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Colorectal Cancer

Colon, rectal and anal disorders, such as cancer, crohn’s and colitis may be diagnosed or treated by the Colorectal team at LTHTR. Our specialist colorectal team consists of Colorectal surgeons, Endoscopists, Oncologists, Radiologists, Histo-pathologists and Clinical Nurse Specialists.

Contact us:

The Colorectal Specialists Nurses work from 8am to 6pm Monday to Friday.

If you have any questions or concerns at any time, you can contact the Colorectal cancer specialist nurses on 01772 522371. If we are not in the office at the time of your call an answer machine is available. If you reach this please leave a message. Your calls will be returned as soon as possible, however please be aware this may not be the same day.

Please note that all telephone calls from the hospital are from an anonymised or withheld number. If your telephone blocks anonymised calls, we may not be able to contact you. Please let us know if this affects you.

Please note that this is not an emergency service and does not operate out of hours. You should contact your GP if you need advice on the same day.

What to expect at your first appointment
Diagnostic Tests
Diagnosis and Treatment
Colorectal Clinical Nurse Specialists
Meet The Team
Colorectal Research and Clinical Trials

Understanding why you have been referred to hospital

Your GP has asked for you to have an urgent appointment or test because you have displayed symptoms which may be caused by cancer

Whilst it is unlikely that you have cancer it is very important that you are seen by a specialist as soon as possible.

The suspected cancer faster diagnosis system has been introduced across the country so that patients with symptoms that could be caused by cancer are seen by a specialist quickly.

Most patients referred under this system turned out not to be diagnosed with cancer, but early diagnosis can increase the success rate of many cancer treatments.

 

What happens when you have been referred

Your GP will send your referral to Lancashire Teaching Hospitals.

If your GP gives you a blood test performed as part of your referral you will need to arrange to have a blood test through your GP surgery before you attend your first hospital appointment. These blood tests are required as soon as possible for diagnostics to be arranged at the hospital.

If you are unable to access a blood clinic within 24 to 48 hours, then please use the urgent walk-in clinic at Royal Preston Hospital outpatient department.

Opening hours are 08.30am to 4.30pm Monday to Friday

 

What to expect at your first appointment

Following a referral from your GP you will receive an appointment for a telephone consultation from one of the specialist clinicians. If the patient would prefer a face to face appointment this can also be arranged.

You will be given an approximate time to expect the call and the appointment would be expected to last 10-15 minutes. The clinician will ask you a variety of questions including why you have been referred to the colorectal service, the problems/concerns you have been having, your past medical history, any medications you are taking and any allergies you may have. You may find that you are repeating all the information that you have already told the GP, but it is important for us to try and understand your concerns and address all the problems you are having.

If you are attending the hospital for a face to face appointment, please be aware that the clinician may need to examine your tummy and also examine your back passage. This will depend on the symptoms you are having. Following this consultation you are likely to require specialist investigations to assist in diagnosis. These tests will be done as an outpatient and will be carried out within 2 weeks of your initial consultation. 

You can find more information about diagnostic tests and what they involve on the next tab.

 

 

Colorectal  Cancer image

Diagnostic Tests

Following your first consultation you are likely to require specialist investigations to assist in your diagnosis, these often include:

 

Further Tests

The specialist team may ask for further tests to help with your diagnosis. These may include:

 

Waiting for Results

We understand that waiting for test results may be difficult. If your investigations are suspicious for a colorectal cancer you will be contacted by a Colorectal Specialist Nurse who will explain the next steps in your treatment pathway. This will include discussion of your investigations in the Colorectal MDT (Multi-disciplinary Team), followed by a clinic appointment with your named consultant and specialist nurse. If you do not have a diagnosis of colorectal cancer you will receive your results in writing.

 

Receiving a diagnosis

At your appointment with your consultant and specialist nurse we will explain your diagnosis and treatment options.  Your consultant will explain the aim of the treatments and whether the aim is to cure or control the cancer. We will make you aware of the benefits and side effects of treatment. All treatment options will be discussed with you and we can also talk through what may happen if you decide against any treatment.  You will be guided through these treatment options and supported in making your decision. 

