Bowel Cancer
SYMPTOMS, DIAGNOSTICS & TREATMENT OF
Bowel Cancer
Private Bowel Cancer Consultant in Chester
As a Consultant Colorectal Surgeon in Chester, Mr Peter Asaad regularly diagnoses and treats bowel cancer and other bowel-related conditions. Most bowel symptoms are not caused by cancer, but persistent or concerning symptoms should always be properly assessed.
If you are concerned about bowel cancer, have been referred for investigation, or have recently received a diagnosis, Mr Peter Asaad can provide specialist advice and help you understand your diagnosis and treatment options.
Condition
What is Bowel Cancer?
Bowel cancer is a cancer that develops within the bowel. Most bowel cancers occur in the large bowel, which is made up of the colon and rectum. These are known as colon cancer and rectal cancer, and together are often referred to as colorectal cancer.
Cancer can also develop in the small bowel, although this is much less common and its investigation and treatment can differ from colorectal cancer.
Most colorectal cancers develop from the inner lining of the bowel, sometimes from growths called polyps. Some polyps can gradually develop into cancer over time, although most polyps do not become cancerous.
There are different types of bowel cancer, and treatment is not the same for everyone. The treatment recommended will depend on factors including the type of cancer, its location, its stage, whether it has spread elsewhere, and your individual health and circumstances.
Symptoms
Bowel Cancer Symptoms
Bowel cancer can present in different ways. The symptoms included in this section are not necessarily caused by cancer. Conditions such as haemorrhoids, diverticular disease and other bowel conditions can cause similar symptoms.
However, persistent or unexplained symptoms should not simply be assumed to be benign. A specialist assessment can help determine whether further investigation is required.
SYMPTOMS INCLUDE:
- Blood in or on your stool
- Persistent change in bowel habit
- Unexplained weight loss
- Unexplained abdominal pain
- Iron-deficiency anaemia
- Unexplained tiredness
- Incomplete feeling after emptying your bowel
- Lump or swelling within the abdomen
Diagnostics & TESTS
Bowel Cancer Investigations & Diagnosis
If you are worried that you may have bowel cancer, Mr Peter Asaad can assess you privately and arrange appropriate investigations to establish the cause.
Specialist Assessment
Your consultation will include a detailed discussion about your symptoms, general health, medical history and any investigations you have already had.
Depending on your symptoms, an abdominal or rectal examination may also be appropriate.
Investigation
The investigations required will depend on your individual circumstances and will be discussed with you by Mr Peter Asaad.Â
These may include blood tests, stool tests, or a colonoscopy. If an abnormal area is identified during a colonoscopy, biopsies can usually be taken.
Your Results
Your results will be discussed with you, including what they mean. For many patients, investigations are reassuring or identify a non-cancerous cause for their symptoms.
If bowel cancer is diagnosed, you will be referred to a specialist cancer team for further staging and treatment.
What happens if bowel cancer is diagnosed?
Staging
Once bowel cancer has been diagnosed, further investigations are usually required to establish its stage.
Staging helps determine how far the cancer has grown and whether it has spread elsewhere.Â
This usually includes CT scanning. Rectal cancers will usually also require an MRI scan of the pelvis to provide more detailed information about the tumour and surrounding structures.
These investigations should be organised through the hospital cancer pathway responsible for your treatment.
Multidisciplinary team review
Bowel cancer treatment should not be decided by one surgeon in isolation.
Patients with a new diagnosis are discussed by a specialist colorectal multidisciplinary team (MDT). This brings together colorectal surgeons, radiologists, pathologists, oncologists and other healthcare professionals who review the investigations and agree an appropriate treatment strategy.
I am a regular member of the colorectal cancer MDT within my NHS practice and am involved in the assessment, discussion and treatment planning of patients with bowel cancer.
Your Individual Treatment Plan
There is no single treatment that is right for every bowel cancer.
Some patients require surgery first. Others may benefit from chemotherapy and/or radiotherapy before an operation. In other circumstances, treatment may primarily involve oncology rather than surgery.
