Bowel cancer treatments

Your team will explain what treatment is recommended for you.
They will also discuss with you any research trials available.

Unfortunately, if cancer has become too advanced, it may not be possible to remove it. Treatment in this situation may be given to control any symptoms caused by the cancer and to slow down its progress. This is known as palliative treatment.

Prehabilitation

Prehabilitation is a specialised programme aimed at helping you to improve your fitness during and after treatment. Making small lifestyle changes and increasing daily activity can help people to cope better with the side effects of treatment, helping them to recover more quickly. It can also help you to live a healthy life after treatment and stay cancer free. Your bowel cancer nurse will discuss how prehabilitation may be helpful to you.

For more information, please follow the link to the BTHFT prehabilitation information page.

More information on prehabilitation at Bradford Teaching Hospitals
Bradford Encouraging Exercise in People

Treatments for colon cancer (cancer of the large bowel)

Colonic stent insertion

A colonic stent is used to treat a partial bowel obstruction and prevent a full blockage from happening. It is a fine metal mesh that is inserted inside the bowel where the cancer is growing. It is used to hold open the walls of the bowel and prevent the cancer from closing the bowel and blocking it. The stent is inserted by colonoscopy (internal camera).

For more information on colonic stent insertion please see:

Chemotherapy

Chemotherapy may be advised before or after bowel surgery, or both. It is given to treat the cancer and reduce the risk of it returning in the future. Chemotherapy is a type of cancer treatment that uses cytotoxic (anti-cancer) drugs to destroy cancer cells. Immunotherapy may also be discussed for certain patients, and this treats bowel cancer by helping the body’s own immune system to help fight cancer cells. It can be used alone or in combination with other treatments. Chemotherapy is managed by a specialist Medical Oncologist team which is made up of Chemotherapy Doctors and Acute Oncology Nurses. Your Medical Oncology team will give you specific advice regarding Chemotherapy before starting any treatment. Chemotherapy treatment is provided at the Meadows Unit at Eccleshill Community Hospital.

Surgery

Surgery (an operation involving cuts) may be offered to remove the part of the bowel where the cancer is growing. The type of surgery will depend on where in the large bowel (colon) the cancer is. Your bowel surgeon will discuss this with you and what to expect. It is often possible to rejoin the bowel back together after removing a portion of it. This join is known as an anastomosis (an-ast-to-mo-sis).

After surgery it is normal to have a change to your usual bowel habit and some people will have looser stools (diarrhoea) and more frequent bowel movements or constipation and less frequent bowel movements. It may take a few months for your bowel habits to settle to a new normal pattern after surgery. Sometimes bowel surgery will involve the creation of a temporary or permanent stoma (please see the section on Stoma formation for more information).

Surgery is generally provided at the Bradford Royal Infirmary however some procedures may only be offered in specialist centres such as Leeds or Manchester. You will likely need to stay in hospital for approximately 5 nights after surgery.

For further information on having bowel surgery please see:

Stoma formation

Bowel surgery may result in a temporary or permanent stoma being made. A stoma is an opening on the abdomen (tummy) which is connected to the bowel. Bowel waste passes out of the body, through the stoma into a collection bag known as a stoma bag. A stoma may be planned as a part of your surgery, to divert the body’s waste away from the cancer or a new internal bowel join. A stoma may also be made if it is not possible to rejoin the remaining bowel. There are two types of bowel stoma. An Ileostomy is a stoma made from the small bowel. A colostomy is a stoma made from the large bowel. If surgery involves making a stoma, our team of stoma nurses will provide support and information to help you to adapt to living with a stoma before you go home.

For further information on stoma formation please follow the links.

Treatment for rectal cancer

Rectal cancer that has reached the muscle layer of the bowel wall or has spread to the local lymph nodes or blood vessels is treated with a combination of surgery with radiotherapy and or chemotherapy.

The location of the cancer inside the rectum will determine the type of surgery needed.

Rectal surgery may be either an Anterior resection, a Hartmann’s procedure or an Abdominoperineal resection of the rectum (APER). Surgery may involve formation of a temporary or permanent stoma formation. (please see the section on Stoma formation for more information).

For more information on surgery for rectal cancer:

Treatment for early rectal cancer

Early rectal cancer refers to cancers inside the rectum that have only grown through the inner layers of the bowel wall and have not invaded the middle muscle layer or spread to the nearby lymph nodes or blood vessels. They are staged at T2 or less, N0. At Bradford hospital, early rectal cancers can be treated without removing a portion of the bowel, using a combination of radiotherapy and a surgical procedure called TEMS (Transanal Endoscopic Microsurgery) or Trans Anal Minimally Invasive Surgery (TAMIS).

Radiotherapy

Radiotherapy uses high-energy rays (like X-rays), to target and destroy cancer cells. Radiotherapy is managed by a specialist Clinical Oncology team who will carefully plan and provide Radiotherapy treatments.
Sometimes chemotherapy drugs are given alongside Radiotherapy to make the cancer cells more sensitive to the effects of the radiotherapy. This is known as Chemoradiation. Radiotherapy is only provided locally at the Cancer Centre in Leeds.

This is in the Bexley Wing at St. James’s University Hospital. Hospital transport can be arranged to take you to your Radiotherapy appointments.

For further information on having radiotherapy please follow the links.

TEMS (Transanal Endoscopic Microsurgery)

TEMS is a specialist surgical procedure that removes early cancers from inside the rectum. It is performed by inserting a microscope inside the rectum. Tools can be attached to the microscope to remove the cancer from the rectal wall, without needing to remove a portion of the rectum. This avoids the need for major surgery. Close monitoring with regular camera tests (flexible sigmoidoscopies) and MRI scans is recommended after treatment for early rectal cancer with radiotherapy and TEMS.

For more information on TEMS or treatment for Early rectal cancer please contact your bowel nursing team.

Bradford Teaching Hospitals TEMS information booklet