07 April, 2021
Bowel Cancer, also known as Colorectal cancer includes large-bowel cancer (colon cancer) and rectal cancer. The large bowel has five sections (ascending colon, transverse colon, descending colon, sigmoid colon and the rectum). Cancer develops as a result of cells changing and growing in an uncontrolled way.
54% of bowel cancer cases in the UK are preventable*.
Hereditary factors can also mean a higher-than-average risk. Other conditions associated with an increased risk factors include inflammatory bowel disease.
Symptoms of Bowel Cancer can include:
Referral should be to a team specialising in the management of colorectal cancer. The recommendations for the investigation and diagnosis of colorectal cancer are outlined in the NICE Guidelines 2014. Initial investigations should be with either a colonoscopy or a sigmoidoscopy, depending on the patient's medical history and any other existing problems, staging is by way of a CT scan or MRI scan.
Staging is essential to effective treatment and dictates condition and prognosis. The international standard for colorectal cancer staging is the TNM system, which takes into account the size and position of the primary tumour (T), whether there is any lymph node spread (N) and whether there is any metastatic disease (M).
Rectal cancer is managed according to the NICE Guidelines published in 2011 and updated in 2014 (CG131). The basis of treatment is as follows:
The NHS bowel screening programme has increased survival. The stage of disease at diagnosis generally dictates diagnosis. Stage I l colorectal cancer has a five-year survival rate of about 84%. Stage Ill colorectal cancer has a five year survival rate of about 65%. Stage IV colorectal cancer has a five-year survival rate of about 10%.*
The guidance for follow-up was introduced in 2011 with the NICE Guidelines. At least two CT scans of the chest, abdomen and pelvis should be performed in the first three years, as well as regular serum CEA tests.
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