The recommended treatment depends on factors including:
- Whether the cancer is in the colon or rectum
- The stage of the cancer
- Whether it has spread elsewhere
- The characteristics of the tumour
- Your general health and fitness
- Your individual circumstances and preferences
The MDT recommendation should then be discussed with you so that you understand the available options and can be involved in decisions about your treatment.
Treatment
Bowel Cancer Treatment
Treatment for Bowel Cancer
Bowel cancer treatment is increasingly personalised. The biological and genetic characteristics of an individual tumour can sometimes influence the treatments that may be considered.
This is another reason why specialist pathological testing and MDT review are important, rather than considering surgery in isolation.
The most common types of treatment can be found in this section.Â
Surgery
Surgery remains an important treatment for many bowel cancers and may offer the possibility of cure when the cancer can be completely removed.
I have a busy colorectal cancer practice within the NHS and regularly perform laparoscopic (keyhole) surgery for colon and rectal cancer.
The precise operation depends on where the cancer is situated. Surgery will usually involve removing the section of bowel containing the cancer together with its associated lymph nodes. Where appropriate, the remaining bowel can then be joined back together.
Not every patient requires the same operation, and not every operation can or should be performed laparoscopically. The surgical approach is tailored to the cancer and the individual patient.
If you require an operation for bowel cancer, this would usually take place through the NHS cancer pathway rather than through my private practice.
Chemotherapy
Chemotherapy is not required for every bowel cancer.
It may be recommended after surgery to reduce the risk of the cancer returning, before surgery in some circumstances, or as treatment for cancer that has spread elsewhere.
Whether chemotherapy is appropriate will depend on the stage and characteristics of the cancer and should be considered by the specialist MDT and oncology team.
Radiotherapy
Radiotherapy is mainly used in the treatment of rectal cancer rather than colon cancer.
Some patients with rectal cancer may receive radiotherapy, often together with chemotherapy, before considering surgery. Whether this is appropriate depends on the position and stage of the tumour and the overall treatment strategy.
Already been diagnosed with bowel cancer?
Being told that you have bowel cancer can be overwhelming. You may have been given a large amount of information in a relatively short consultation and then thought of questions afterwards. You may also simply want more time with an experienced colorectal cancer surgeon to understand exactly what has been found and what happens next.
Mr Peter Asaad is happy to see you privately for this purpose.
If you are booking a consultation after a diagnosis of bowel cancer, I would ask you to provide copies of the relevant investigations and reports from your treating hospital before your appointment.
Please provide (where available):
- Your Colonoscopy report
- Your biopsy or histology result
- Your CT scan report
- Your MRI report, if you have had one
- Your MDT outcome, if available
- Relevant hospital clinic letters
Having this information in advance is important because it allows me to review your particular cancer and individual circumstances before we meet, rather than simply giving you general information about bowel cancer.
During the consultation, I can talk you through what your investigations show, explain unfamiliar terminology, answer your questions and help you understand the treatment pathway being considered.
This consultation does not replace your hospital cancer pathway. I would not usually repeat or arrange your cancer staging privately. Your formal staging investigations, MDT discussion and definitive cancer treatment should continue through the specialist cancer team looking after you.
About
Mr Peter Asaad
Mr Peter Asaad is a Consultant General and Colorectal Surgeon in Chester with significant experience in the diagnosis and surgical treatment of bowel cancer.
Alongside his private practice, he has a busy NHS colorectal cancer practice and regularly performs laparoscopic operations for colon and rectal cancer. He is a regular member of his hospital’s specialist colorectal cancer MDT and is involved in assessing patients, reviewing investigations, discussing newly diagnosed cancers and planning treatment.
This means that whether you are worried about symptoms or have recently received a diagnosis, you can be assessed by a surgeon who regularly looks after patients throughout the colorectal cancer pathway.
If you have already been diagnosed, he can review the reports and results from your treating hospital before your consultation and give you additional time to understand your diagnosis, investigations and likely treatment pathway.
testimonials
What Patients Say
Frequently Asked Questions
These are some of the most common questions patients ask about bowel cancer and treatment. As new questions arise, this section will be updated to provide clear and relevant information.
Does a positive FIT mean I have bowel cancer?
