Colorectal cancer

Your doctor may need to do a series of tests to find out more about your cancer. You may need to undergo one or more of the following investigations.

Colonoscopy

This is a test which allows the doctor to assess the lining of the large bowel.

The following scans also build up a picture of the inside of your body by taking a series of images:

• CT (computerised tomography) scan
• MRI (magnetic resonance imaging) scan
• PET scan (positron emission tomography)

Blood tests

The specific blood test for bowel cancer is called CEA (tumour marker).

It may take up to a couple of weeks to complete these investigations. Should you have any concerns during this time, please contact your clinical nurse specialist.

Further information about all cancer investigations can be found on the Macmillan or Bowel Cancer UK websites.

The colorectal and anal cancer team at Barts Health have regular multi-disciplinary team meetings (MDTs). This is where a group of health professionals with expert knowledge manage your investigations and treatment.

You do not attend the meeting but a member of the cancer team, usually your specialist nurse, will tell you about the results of the meeting. You may be given a choice of treatment options, which your specialist will discuss with you. If you don't understand what you've been told, let the staff know so they can explain it to you again.

Before you have any treatment, you will need to give permission (consent). Further information about types of treatment used for treating colorectal anal cancer is available on the Macmillan or Bowel Cancer UK websites.

Surgical colorectal cancer clinics for patients at The Royal London and Newham hopsitals take place on Tuesday mornings at The Royal London. Surgical colorectal clinics for patients at Whipps Cross take place on alternate Monday and Tuesday mornings and occassionally on Tuesday and Thursday afternoons.

Medical oncology clinics are held at St Bartholomew’s Hospital every Monday (all day), Tuesday afternoon for follow-up clinics and Wednesday afternoons for new patients. Clinical oncology clinics are held at St Bartholomew's Hospital every Monday morning for new patients and every Thursday for follow-up clinics.

You will see your specialist doctor in the clinic after the multidisciplinary team has met. Your doctor might talk to you about your diagnosis and treatment plan and you can also talk to them about any concerns you may have.

It may be a good idea to take someone with you to your clinic appointment. You may also find it useful to have a list of questions ready to make sure you get the information you need.

The colorectal and anal cancer team at Barts Health include the following staff:

Colorectal surgeon

Specialist doctor who is trained in operating on colorectal and anal cancers.

Medical oncologist

Doctor trained in diagnosing and treating cancer patients with chemotherapy.

Clinical oncologist

Doctor trained in diagnosing and treating cancer patients with radiotherapy.

Consultant radiologist

A doctor who is expert in interpreting X-rays and scans. They may also perform biopsies (taking tissue samples) with the aid of imaging techniques.

Consultant pathologist

A doctor who looks at tissue samples under a microscope to search for cancer cells.

Clinical nurse specialist (CNS)

An experienced nurse who acts as your key worker. They will give you advice and support as you go through investigations and treatment and support you through your care pathway.

Member of the palliative care team

The palliative care team specialises in relieving pain and other symptoms, including psychological difficulties caused by cancer.

Multi-disciplinary team co-ordinator

The co-ordinator provides administrative support to the colorectal and anal cancer team and aims to ease the pathway from referral to treatment.

The colorectal and anal cancer team are a group of experts, and will work with you to conduct and provide the best care plan possible.

If you have any concerns, please talk to the team who will be considerate of your decisions and wishes.

Referral information 

Sources of referrals to the colorectal and anal cancer teams are as follows:

• The two week wait pathway from the GP
• The national bowel cancer screening programme
• Inpatient referrals via the MDT co-ordinator
• Tertiary referrals from other NHS trusts