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Colorectal Cancer

What we do

Planning your care

The Colorectal Multi-disciplinary team (MDT) is made up of healthcare professionals that specialise in the treatment and management of cancer of the large bowel (colon) and the rectum.

The Colorectal MDT includes;

¢ five Colorectal Surgeons,

¢ a Medical Oncologist (chemotherapy doctor),

¢ a Clinical Oncologist (radiotherapy doctor),

¢ Radiologists (x-ray specialist doctors),

¢ Histopathologists (cell specialist doctors)

¢ a Gastroenterologist (a Doctor that specializes in diseases of the digestive system and Colonoscopy Bowel Cancer Screening),

¢ three Colorectal Nurse Specialists,

¢ Bowel Cancer Screening Practitioners and

¢ Research nurses

The Colorectal MDT meets every week on a Monday morning.

It is the role of the MDT to review each person's individual bowel cancer and make decisions about the most appropriate treatment, based upon, up-to-date research evidence and best possible outcomes.

You will receive a clinic appointment shortly after your MDT review date in order that you can discuss your treatment plan and options with your colorectal specialist surgeon and nurse specialist. They will support you and your family in making decisions about your care and management. It is often sensible to write down any questions or concerns that you have before your appointment to make sure that these can be addressed face to face. You will be offered a written summary of your treatment plan that you can refer to in the future and your Nurse Specialist will also be available to contact at any time should you have any further queries or need any more information or support.


 Support “ Colorectal and Stoma care Clinical Nurse Specialists

At the beginning of your cancer pathway, you will be introduced to a Colorectal Clinical Nurse Specialist who you will be able to contact directly for support and advice throughout your treatment and beyond.

At Bradford hospitals there are three Colorectal Nurse Specialists who will be involved in your care and can support you and your family by:

  • Keeping you informed of developments in your treatment,
  • Co-ordinating your care and appointments,
  • Explaining treatment options, supporting you in making decisions about your treatment and answering any questions you may have,
  • Being available to listen to what is important to you and work to ensure this is central to your care,
  • Liaising with other healthcare professionals, agencies and your consultant on your behalf to support you and your family in the best way possible
  • Practical support and advice regarding symptoms and side effects of treatment. A weekly stoma clinic is also available.

 Contact Us

You can contact the Colorectal Nurse Specialists;

Donna Kellett “ Lead Colorectal Clinical Nurse Specialist

Samantha Barker “ Colorectal and Stoma care Clinical Nurse Specialist

Nicola Edwards - Colorectal and Stoma care Clinical Nurse Specialist

Colorectal and Stomacare Nursing Department

Extension Block

St. Luke's Hospital

Bradford Teaching Hospitals NHS Foundation Trust

BD5 0NA

Tel: 01274 365554

If no-one is available to take your call, please leave a message with your name and contact details. The messages are checked daily and your call will be returned.


Feedback, complaints and compliments

Please contact the Colorectal Nurse specialists as above.


Referral Pathways

You may have been initially referred to the hospital to see a Colorectal Specialist by your G.P as you had noticed changes to your bowel habit or symptoms that were of some concern.

If you are over the age of 60 you will be eligible to partake in the National Bowel Screening Programme. The bowel screening programme invites you to send a small sample of stool discretely for a specific test looking for hidden blood in your stool (Faecal Occult Blood test). This can be an early sign of a bowel cancer however is often not seen and therefore can be missed. A positive test result will prompt you to be invited for a further more in-depth camera investigation of your large bowel, a Colonoscopy, following which you will be referred to the hospital to meet with a Colorectal specialist.


First Appointment

After seeing the G.P you will have been referred to either a ˜Fast Track' clinic or the Consultant Colorectal Clinic dependent upon your specific symptoms.

At the Fast Track clinic you will be met by a colorectal specialist who will discuss with you your symptoms and take a medical history from you. It is advisable to allow a couple of hours for this appointment.

