You will be referred to the colorectal department if you have symptoms that could be caused by a bowel cancer. It is important if you do have a cancer that we diagnosis it as quickly as possible. 

Every referral is screened by a colorectal clinical nurse specialist. This helps determine whether you should be examined in our consultant-led outpatient clinic or, if suitable, sent directly for investigations following a nurse telephone appointment. This allows for rapid direct access to specialist investigations.

The following tests are used for diagnosing colorectal cancer:

  • flexible sigmoidoscopy
  • colonoscopy
  • CT virtual colonoscopy examination

If colorectal cancer is diagnosed during the initial tests, we will then offer further tests to ‘stage’ the cancer. This means establishing the size, type, and if there is any spread of the cancer. This will allow us to plan treatment specific to your cancer.

The following tests may be used to stage your colorectal cancer:

  • CT scan 
  • MRI scan
  • FDG PET-CT scan

The treatment you will be offered for colorectal cancer depends on:

  • the size of the cancer
  • if the cancer is in your colon or bottom, or both
  • if the cancer has spread to other parts of your body
  • if the cancer has certain genetic changes
  • your general health 

Once diagnostic and staging tests are completed, every patient is discussed at a multi-disciplinary team meeting. This comprises surgeons, oncologists, radiologist, histopathologists and clinical nurse specialists. 

All results and patient history are discussed, and an individualised treatment plan advised. You do not attend this meeting — you will have an appointment with a team member after this meeting to discuss the outcomes and plan. 

You may be offered a combination of treatments including surgery, chemotherapy, radiotherapy, and targeted medicines.


Surgery may be carried out to remove cancer from the bowel. To help your recovery, you may need a colostomy or ileostomy which may be temporary or permanent.


Chemotherapy is a medicine that kills cancer cells.  

You may have chemotherapy:

  • before or after surgery for bowel cancer 
  • if you are unable to have surgery 
  • if the cancer has spread to other parts of the body


Radiotherapy uses radiation to kill cancer cells. A machine is used to target beams of radiation directly at tumours.  

You may have radiotherapy:

  • if you have cancer in your rectum
  • if cancer has spread to other parts of the body

Radiofrequency ablation (RFA)

This uses heat made by radio waves to kill cancer cells. 

You may have RFA alone or in combination with other treatments if you have: 

•    secondary cancer in the lungs
•    secondary cancer in the liver
•    secondary cancer in the bones 

Surgery to other parts of the body

If one or two small areas of cancer spread (secondaries) in the liver or lungs, you may be offered surgery to remove them. This is not a suitable treatment for everyone.

Targeted medicines and immunotherapy

Targeted medicines kill cancer cells, while immunotherapy is where medicines are used to help your immune system kill cancer.

Targeted medicines or immunotherapy are sometimes used to treat advanced colorectal cancer that has spread to other parts of the body.  

We believe research is essential to raise standards of cancer care, and to improve the outcome for patients with bowel cancers. 

Not all patients are suitable or willing to take part in a clinical trial, however, our philosophy is to give patients the option of a research trial if one is available.