What happens once you are diagnosed?
Being diagnosed with bowel cancer often comes as a terrible shock. As the news sinks in and you are ready to talk about what's going to happen, the most important thing to remember is that it's your body you are discussing. Don't be rushed into making decisions and don't be frightened to ask the doctor or nurse to explain things more than once if you don't understand. You may also wish to request a second opinion (see below).
Your cancer has a whole new language and it is going to be a while before you understand it all. The experts treating you can sometimes forget this – don't let them!
A guide to what you can expect to happen next
Tests to assess how far the cancer has spread
You will need to have more tests to find out the extent of the cancer and whether it has spread to other parts of your body. This process is known as 'staging'.
The doctor will choose from a range of investigations which will usually include blood tests, X-rays and a CT scan. You may also have an MRI scan, PET scan and / or ultrasound. At each stage, your specialist team should take time to tell you what the results are and they will explain why you need to have these and any other tests done.
Putting together your treatment plan
Once your doctor has received your test results, he / she will be able to discuss your diagnosis - and what it means - more fully with you. This will help you to understand your options as you start to get involved in putting together your individual treatment plan. This will be unique to your own personal circumstances, and will depend on a number of factors including the type, size and location of the cancer and your general health.
All decision making will be done jointly between you and your MDT (multi-disciplinary team). Your doctors will help you to understand the advantages and disadvantages of what is being proposed so that you can be confident in the decisions taken, and satisfied that your individual needs and wishes have been fully considered.
Your specialist nurse will also make an assessment of your general health and fitness – known as Holistic Needs Assessment – and consider any underlying health problems. It is also important that they understand what home and family issues need to be considered as well as any practical concerns, as these might also have an impact on your health and treatment choices. This process will also help you to manage your own care much more effectively so that you will know when and how to ask for help.
There are three main types of treatment for bowel cancer, based on – surgery, chemotherapy and radiotherapy techniques. Depending on the stage and location of your cancer, you will usually receive one or a combination of these treatments. Bowel cancer patients may also receive monoclonal antibody treatments if the bowel cancer has spread to other parts of the body.
Requesting a second opinion
You may wish to have your doctor's planned course of treatment confirmed by another consultant, or to explore the possibility of alternative treatments at another specialist centre. Most doctors are willing to refer you for a second opinion. However, they will be honest if they do not feel you will gain anything from seeing another consultant.
It is also important that you recognise that this process can take time and could delay starting your treatment. Talk to your consultant or your GP and explain why you would like another opinion; this can then be arranged if required.
For more information please download our booklet 'Bowel Cancer Treatment - Your Pathway'.