We would advise that you bring a relative/friend to support you at this appointment.

Treatment Options

Treatment may include an operation to remove the cancer and/or relieve your symptoms. This would involve removal of the affected part of bowel and the surrounding lymph nodes. However, surgery alone is not always successful in curing bowel cancer and often chemotherapy or radiotherapy is given before or after surgery, either to shrink the cancer prior to removal or reduce the risk of cancer returning later on.

Lancashire Teaching Hospital specialises in the treatment of early colon and rectal cancers. If you are diagnosed with an early colon/rectal cancer, surgical excision alone can be an effective treatment.

Your Cancer Treatment Plan

 

Patient Contribution to Case Notes (PCCN)

The PCCN is your voice to help us improve our services. You will receive the booklet at pre-op and are encouraged to start filling it in before you come into hospital

It is a document for our patients and families to use which encourages the conversation to be around what is important and what matters to you.

The booklet gives you space to write about what you want to know, about your progress and what questions you might have that you want to discuss.

See our Patient Contribution to Case Notes page.

Your Colorectal and Stoma Care Clinical Nurse Specialist (CNS)

Our Colorectal and Stoma Care Nurses Specialists are here to offer advice and support to you and your family following a colorectal diagnosis of both malignant (cancer) and benign (non-cancer). They have expert knowledge and experience in Colorectal disease and may sometimes be referred to as your key worker.

Colorectal and Stoma Nurses Team Photo wide

 

How can we help?

We can provide an opportunity to discuss your diagnosis, disease and treatment plan, including a chance to talk through information you have been given. We can explain what investigations are for and what they involve, making sure you understand what is happening at each stage of your treatment.

We can put you in touch with other services in the hospital and in the community. There are a number of support agencies that you may like to know about.

If you are experiencing any problems or symptoms at home then please contact us. If we are unable to answer your questions we will endeavour to help you find the information you need, or put you in touch with the right person.

It is often when you have left hospital that you think of things you should have asked, or would like more explanation. We are available to help at this time. If you are admitted to any hospital for any reason, please ask someone to let your specialist nurse know.

We are also available to speak to your family (with your consent). They may have their own questions about your illness or treatment.

The CNS can provide information, advice and support for patients and their families, from diagnosis onwards, in areas including:

  • Surgery
  • Chemotherapy
  • Radiotherapy
  • Clinical trials
  • Fistula Management
  • Ileo-anal pouch advice
  • Dietary advice
  • Psychosexual issues
  • Support agencies/groups
  • Fertility and infertility advice and information
  • Finance
  • Hospice Care
  • Symptom Control
  • Local and national services
 

You may meet your nurse specialist:

  • At the outpatient surgical clinic
  • At the outpatient oncology clinic
  • On the ward
 

The role of the Colorectal CNS team:

We provide support for patients and their families and to act as a link between health care professionals.

We provide a point of contact for patients and carers from diagnosis onwards. This can be a very uncertain time in your life. By providing clear information we hope to reduce some of the fears and anxieties you may be facing.

  • To act as your key worker
  • To make sure your care runs smoothly
  • To act as a point of contact about any aspect of your care
  • The service is confidential. You can discuss your worries and / or concerns directly
  • To provide a link between you and your doctors
 

Who can access this service?

  • Any patient who has a diagnosed UGI cancer
  • Family and carers of any diagnosed UGI cancer patients
  • Other health professionals to access information and to provide a seamless pathway of care for the patient
 

What is a Holistic Needs Assessment (HNA)

A cancer diagnosis can affect you in many different ways.

A holistic needs assessment is a discussion between a you and a healthcare professional in which concerns can be identified and a personalised care and support plan can be put in place. It is a way to start a conversation about any needs or concerns that you may have and allows the team to signpost these concerns to relevant services that can assist and support accordingly. This could include; Practical, emotional, spiritual or physical concerns as well as identifying areas where more information or further support is needed.

 

Clinical Trials

Research can give you access to treatments which are otherwise unavailable. Clinical trials will lead to faster results and quicker improvements in cancer treatment for future cancer patients.