A full examination will also be performed at this appointment. This will involve the colorectal specialist performing both an abdominal (tummy) examination and a digital (finger) examination of your back passage. A short camera examination of your back passage and rectum may also be performed (flexible sigmoidoscopy). You will not need to prepare for this appointment before you arrive, however an enema is given before the camera test to empty the lower part of the large bowel and rectum and ensure the lining of the bowel can be clearly seen. We understand that these investigations are very personal and can cause embarrassment however every effort is taken to make sure you are made to feel as comfortable as possible and that your dignity is maintained throughout.

At the consultant clinic appointment, the colorectal specialist will discuss with you your symptoms and examine both your abdomen (tummy) and back passage. Following this they may recommend further tests to help make a diagnosis. This will mean additional outpatient appointments at the hospital. If a cancer of the bowel is suspected, the tests will be requested on a fast-track basis to ensure they occur rapidly, so as to enable a quick diagnosis. Your colorectal specialist will explain which tests they feel will provide the information necessary to make a diagnosis and the reason behind them to help you make an informed choice about your treatment.

You may be advised to have one or more of the following tests:

¢ Colonoscopy “ a thin fibre optic tube with a camera on the end is inserted into the back passage and passed through the large bowel. It enables the doctor to see the inner lining of the large bowel and rectum and take samples (biopsies) of abnormal areas.

¢ Flexible Sigmoidoscopy “ similar to a colonoscopy, however the whole bowel is not viewed, only the left side (the section directly before your rectum and back passage).

¢ Scans“ are important as they provide information about abnormalities inside the body that are otherwise not seen. There are several different types of scans that provide detailed images of the inside of your body and your organs i.e. CT scans, MRI scans, PET scans and Ultrasound.

Not all of the different types of scans available may be needed to get the information needed, one may suffice. Similarly some scans may not be appropriate due to co-existing conditions.

¢ CT Colonoscopy “ in certain circumstances it is desirable to view the inner lining of the bowel, but it is felt that insertion of the Colonoscope (fibre optic camera tube) would cause too much distress or carry too high a risk for it to be justified. In such circumstances the inner lining of the bowel can be visualised using specialised CT imaging.

¢ CEA blood test “ this is a simple blood test that measures levels of a specific protein called carcinoembryonic antigen (CEA). It is not used to diagnose a colorectal cancer but can help to monitor disease.

Waiting for results can be an anxious and worrying time. You will be advised of when the results will be available you will be given an appointment to see your specialist again to discuss them and your treatment options. It is recommended that you bring someone with you to this appointment.


 Medication

Please bring an up to date list of your current medications with you to your clinic appointments and advise the team of any allergies you may have.


Translators and Interpreters

The hospital has an interpreting service and can arrange an interpreter to be present at your appointment if you wish.

Cancellations

If you are unable to attend your appointment please contact the Colorectal secretaries as soon as possible to reschedule a new appointment.

Colorectal secretaries: (01274) 386819 / 382046 / 383122


Location

Colorectal outpatient appointments are held both in the Horton Wing Outpatients Department at St. Luke's Hospital and at the Bradford Royal Infirmary. You will be informed of where your appointment is.

 Further contacts “ links

¢ Bradford and Airedale Cancer Support Centre

Provides help with practical issues like information, transport and welfare rights advice. Also provides emotional support by offering counselling, complementary therapies and a range of classes, courses and support groups.

You can contact the centre direct without going through a healthcare professional; all of the services are free to access.

Contact: Daisy House Farm, 44 Smith Lane,

Bradford, BD9 6DA

Tel: 01274 77 66 88

¢ Beating Bowel Cancer “ www.beatingbowelcancer.org

¢ MacMillan Cancer Support “ Bowel Cancer - www.macmillan.org.uk

¢ Bowel Cancer UK “ www.bowelcanceruk.org.uk

¢ Bladder and Bowel Foundation “ www.bladderandbowelfoundation.org

¢ Cancer Research UK “ www.cancerresearchuk.org/bowel-cancer

¢ NICE Colorectal Guidelines “ http://www.nice.org.uk/guidance/cg131/resources/guidance-colorectal-cancer-pdf