After a diagnosis of bowel cancer, you will have tests to
check if the cancer has spread to other parts of the bowel, lymph nodes and to
other parts of the body, such as the liver and lungs.
These tests are called staging the cancer – many people
have curable cancers at this stage and the tests give your medical team your
“prognosis”, your outlook, and the evidence they need to plan the best
treatment for you. The tests also give an indication of whether you are likely
to need any additional (adjuvant) treatment as well as surgery.
The best way to be cured of bowel cancer is to have the
cancer completely surgically removed. However in a small number of cases the
chance of cure by surgery can be improved by giving additional or ‘adjuvant’ radiotherapy
(x-ray/radiation treatment) and or chemotherapy (treatment with drugs). This
‘adjuvant’ (additional) treatment can destroy, in some patients, small amounts
of residual hidden cancer which might be left after apparently curative surgery. Additional chemo-radiotherapy can be given either before or after a surgical operation.
The problem with this sort of treatment - it has to be given to
patients who might already be cured and those who will die from their disease in spite of
adjuvant treatment. This means many patients who cannot benefit from the
treatment have to be given ‘adjuvant’ therapy to benefit those that can.
Chemo-radiotherapy can also be given to patients where the
cancer has spread and cannot be cured. Great advances in this sort of
‘palliative’ treatment have been made over the last 20 years so that many bowel
cancer patients have good quality life ‘living with their disease’ which is
kept under control rather than cured.
The staging tests - and discussions between the medical and
surgical team at multi-disciplinary meetings, can take time but this is worth
it to make sure the best combination of treatments are chosen to give the best
chance of cure.
Every effort will be made to plan the simplest, safest
treatment schedule and any short delays at this stage will not have any adverse
As far as possible the team should involve you, the
patient, and your family in all the decision-making.