We have a core team of doctors, nurses, radiotherapists and data managers to support patients to participate in clinical trials and research studies.

At Lancashire Teaching Hospitals we offer a range of research studies and clinical trials at any one time for most cancers, ranging from brain to breast cancer, prostate to pancreas and many more. Research can lead to better prevention, detection and treatment of cancer.

 

Some helpful organisations:

Cancer Research

PO Box 123 Lincoln’s Inn Fields London WC2A3PX

Tel 020 7121 6699 www.cancerresearchuk.org

Oesophageal Patients Association

22 Vulcan House Vulcan Rd Solihull West Midlands B91 2JY

Tel 0121 704 9860 www.opa.org.uk

Cancer Help Preston

Vine House 22 Cromwell Road Ribbleton Preston PR2 6YB

Tel 01772 793344 www.cancerhelppreston.co.uk

 

Contact us:

The Colorectal Specialists Nurses work from 8am to 6pm Monday to Friday.

If you have any questions or concerns at any time, you can contact the Colorectal cancer specialist nurses on 01772 522371. If we are not in the office at the time of your call an answer machine is available. If you reach this please leave a message. Your calls will be returned as soon as possible, however please be aware this may not be the same day.

Please note that all telephone calls from the hospital are from an anonymised or withheld number. If your telephone blocks anonymised calls, we may not be able to contact you. Please let us know if this affects you.

Please note that this is not an emergency service and does not operate out of hours. You should contact your GP if you need advice on the same day.

 

Sources of further information

www.patient.co.uk

www.macmillan.org.uk

www.cancerhelp.org.uk

www.nhs.uk

www.accessable.co.uk

Get to know your multidisciplinary cancer care team

If you have been told you have cancer or are under investigations for cancer, your care and treatment will be overseen by a multidisciplinary team of specialist healthcare professionals also known as an MDT.

Cancer care can be complicated and there can be a number of health care professionals involved in your diagnosis, treatment and ongoing care. As an MDT they work together and meet regularly reducing the time needed to reach a diagnosis and plan the treatment they feel is best for you.

The Colorectal MDT consists of:

  • Colorectal Surgeons
  • Colorectal Specialist Nurses (CNS)
  • Advanced Specialist Practitioners (ASP)
  • Specialist Stoma Nurses
  • Oncologists
  • Histopathologists
  • Radiologists
  • Endoscopists

You can find more information about our colorectal team and the individual roles in the drop downs below…

Multidisciplinary Cancer Team MDT

 

Your Multidisciplinary Cancer Care Team

When you visit The Department of Colorectal Surgery at Lancashire Teaching Hospitals NHS Foundation Trust, you may be asked about participation in a research study. We are passionate about including our patients in research as we know that through that process we can continue to improve clinical care and patient experience.    

Mandie Alty is our lead colorectal research nurse. She coordinates a number of different studies running locally within the department and larger national and international trials. We run studies focussed on early diagnosis of colorectal and anal cancer, new cancer treatments and improving patient experience and surgical outcomes.

 

Current Trials and Research Studies

The link below lists several current trials and research studies we are involved with:
https://sites.google.com/nihr.ac.uk/tics/home/home_preston/colorectal-v2

 

Departmental Publications

These are the most recent peer-reviewed publications from The Department of Colorectal Surgery, Lancashire Teaching Hospitals NHS Foundation Trust:
 

An extraperitoneal single-port robotic approach to low anterior resection-Cadaveric experience.
Hany TS, Stein H, Bhowmick AK.Colorectal Dis. 2024 Aug 6. doi: 10.1111/codi.17120. Online ahead of print.PMID: 39107877

SF-CORNER (splenic flexure colorectal cancer): an international survey of operative approaches and outcomes for cancers of the splenic flexure.
Sekhar H, Dyer M, Khan M, Mitchell PJ, West NP, Moug S, Vimalachandran D; SF‐CORNER collaborative study group.Colorectal Dis. 2024 Apr;26(4):660-668. doi: 10.1111/codi.16895. Epub 2024 Feb 12.PMID: 38345176