No. A positive FIT means that blood has been detected within your stool. There are several possible causes, and a positive FIT does not by itself mean that you have bowel cancer.
However, depending on your circumstances, a positive FIT may require further investigation, often with a colonoscopy.
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Is surgery always needed for bowel cancer?
No. Although surgery is an important treatment for many bowel cancers, the appropriate treatment depends on the location and stage of the cancer and your individual circumstances.
Some very early cancers can sometimes be removed during an endoscopic procedure, while other patients may require chemotherapy or radiotherapy before considering surgery. In some circumstances, treatment may primarily involve oncology rather than surgery.
Will I need chemotherapy for bowel cancer?
Not necessarily.
Whether chemotherapy is recommended depends on the stage and characteristics of your cancer and whether it has spread.
It may be given before or after surgery, or as the main treatment in some circumstances. Your case should be discussed at a specialist colorectal MDT before a recommendation is made.
Is radiotherapy used for all bowel cancers?
No. Radiotherapy is mainly used for rectal cancer and is not routinely used to treat colon cancer.
Whether it is recommended depends on the position and stage of the rectal cancer and the overall treatment strategy agreed by the MDT.
Who decides my treatment?
Your treatment should be considered by a specialist colorectal cancer MDT consisting of colorectal surgeons, radiologists, pathologists, oncologists and other specialists.
The MDT makes a recommendation based on your investigations, but the treatment options should then be discussed with you so that you can make an informed decision about your care.
Can bowel cancer be cured?
Yes. Many bowel cancers can be cured, particularly when the cancer can be completely removed and has not spread to distant organs.
However, prognosis varies considerably depending on the stage and characteristics of the individual cancer. Once staging investigations are complete, your treating cancer team will be able to give you more meaningful information about your individual situation.
How quickly does treatment begin after diagnosis?
This varies according to the cancer and the treatment required.
Before treatment begins, it is important that the appropriate staging investigations are completed and the case is discussed at the specialist MDT so that the correct treatment is chosen.
Some patients proceed to surgery, while others may need to see an oncologist and receive treatment before an operation.
What happens after I am diagnosed with bowel cancer?
Once bowel cancer has been confirmed, you will usually undergo staging investigations to establish the extent of the disease.
The results are then reviewed by the colorectal cancer MDT and an individual treatment recommendation is made. You should then meet with the appropriate specialist to discuss the findings and your treatment options.
Can I have a private consultation if I have already been diagnosed through the NHS?
Yes. If you have already been diagnosed and would like more time to understand what has been found and what happens next, I can see you privately to talk through your diagnosis and treatment pathway.
Before your appointment, please provide the relevant reports and results from your treating hospital, including your colonoscopy and biopsy results, CT or MRI reports and any available MDT outcome or clinic letters.
This allows me to review your particular situation in advance and means that our consultation can focus on explaining what your results mean, answering your questions and helping you understand the treatment pathway being considered.
Your formal staging investigations, MDT discussion and cancer treatment would remain with your hospital cancer team.
Will I need a stoma?
Not everyone undergoing bowel cancer surgery requires a stoma.
Whether one is necessary depends on factors including the location of the cancer, the type of operation required and whether it is safe to join the bowel back together.
When a stoma is required, it may be temporary or permanent. If surgery is recommended, your surgeon should discuss the likelihood of needing a stoma with you before your operation.
What is the difference between colon cancer and rectal cancer?
Both are types of bowel cancer, but they arise in different parts of the large bowel.
Colon cancer develops within the colon, whereas rectal cancer develops within the rectum, the final part of the large bowel.
The distinction is important because treatment can differ considerably. Surgery is often the main treatment for localised colon cancer, whereas some rectal cancers may benefit from chemotherapy and/or radiotherapy before surgery.
Can bowel cancer occur in the small bowel?
Yes, although it is much less common than cancer of the colon or rectum.
Small-bowel cancers are a different group of cancers and their investigation and treatment can differ depending on the type of tumour and where it is located. Most of the information on this page relates to colorectal cancer, which accounts for the majority of cancers commonly referred to as bowel cancer.