 0845 123 23 29
Confidential helpline for people affected by cancer, run by trained volunteers with personal experience of cancer.
www.canceraid.co.uk

Beating Bowel Cancer
39 Crown Road
St. Margarets
Twickenham TW1 3EJ
Tel: 020 8892 5256
E-mail: info@beatingbowelcancer.org
Website: www.bowelcancer.org
Information and support from people who've had bowel cancer themselves. Leaflets about the symptoms of bowel cancer and about treatment for bowel cancer. Colorectal Nurse Specialist available to provide medical advice on Tuesdays 9.30am - 5.00pm, and Fridays 9.00am - 1.00pm on 020 8892 1331.

Bowel Cancer UK
7 Rickett Street
London SW6 1RU
Tel: 020 7381 9711
E-mail: advisory@bowelcanceruk.org.uk
Telephone: 08708 50 60 50
Website: www.bowelcanceruk.org.uk
Information and support for anyone who is worried about bowel cancer or who has been diagnosed with bowel cancer.
Confidential telephone advisory service staffed by trained staff including Specialist Nurses, available Monday to Friday 10.00 am - 4.00pm, answerphone at other times.

For more information about support for people affected by cancer please go to our support page via this link

Family History Clinic at St. Mary's Hospital back to top of page
Colorectal Cancer and Family History

If you have a strong family history of colorectal cancer in your family, that is if you have more that one immediate relative (mother, father, brother, sister, son or daughter) who has been diagnosed with colorectal cancer under the age of 45 years then you may have an increased risk of developing colorectal cancer yourself. If you are symptom free, you may be referred to the family history clinic at St Mary's Hospital where a detailed history of your family will be taken. An assessment will then made of your risk of developing colorectal cancer.

Click here for more information about the Family History Clinics at the Trust.

Useful links (click on the link to take you to the information)

Information about colorectal cancer produced by Cancer Research UK

Information about colorectal cancer produced by Cancerbackup

The Association of Coloproctology of Great Britain and Ireland

If you would like more information or have any questions about any aspect of cancer please e-mail your question by clicking here