Predictors of recurrence following local excision for early-stage anal squamous cell carcinoma.
Parkin E, Kallipershad S, Nasser A, Al-Mudhaffer M, Rosero D, Haston J, Williamson D, Mitchell P.Eur J Surg Oncol. 2023 Nov;49(11):107093. doi: 10.1016/j.ejso.2023.107093. Epub 2023 Sep 22.PMID: 37801832

Extraperitoneal approach to left-sided colorectal resections (EXPERTS procedure).
Hany TS, Jadav AM, Parkin E, Bhowmick AK.Br J Surg. 2023 Sep 6;110(10):1348-1354. doi: 10.1093/bjs/znad173.PMID: 37535960

Delay in loop ileostomy reversal surgery does not impact upon post-operative clinical outcomes. Complications are associated with an increased loss of microflora in the defunctioned intestine.
Beamish EL, Johnson J, Shih B, Killick R, Dondelinger F, McGoran C, Brewster-Craig C, Davies A, Bhowmick A, Rigby RJ.Gut Microbes. 2023 Jan-Dec;15(1):2199659. doi: 10.1080/19490976.2023.2199659.PMID: 37055940

The Extraperitoneal Approach to Left-Sided Colorectal Rectal Resections: EXPERTS Procedure.
Hany TS, Jadav AM, Lamoon C, Cassidy K, Bhowmick AK.Ann Surg Oncol. 2023 Mar;30(3):1739-1740. doi: 10.1245/s10434-022-12848-8. Epub 2022 Dec 21.PMID: 36542250

ASO Author Reflections: From the Retroperitoneal to the TME Plane: Accessing the Holy Plane from the Holy Plane.
Hany T, Jadav A, Cassidy K, Lamoon C, Bhowmick A.Ann Surg Oncol. 2023 Mar;30(3):1741. doi: 10.1245/s10434-022-12963-6. Epub 2022 Dec 21.PMID: 36542248 

The Extraperitoneal Approach to Left-Sided Colorectal Resections: A Human Cadaveric Study.
Hany TS, Jadav AM, Parkin E, McAleer J, Barrow P, Bhowmick AK.J Surg Res. 2023 Mar;283:172-178. doi: 10.1016/j.jss.2022.10.038. Epub 2022 Nov 18.PMID: 36410233

A cohort study of duplicate faecal immunochemical testing in patients at risk of colorectal cancer from North-West England.
Hunt N, Rao C, Logan R, Chandrabalan V, Oakey J, Ainsworth C, Smith N, Banerjee S, Myers M.BMJ Open. 2022 Apr 13;12(4):e059940. doi: 10.1136/bmjopen-2021-059940.PMID: 35418441

Detecting colorectal cancer using infrared spectroscopy.
Cameron D, Talari A, Rehman I, Mitchell P, Parkin E.Br J Surg. 2022 Mar 15;109(4):e61-e62. doi: 10.1093/bjs/znab462.PMID: 35141745 

Radical surgery versus organ preservation via short-course radiotherapy followed by transanal endoscopic microsurgery for early-stage rectal cancer (TREC): a randomised, open-label feasibility study.
Bach SP, Gilbert A, Brock K, Korsgen S, Geh I, Hill J, Gill T, Hainsworth P, Tutton MG, Khan J, Robinson J, Steward M, Cunningham C, Levy B, Beveridge A, Handley K, Kaur M, Marchevsky N, Magill L, Russell A, Quirke P, West NP, Sebag-Montefiore D; TREC collaborators.Lancet Gastroenterol Hepatol. 2021 Feb;6(2):92-105. doi: 10.1016/S2468-1253(20)30333-2. Epub 2020 Dec 11.PMID: 33308452 

Perineal Turn over Perforator Flap: A Novel Surgical Technique for Combined Perineal and Posterior Vaginal Wall Reconstruction.
Moura FS, Chasapi M, Mitchell P, Dalal MD.World J Plast Surg. 2021 Jan;10(1):114-118. doi: 10.29252/wjps.10.1.114.PMID: 33833963

