A small tube with a bright light at the end is inserted into the back passage so that the lower bowel (rectum) can be seen. The examination takes no more than two or three minutes to complete, during which time some air is inserted into the bowel. You may feel the need to pass wind but try not to worry, your consultant is aware that this may happen.

This simple procedure allows your consultant to examine more of the lower bowel (sigmoid and some of the descending colon). It involves passing a thin, flexible tube with a miniature camera on the end (an endoscope) through the anus to examine the rectum and the lower parts of the colon. It can be performed as an outpatient, and no sedation is usually required. A disposable enema will be given to you prior to the procedure.

Flexible sigmoidoscopy

You will be asked to take a laxative to completely clear out the bowel. A sedative may be given to help relieve any fears and anxieties you may have, but you can choose not to have this if you wish.

Your consultant will insert the colonoscope into your anus. Small amounts of carbon dioxide gas are infused to expand the bowel and to get a better view. The endoscopist will guide the thin, flexible tube through the bowel. There is a small camera on the end of device, which allows the consultant to view the entire colon, both lower and upper sections, and to remove any polyps at the same time. This is usually completed within 30 minutes.

Colonoscopy 

Virtual colonoscopy (VC) uses scanning technology to detect or stage bowel cancer. A small thin tubeis inserted into the bottom and carbon dioxide is used to distend the bowel. You will then have a CT (Computerised Tomography) scan which picks up any abnormalities.

Virtual colonoscopy

Blood tests are taken to check your general health Sometimes this includes a carcinoembryonic antigen (CEA) blood test, which can also be used to monitor your recovery.

Blood tests and investigations

An ultrasound will take approximately 15 to 20 minutes and is completely painless. An ultrasound scan uses beams of high-pitched sound, which you cannot hear, directed via a small device like a microphone into the abdomen. Sound is reflected back onto a computer showing internal organs ona monitor for your consultant to view. Ultrasound is completely safe and is used for scanning babies in the womb.

Ultrasound scan

For this scan you will be asked not to eat or drink anything for four hours before the scan, and the actual scan will take about 30 to 40 minutes. The scan is painless but you will be asked to lay still for this time.

Before the scan you may be asked to drink a special liquid which shows up on X-ray, and then again in the X-ray department. Just before the scan a similar liquid may be passed into your back passage through a small tube. This may be slightly unpleasant but it does ensure a clear picture is obtained.

This is a very useful type of scan for cancer affecting the lower part of the anal canal (rectum). MRI scanning uses a magnetic field to produce a detailed image of the body. The scan can last for 30 to 60 minutes.

You may need to stop eating or drinking for four hours prior to the scan, depending on what part of the body is being scanned. If you have any metal implants you need to inform the department prior to your scan.

MRI scan

Radiotherapy uses high energy rays to destroy cancer cells. It is sometimes given to patients with rectal cancer before surgery. The treatment is individually planned and monitored for each person, to ensure that normal cells suffer very little and there is no long term damage. Some patients may also benefit from radiotherapy after surgery.

Radiotherapy or chemotherapy may be used before surgery to shrink the size of the cancer, especially if it is located in the rectum. It can also be used after surgery with the aim of killing any cancer cells circulating in the body, or any which have spread to other sites.

Your surgeon will refer you, if appropriate, to an Oncologist (cancer specialist) who will advise you on the most appropriate treatment for your needs.

Chemotherapy may be discussed following surgery once the full pathology report is back. This involves using drugs which attack cancer cells. 

Chemotherapy is usually given in the form of an injection into a vein, or in tablet form. The treatment is planned individually and is administered over a period of months. 

Before each treatment a blood test is done to ensure that there are enough healthy blood cells to protect you from infection, as chemotherapy has the potential to damage good cells as well as bad. 

During your course of treatment you may also have further scans which will be ordered by your consultant. 

Chemotherapy

The London Clinic is the first private hospital to use colorectal intraoperative radiotherapy (IORT). 

This advanced technology may help destroy microscopic disease, decrease radiation treatment times or provide extra radiation.  

 Intraoperative radiotherapy