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					All treatment options will be discussed fully         WHO ARE WE?
with you and, with your permission, the people
important to you, before any decisions are made.      We are consultant general surgeons who specialise in
                                                      bowel (colorectal) disorders. We are therefore experts
7. WHAT ARE THE CHANCES OF CURE?                      in the surgical and non-surgical treatment of bowel
                                                      diseases. These include piles, fissures, colitis, Crohns
Appropriate surgery offers the best chance of cure    Disease, Diverticular Disease, IBS and bowel cancer.
possibly combined with chemothrerapy and                                                                              Mr Mike Robinson DM, FRCS
radiotherapy. The earlier the cancer is detected      WHEN AND WHERE DO WE CONSULT?                                   Mr Charles Maxwell-Armstrong DM, FRCS
and treated then the more likely the cure. In early                                                                   Mr Julian Williams MD, FRCS
cancers the cure rate is greater then 90%, in         We see patients every:
cancers at a more advanced stage then the chances
of cure may be less than 50%.                         • Monday evening 6pm – 9pm                                      INFORMATION SHEET 21
                                                        at: Nottingham The Nuffield Hospital
8. WILL I NEED TO BE SEEN AGAIN?                        tel: 0115 920 9209
                                                                                                                      RECTAL
You will be checked on a regular basis following
your treatment. This will usually include visits to
                                                      • Tuesday & Thursday evenings 6pm – 9pm
                                                        at: The Park Hospital, Arnold, Nottingham                     CANCER
                                                        tel: 0115 9670670
the clinic (usually once a year), a CT scan (a year
after your operation) and a colonoscopy every 3 to                                                                    QUESTIONS & ANSWERS
                                                         contact: Jane Islip, Colo-Care secretary
5 years. This follow up programme will be tailored
                                                         at: BMI The Park Hospital
to you own particular circumstances.
                                                         direct line tel: 0115 9662122
                                                         email: jislip@bmihealthcare.co.uk
9. CAN I FIND OUT MORE?                                                                                          other colo-care information sheets:
                                                                                                                 1.  anorectal bleeding                    14. hernias
                                                                                                                 2.  anal abscess and fistula              15. instructions to patients
                                                         For more information, visit our website at:             3. anal fissure                               following haemorrhoidectomy
Further information can be obtained from;                www.colo-care.com                                       4. banding of piles                       16. irritable bowel syndrome
                                                                                                                                                           17. laparoscopic colorectal surgey
Cancer Research UK at www.cancerresearchuk.org                                                                   5. colon cancer
                                                                                                                 6. colonoscopy & flexible sigmoidoscopy   18. lumps and bumps

CancerBACUP, a cancer information and support                                                                    7. constipation                           19. pilonidal sinus

                                                                                                                 8. crohn’s disease                        20. pruritis ani
service on 0800 800 1234 or at                                                                                   9. diarrhoea
                                                                                                                                                           21. rectal cancer

www.cancerbacup.org.uk                                                                                           10. diverticular disease
                                                                                                                                                           22. rectal prolapse
                                                                                                                                                           23. sacral nerve stimulation
                                                                                                                 11. faecal incontinence
The Association of Coloproctology of Great Britain                                                               12. haemorrhoids                          24. screening for bowel cancer
                                                                                                                                                           25. ulcerative colitis
and Ireland at www.acpgbi.org.uk                                                                                 13. having a barium enema
1. WHAT IS RECTAL CANCER?                              4. HOW CAN IT BE TREATED?                             6. ARE THERE ANY OTHER FORMS OF
                                                                                                             TREATMENT?
Colorectal cancer is the third most common cancer      The best chance of curing rectal cancer is with an
in men and the second most common cancer in            operation which aims to remove the segment of         Radiotherapy. Some rectal cancers respond to a
women in the UK. The cells that line the rectum        rectum with the cancer in it along with the blood     course of radiotherapy before surgery. This may
may become damaged such that they begin to             supply and lymph nodes (glands) that supply it.       make surgery easier and possibly prevent the
divide in an uncontrolled way. This may lead to        The type of operation will depend on the location     cancer coming back at the same place. If
the formation of a polyp or eventually a cancer.       of the cancer. Anterior resection involves removing   radiotherapy is recommended then you will be
                                                       the upper rectum and some of the colon on the left    able to discuss it further with a specialist in this
2. WHAT ARE THE SYMPTOMS?                              of the body and joining the colon back up to the      field (oncologist). Chemotherapy. Once you have
                                                       rectum so that the bowel functions normally.          recovered form your surgery and the cancer has
Common symptoms include:                               Abdominoperineal resection (APR) If the cancer is     been thoroughly examined by the pathologist it
• Bleeding from the back passage                       very low in the rectum then it is not possible to     may be appropriate to recommend a course of
• A change in the frequency of bowel activity          remove the cancer without damaging the muscles        chemotherapy. This will depend upon your general
• The passage of mucus or slime                        which control the bowel (sphincters). This would      state of health and the stage of the disease. The
• Weight loss and poor appetite                        lead to faecal incontinence. In such circumstances    stage of disease gives an indication as to whether
However these symptoms are very common and             it is better to remove the rectum and anus and        the cancer has spread to other organs (usually the
are usually NOT due to rectal cancer.                  form a colostomy, or artificial opening of the        glands close to the bowel, the liver or lungs). The
                                                       colon on to the abdominal wall.These are the          stage of disease is assessed by a combination of
3. HOW IS THE DIAGNOSIS MADE?                          commonest types of operations but there are           the tests that you had before your operation
                                                       others which may be discussed and can be fully        (CT,MRI) and the pathologist’ opinion when the
To make a diagnosis of rectal cancer it is essential   explained by your surgeon.                            cancer is examined under the microscope. If
to examine the colon and rectum either with a                                                                chemotherapy is recommended then you will be
flexible telescope (flexible sigmoidoscope or          5. IS A STOMA NECESSARY?                              able to discuss it further with a specialist in this
colonoscope) or a special Xray called a barium                                                               field (oncologist). Liver surgery If the cancer has
enema. During colonoscopy a tiny portion of            A stoma (colostomy, ileostomy), or artificial         spread to the liver it may still be possible to
tissue (biopsy) is taken from the cancer for           opening of the colon on to the abdominal wall is      attempt to cure the cancer by removing a segment
laboratory examination. In addition a CT scan will     NOT always necessary in these operations.             of the liver at an operation. If this is
be arranged to examine the lungs and liver to          Sometimes it is necessary to have a temporary         recommended then you will be able to discuss it
check that the cancer has not spread. A MRI scan       stoma (for 3 months or so) to allow the bowel join    further with a specialist in this field (hepatobiliary
may also be required to help plan the most             to heal. The possibility of requiring a stoma will    surgeon).
appropriate course of treatment.                       be discussed with you and if it isrequired then you
                                                       will get all the support that you need.

				
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posted:10/11/2011
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