Current Management of Malignant Colorectal Polyps Across a Regional United Kingdom Cancer Network.
Sharma V, Junejo MA, Mitchell PJ.Dis Colon Rectum. 2020 Jan;63(1):39-45. doi: 10.1097/DCR.0000000000001509.PMID: 31569095

 

Collaborative Research

These are recent peer-reviewed surgical publications that we have collaborated on with colleagues from other institutions:

 

Evaluating the Effect of a Novel Digital Ostomy Device on the Leakage Incidents, Quality of Lif, Mental Well-Being, and Patient Self-Care: An Interventional, Multicentre Clinical Trial. Brady R, Sheard D, Alty M, Vestergaard M, Boisen E, Ainsworth R, Hansen H & Ajslev T. Journal of Clinical Medicine 2024, 13, 5673. https://www.mdpi.com/2077-0383/13/19/5673/pdf

Developing a curriculum for advanced fellowship training in complex cancer for the UK.
Mohan H, Harji D, Drami I, Griffiths B, Larkins K, Boyle K, Daniels IR, Baker R, Jenkins JT; Curriculum for Complex Cancer Working Group [Colorectal] the ACPGBI Advanced Malignancy Subcommittee, UK Pelvic Exenteration Network [UKPEN] and Dukes' Club.Colorectal Dis. 2024 Aug;26(8):1551-1559. doi: 10.1111/codi.17084. Epub 2024 Jul 11.PMID: 38992945

A prognostic model for use before elective surgery to estimate the risk of postoperative pulmonary complications (GSU-Pulmonary Score): a development and validation study in three international cohorts.
NIHR Global Health Research Unit on Global Surgery; STARSurg Collaborative.Lancet Digit Health. 2024 Jul;6(7):e507-e519. doi: 10.1016/S2589-7500(24)00065-7.PMID: 38906616 

The 'Pelvic exenteration lexicon': Creating a common language for complex pelvic cancer surgery.
Burns EM, Quyn A; Lexicon Collaboration of UKPEN and the ACPGBI Advanced Cancer subcommittee.Colorectal Dis. 2023 May;25(5):888-896. doi: 10.1111/codi.16476. Epub 2023 Feb 15.PMID: 36660781

Quality-of-life outcomes in older patients with early-stage rectal cancer receiving organ-preserving treatment with hypofractionated short-course radiotherapy followed by transanal endoscopic microsurgery (TREC): non-randomised registry of patients unsuitable for total mesorectal excision.
Gilbert A, Homer V, Brock K, Korsgen S, Geh I, Hill J, Gill T, Hainsworth P, Tutton M, Khan J, Robinson J, Steward M, Cunningham C, Kaur M, Magill L, Russell A, Quirke P, West NP, Sebag-Montefiore D, Bach SP; TREC collaborators.Lancet Healthy Longev. 2022 Dec;3(12):e825-e838. doi: 10.1016/S2666-7568(22)00239-2. Epub 2022 Nov 17.

Colorectal Endoscopic Stenting Trial (CReST) for obstructing left-sided colorectal cancer: randomized clinical trial.
CReST Collaborative Group.Br J Surg. 2022 Oct 14;109(11):1073-1080. doi: 10.1093/bjs/znac141.PMID: 35986684 

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study.
COVIDSurg Collaborative.Colorectal Dis. 2022 Mar 14;24(6):708-26. doi: 10.1111/codi.16117. Online ahead of print.PMID: 35286766 

Death following pulmonary complications of surgery before and during the SARS-CoV-2 pandemic.
STARSurg Collaborative and COVIDSurg Collaborative.Br J Surg. 2021 Dec 1;108(12):1448-1464. doi: 10.1093/bjs/znab336.PMID: 34871379 

Watch and wait after a clinical complete response in rectal cancer patients younger than 50 years.
Bahadoer RR, Peeters KCMJ, Beets GL, Figueiredo NL, Bastiaannet E, Vahrmeijer A, Temmink SJD, Meershoek-Klein Kranenbarg WME, Roodvoets AGH, Habr-Gama A, Perez RO, van de Velde CJH, Hilling DE; International Watch & Wait Database Consortium (IWWD).Br J Surg. 2021 Dec 17;109(1):114-120. doi: 10.1093/bjs/znab372.PMID: 34738104

Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study.
COVIDSurg Collaborative.Lancet Oncol. 2021 Nov;22(11):1507-1517. doi: 10.1016/S1470-2045(21)00493-9. Epub 2021 Oct 5.PMID: 34624250 

SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study.
COVIDSurg Collaborative; GlobalSurg Collaborative.Anaesthesia. 2022 Jan;77(1):28-39. doi: 10.1111/anae.15563. Epub 2021 Aug 24.PMID: 34428858 

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study.
COVIDSurg Collaborative, GlobalSurg Collaborative.Br J Surg. 2021 Sep 27;108(9):1056-1063. doi: 10.1093/bjs/znab101.PMID: 33761533

Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic.
COVIDSurg Collaborative.
Br J Surg. 2021 Jan 27;108(1):88-96. doi: 10.1093/bjs/znaa051.
PMID: 33640908

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.
Glasbey JC, Nepogodiev D, Simoes JFF, Omar O, Li E, Venn ML, Pgdme, Abou Chaar MK, Capizzi V, Chaudhry D, Desai A, Edwards JG, Evans JP, Fiore M, Videria JF, Ford SJ, Ganly I, Griffiths EA, Gujjuri RR, Kolias AG, Kaafarani HMA, Minaya-Bravo A, McKay SC, Mohan HM, Roberts KJ, San Miguel-Méndez C, Pockney P, Shaw R, Smart NJ, Stewart GD, Sundar Mrcog S, Vidya R, Bhangu AA; COVIDSurg Collaborative.J Clin Oncol. 2021 Jan 1;39(1):66-78. doi: 10.1200/JCO.20.01933. Epub 2020 Oct 6.PMID: 33021869 

Conditional recurrence-free survival of clinical complete responders managed by watch and wait after neoadjuvant chemoradiotherapy for rectal cancer in the International Watch & Wait Database: a retrospective, international, multicentre registry study.

Fernandez LM, São Julião GP, Figueiredo NL, Beets GL, van der Valk MJM, Bahadoer RR, Hilling DE, Meershoek-Klein Kranenbarg E, Roodvoets AGH, Renehan AG, van de Velde CJH, Habr-Gama A, Perez RO; International Watch & Wait Database Consortium.Lancet Oncol. 2021 Jan;22(1):43-50. doi: 10.1016/S1470-2045(20)30557-X. Epub 2020 Dec 11.PMID: 33316218

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic.
COVIDSurg Collaborative.Colorectal Dis. 2020 Nov 15;23(3):732-49. doi: 10.1111/codi.15431. Online ahead of print.PMID: 33191669

Hartmann's procedure versus intersphincteric abdominoperineal excision (HiP Study): a multicentre prospective cohort study.
Fowler H, Clifford R, Sutton P, Watson A, Fearnhead N, Bach S, Moran B, Rose A, Jackson R, Vimalachandran D; HiP collaborators.Colorectal Dis. 2020 Dec;22(12):2114-2122. doi: 10.1111/codi.15366. Epub 2020 Oct 2.PMID: 32939956

Safety of hospital discharge before return of bowel function after elective colorectal surgery.
EuroSurg Collaborative.Br J Surg. 2020 Apr;107(5):552-559. doi: 10.1002/bjs.11422. Epub 2020 Jan 24.PMID: 31976560
13

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery.
EuroSurg Collaborative.Br J Surg. 2020 Jan;107(2):e161-e169. doi: 10.1002/bjs.11326. Epub 2019 Oct 9.PMID: 31595986

 

Colorectal Patient Information Leaflets

Get in touch

Chorley and South Ribble Hospital

Preston Road

Chorley

PR7 1PP

01257 261222

Royal Preston Hospital

Sharoe Green Lane

Fulwood

Preston

PR2 9HT

01772 716565

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