Bowel Cancer

Patients with suspected bowel cancer, also known as colorectal cancer, are referred to the Belfast City Hospital.

Treatment of this cancer is provided by a Multi Disciplinary Team (MDT) of specialists in bowel cancer diagnose and treat bowel cancer. For information on the pathway patients follow when they are referred with suspected bowel cancer, please follow the links on the right hand side of this page.

For information on the signs and symptoms of bowel cancer, please follow this link.

Please note that this section details services provided to adult patients. Please follow the link for information on Children’s Cancers.


  • Types

    Bowel Cancer can develop in one of two areas of the digestive system:

    • The large bowel (colon)
    • The back passage (rectum)

    These cancers are known as colorectal cancers.

    The cancer grows from a polyp in the bowel. Many polyps are benign, however if left untreated they could develop into a cancerous tumour. The removal of polyps can prevent the growth of cancerous tumours in the bowel.

    It is important that if a patient experiences symptoms of bowel cancer they should always see their GP. For more information on the signs and symptoms of bowel cancer, please follow this link.

    The walls of the colon and rectum are made up of layers of body tissue. Most colon and rectal cancers start in the innermost lining of the bowel and develop from small growths called polyps. The formation of the lower intestinal tract has been shown below.

    Source: Macmillan Cancer Support (2011)

    The Multi-Discplinary Team would also diagnose and treat rarer cancers such as:

  • Referral

    If a GP suspects a patient of having bowel cancer, they will refer them to the Belfast City Hospital. Patients will be contacted regarding an appointment.

    Bowel Cancer Screening

    The Northern Ireland Bowel Cancer Screening Programme offers screening every two years to all men and women aged 60 to 74. People in this age group will automatically be sent an invitation and a screening kit so they can do the test at home.

  • Investigations and Diagnosis

    Patients may be referred for a number of investigations and scans in order to find out whether they have cancer. These investigations also allow doctors to make a diagnosis and see the extent of any disease.

    Tests and scans may be done at Belfast City Hospital, Royal Victoria Hospital or Mater Hospital.

    Diagnostic investigations may include:

    • Proctoscopy/Sigmoidoscopy
    • Colonoscopy
    • Barium Enema
    • CT
    • MRI
    • PET
    • Flexible Sigmoidoscopy
  • Multi-disciplinary team

    In order to provide the highest quality of treatment possible, a team who specialise in bowel cancer, work together to provide timely diagnoses and effective treatment plans. This team is known as the Colorectal Multidisciplinary team (MDT). The team consists of surgeons, oncologists, clincial nurse specialists, stoma nurses, ward staff, radiologists, pathologists as well as administrative staff and other health and social care professionals.

    The Colorectal Cancer MDT meets every Friday morning to discuss colorectal patients. Detailed discussions between all the relevant specialists take place, looking at all the available results for each patient to ensure that the best treatment plan for every patient is agreed.

    A record of this discussion will be sent to patients’ GPs.

  • Treatment

    A decision of how to treat a patient’s cancer will be made at a specialised colorectal multidisciplinary meeting. Treatments are dependent upon the size, cell type and position of the cancer.

    Before patients begin treatment, a doctor will discuss with them the type of treatment they are to have along with the benefits and risks.

    Before a paient begins their treament, they will be asked to sign a consent form. This is to ensure they understand the benefits and the risks of their chosen treatment type.

    Surgery

    Surgery involves a hospital stay and takes place under general anaesthetic. Patients will have surgery in the Belfast City Hospital. Click on the links for more information on types of surgery for colon cancer and rectal cancer.

    Pre-assessment

    Patients coming to Belfast City Hospital or Royal Victoria Hospital for surgery may be asked to come up to meet one of our medical team for a pre-assessment appointment in the Outpatients Department before surgery to ensure they are fit and safe for surgery. In some cases patients are asked to have an anaesthetic assessment. Most patients are admitted on the morning of their surgery but some may be admitted the day before.

    Chemotherapy

    For information on how chemotherapy is used to treat bowel cancer, please follow these links:

    For information on chemotherapy services in the Belfast Trust, for all types of cancer, please follow this link.

    Radiotherapy

    Radiotherapy is generally used to treat rectal cancer.

    For information on radiotherapy services in the Belfast Trust, for all types of cancer, please follow this link

  • Follow up

    As part of their cancer review following cancer treatment patients will be asked to return to the hospital to see one of the colorectal cancer team. The frequency of these review appointments will differ for each patient. The review appointments allow the team to assess patient progress following treatment. The check-ups are also a good opportunity for patients to talk to their doctor about any problems or worries they may have.

    Follow up appointments will take place in an outpatients department in Belfast City Hospital.

    If patients notice any new symptoms, or have any worries, they should contact their consultant, their local GP or the colorectal clinical nurse specialist to discuss the symptoms.

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