Types of CancerNavigation
Bowel cancer is the second most common cancer in Ireland affecting both men and women.
Beaumont RCSI Cancer Centre is a national referral centre for the treatment of bowel cancer and one of the 8 national centres designated by the National Cancer Control Programme for Rectal surgery. As part of the wider RCSI Hospital Group we have close links with Connolly Hospital in Blanchardstown, Our Lady of Lourdes Hospital in Drogheda and Cavan General Hospital. We participate in the National Bowel Screening Programme and patients diagnosed with cancer in the screening centres in Connolly Hospital Blanchardstown and Louth County Hospital are referred here for treatment. For more information on Bowel Screening click here.
We use a multidisciplinary approach in diagnosing and treating colorectal cancers and hold a weekly meeting with specialists from Surgery, Endoscopy, Radiation and Medical Oncology, Pathology, Radiology and Specialist Nurses, where your investigations are reviewed by the team and treatment options decided.
Your Bowel Cancer Team
Beaumont has a number of surgeons that specialise in the care of the patient with bowel cancer.
Prof Deborah Mc Namara, Consultant General and Colorectal Surgeon Beaumont Hospital
Secretary: Kelly Anne Delaney 01) 809 3092
Prof John Burke, Consultant General and Colorectal Surgeon Beaumont Hospital
Secretary: Kelly Anne Delaney 01) 809 3092
Ms Niamh Cawley, Consultant General and Colorectal Surgeon Beaumont Hospital
Secretary Marie Ryan 01) 809 3170
Appointments with a surgeon can be made by a Consultant and GP by referral letter to the relevant consultant or by email (preferred) as below
Colorectal Referrals: firstname.lastname@example.org
A number of consultants from other hospitals are also part of the Beaumont Multidisciplinary team
Ms Eleanour Faul, Consultant General and Colorectal Surgeon Beaumont and Our Lady of Lourdes Drogheda Hospital
Mr David Kearney, Consultant General and Colorectal Surgeon Beaumont and Connolly Hospital Blanchardstown.
Mr David Beddy, Consultant General and Colorectal Surgeon Beaumont and Connolly Hospital Blanchardstown.
Their role is to give you information about the investigations and treatment you will have for your cancer and provide support to you during your treatment journey. They are also involved in your follow up care after you have treatment for cancer. These nurses will meet you in the outpatient clinic or on the ward when you have been diagnosed with bowel cancer.
Contact: 01) 8098322
Enhanced Recovery Nurse
Patients that are to have planned surgery will meet the enhanced recovery nurse in the outpatient clinic beforehand. The enhanced recovery programme is designed to find out before your surgery if you have any medical or other needs that need either investigation or treatment before surgery, or extra support after surgery. This helps to improve your recovery after surgery, to reduce complications and to get you home quicker.
Contact: 01) 8098450
For more information on Enhanced Recovery click here.
You may need a stoma as part of your treatment. The term “stoma” refers to an artificial opening created surgically for patients to allow their urine or faeces to leave their body by a new route. The Clinical Nurse Specialists in Stomacare provide both in-patient and outpatient care for patients with all types of stomas.
Your stomacare nurse provides:
- Preoperative information, consultation, stoma marking and also postoperative care and follow up. This will help ensure a smooth recovery and a return for you to normal daily life as soon as possible.
- Individualized care and instruction at the bedside before and after surgery and in the outpatient department and stoma clinic, and also by phone when you are at home.
- We are located in the outpatient department on the ground floor. For directions click here.
- Telephone: (01) 809 2396 or ring (01) 809 3000 and ask for bleep 284
- Email: email@example.com
If chemotherapy is part of your treatment plan medical oncology consultants provide expert opinion at the Multidisciplinary Team Meeting about the best type of treatment for your type of cancer.
If radiotherapy is part of your treatment plan radiation oncology consultants provide expert opinion at the Multidisciplinary Team Meeting about radiotherapy .
A pathologist looks at the cells from your tumour under a microscope to determine the type of cancer you have when you are diagnosed. If you have surgery they will examine the tumour to see how advanced it is. This helps us in deciding the best treatment for you.
A radiology consultant will review your x-ray imaging to determine the location and how widespread your cancer is. This helps to decide what treatment is most suitable for you.
Other Healthcare Professionals
If you need the support of physiotherapy, occupational therapy, dietician, psycho-oncology or medical social work during your hospital stay to help you with your treatment we will organise these for you.
What is Bowel Cancer?
Bowel cancer occurs when normal cells in your bowel change and grown in an abnormal way. A group of these cancer cells can form a tumour.
Types of Bowel Cancer
Colon Cancer: Cancer that begins in the large bowel is called colon cancer. This cancer may cause a blockage in your bowel, which can affect how your bowel works.
Rectal Cancer: The rectum is the final 15cm of large bowel and links to the anus. To help describe where a cancer is, doctors divide the rectum into three: the upper, middle and lower third. Cancers here have different treatment to those diagnosed in the colon.
Anal Cancer: Anal cancer is cancer that starts in the anus. The anus is the last part of the large bowel that opens to the outside of the body.
Small Bowel Cancer: The small bowel is part of the digestive system and helps your body to digest food and take in vitamins. It is between the stomach and the large bowel (colon) and is between 4 and 6 metres long Cancer that starts here is called small bowel cancer.
Signs and Symptoms of Bowel Cancer
- A lasting change in your bowel habit – going more often, looser motions or constipation, i.e. 6 weeks or more.
- Blood in your stools or bleeding from your back passage.
