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: firstname.lastname@example.org 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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