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Treatment of Bowel Cancer at Good Luck Hospital

The Treatment of Bowel Cancer at Good Luck Hospital, Cuttack
By Dr. Devanand Mohapatra (Gastroenterologist)
MD, MRCP (Gastro)
What is Bowel (Colorectal) Cancer?
“Colorectal” and “large bowel” are terms you may hear used when discussing the bowel.
The bowel is divided into four sections:
• Ascending • Transverse • Descending • Sigmoid. 
The bowel has no digestive function, but it absorbs large amounts of water and electrolytes, which help the maintenance of the body’s systems, known as homeostasis. Undigested food is passed on from the small bowel to the large bowel where water is re-absorbed.
Cancer occurs when cells in your bowel multiply out of control. These cells can invade surrounding tissue and spread to other parts of the body.
Most bowel cancers develop from polyps which are usually non-cancerous and, once detected, can be removed easily if caught early enough.

Bowel cancer - Who is at Risk?
Although the exact cause of bowel cancer is unknown, there are certain factors that increase your risk
Gender and age
Bowel cancer affects both men and women. 85% of all diagnoses are in people over the age of 60
Family history
People with a family history of bowel cancer are often diagnosed before the age of 45, so may need early screening
Diet and lifestyle
An inactive lifestyle and a low fibre diet can increase the risk of bowel cancer. Red and processed meat, insufficient amounts of fruit and vegetables, smoking and excess alcohol are contributory factors Inflammatory bowel disease, people with a history of Crohn’s disease in the large bowel, or ulcerative colitis, or who have had previous polyps removed, may also be at an increased risk

Bowel Cancer - Reducing your risk
A few simple lifestyle changes can help you to reduce the risk of developing bowel cancer
  • Get to know your bowel pattern, so that you know what's normal for you
  • Keep to a healthy weight, through regular exercise
  • Drink plenty of fluids: water, in particular
  • Eat a diet high in fibre, including at least five portions of fresh fruit and vegetables every day
  • Limit your consumption of red and processed meat to a maximum of one portion (approximately 80g) per day
  • Keep alcohol consumption to the recommended maximum of 14 units per week for women and 21 for men
  • avoid saturated fats and increase unsaturated fats
  • Know the symptoms of bowel cancer
  • Don’t smoke
  • Be aware of your bowel cancer family history. You may be eligible for screening if you have a history
  • Take part in the Bowel Cancer Screening Programmes when they roll out in your area and you are invited to do so. This involves completing a simple test which can help identify whether further investigation is necessary

Diagnosis
If you are concerned that you have any of the symptoms you should visit your doctor. Then, if you’re Physician
Feels that you require further investigations, you will be referred to your local hospital to see a gastroenterologist/colorectal surgeon. During the hospital visit, a decision will be made concerning the need for further tests and investigations. These might include:
• Blood tests • X-rays • Scans • Ultrasound • Barium enema • Flexi-Sigmoidoscopy • Colonoscopy

The majority of people with suspected cancer are seen by a specialist within two weeks of being urgently referred by their Physician.
Treatments for bowel cancer

The treatments for bowel or rectal cancer are different and you will have many options to consider. Your specialist consultant will discuss these with you.
The gastroenterologist will tell you which part of the bowel is affected and surgeon will tell what operation will be necessary. They will also answer any questions you or your family may have, and will arrange a date for the operation.

In some cases, surgery alone will be enough to remove the cancer and prevent it from returning. However, you may require neo-adjuvant (prior to surgery) or adjuvant (after surgery) treatment in the form of radiotherapy, chemotherapy and/or biological agents.

Following surgery, you may be referred to an oncologist who is a doctor specializing in cancer treatments and care. Any further treatments will be discussed between the oncologist and the members of the Multi-Disciplinary Team (MDT) who are managing your care. Your specialist will explain what your options are.