- Pain or discomfort in your tummy area or back passage.
- Trapped wind or fullness in your tummy.
- A lump in your tummy area or rectum.
- Feeling you have not emptied your bowel fully after going to the toilet.
- Unexplained weight loss.
- Feeling tired and breathless due to anaemia (fewer red blood cells).
Investigations for Bowel Cancer
A number of tests are carried out to diagnose and stage your cancer. These tell us:
- What part of the bowel is involved?
- How large is the cancer?
- Has it spread to any other parts of your body?
This is a procedure that allows the Endoscopist to look directly at the lining of the large bowel and to take a sample of tissue for a pathologist to examine. For more information click here.
A CT colon, also known as virtual colonoscopy, uses low dose radiation CT scanning to obtain an interior view of the colon. It is sometimes used if a colonoscopy is not possible. For more information about CT colon click here.
This is a CT scan that looks at the organs in your chest, abdominal and pelvic areas to see if your cancer has spread to any other organs. For more information about this CT scan click here.
If you have a cancer of the rectum you will have an MRI of your rectum to help plan your treatment. This helps us to decide if you will go directly to surgery or need treatment with radiotherapy and chemotherapy before your surgery. For more information about MRI click here.
The type of treatment you have will depend on the location of your cancer and the stage of the cancer. The mutlidisciplinary team meets weekly to discuss treatments for patients with bowel cancer. Your Doctor and the Clinical Nurse Specialists attend this meeting and will meet you in the outpatient clinic to discuss the recommendations of the team for your treatment.
Your surgeon will discuss the type of surgery most suitable for you. Surgery aims to remove the part of the bowel containing the tumour. For a small early stage colon cancer, your surgeon might just remove the cancer from the bowel lining, along with a border of healthy tissue. This is called a local resection. For larger cancers, your surgeon will remove the part of the bowel where the cancer is and join the 2 ends of your colon back together. You may need a stoma before surgery if your bowel is blocked or after surgery to allow your bowel time to heal. If you have a stoma after surgery this may be temporary if your bowel needs time to heal or permanent if normal bowel function cannot be restored.
Local Resection: Some early colon cancers and most polyp cancers can be removed during a colonoscopy procedure.
- For a polypectomy, the cancer is removed as part of the polyp, which is cut at its base (the part that looks like the stem of a mushroom).
- A local excision is a slightly more involved procedure. Tools are used through the colonoscope to remove small cancers on the inside lining of the colon along with a small amount of surrounding healthy tissue on the wall of colon.
If some cancer is left behind or if pathology tests show that the tumour has a chance to spread further surgery will be needed. :
Open Surgery: A long cut is made in your abdomen. This means your wound will go from below your breastbone down towards your pelvis in a straight line. The length will depend on where the cancer is.
Laparoscopic (Keyhole) surgery: With keyhole surgery, a small cut is made in your abdomen (tummy area). Your surgeon will put a tube with a tiny telescope and light inside your body through a very small cut. Special instruments can then be used to remove the tumour.
Click on the links below for more information about the main types of surgery used for bowel cancer.
Chemotherapy and Radiotherapy
Chemotherapy and radiotherapy are additional treatments given for cancer. The decision to give these treatments and when is based on the location of your tumour, the stage of the cancer and if it has spread to other organs.
Chemotherapy drugs may be given at different times and for different reasons
- Before surgery with radiotherapy to shrink the tumour and reduce the risk of it coming back. This is called neo-adjuvant treatment and is normally used for some rectal cancers.
- After surgery to reduce the risk of the cancer coming back. This is called adjuvant treatment. The decision to give adjuvant treatment is made by the multidisciplinary team after your surgery where your pathology results are discussed and if there is a higher risk of the cancer coming back.
- As a treatment on its own to treat cancer that has spread to other parts of the body or has come back. This is called primary chemotherapy.
For more information about chemotherapy click here.
Radiotherapy is a cancer treatment used to kill cancer cells and shrink the size of tumours. It is mostly given in the treatment of rectal and anal cancers and can be given before surgery (neoadjuvant) or after surgery (adjuvant). This service is provided primarily by St Lukes Radiation Oncology Network at Beaumont. For further information about radiotherapy click here.
Cancer Follow Up and Support
If you have surgery for bowel cancer we will follow you up with a surveillance programme for 5 years afterwards. The aim of this programme is to give you the best chance of remaining cancer free. Surveillance tests help us to detect any new cancer or spread of cancer early. The Clinical Nurse Specialist will give you a booklet called “Colorectal Service Surveillance Passport” which provides details of:
- The surgery you have had
- Some advice on care after surgery
- The tests you will have and the timing of these
As part of the surveillance programme you will have a CT scan and CEA blood test every 6 months for 2 years and then once a year up to year 5. You will also have a colonoscopy at Year 1, Year 3 and Year 5 after your cancer diagnosis.
You will have contact details for your Colorectal Nurse Specialist and can contact them at any time if you are concerned. There are also a number of support services in Beaumont and the community you can avail of.
- Beaumont Hospital Daffodil Centre
Phone: 01 7974880 Email: firstname.lastname@example.org
- National Cancer Helpline Phone: 1800 200 700
- ARC Cancer Support Phone: 01) 215 0250
- Gary Kelly Cancer Support Centre Phone: 041) 980 5100
- LACES – Life and Cancer – Enhancing Survivorship. A workshop created by the National Cancer Control Programme (NCCP) and the Irish Cancer Society (ICS). for adult patients who have finished their active cancer treatment and are beginning their long-term follow up.