Colon Cancer

This document will give you information about colon cancer and will reinforce what your doctor has told you.  If there is anything you do not understand, please ask your doctor or any member of the health care team.

Our aim is to make sure you receive the best treatment to meet your needs.  We will take account of your views on the treatment you want to have, and we will fully involve you in making decisions about your treatment.  The healthcare team will not treat you without your consent.

What is colon cancer?

Colon cancer is a malignant growth that starts in the wall of the colon (large bowel) (see figure 1).  About 34,000 people develop colon cancer every year in the United Kingdom.

Figure 1 - Large Bowel

Figure 1 – Large Bowel

See Figure 1 – The Large Bowel
Your doctor can mark where the cancer is

Colon cancer can cause your bowel habits to change.  You may get diarrhoea or constipation.  The cancer can eventually cause your bowel to become completely blocked.  It can also bleed, causing you to become anaemic (not enough red blood cells).  You may see blood when you pass a motion or notice that your motions are darker than usual.  If the cancer has spread outside the colon, you may lose weight.  Effective treatment may help to control the cancer and improve your symptoms.

Symptoms /clinical features needing a urgent referral (2WW)

Rectal bleeding with change in bowel habit to loose stools/increased frequency persistent for 6 weeks All ages

Persistent (>6 wks) change in bowel habit (to looser stools and/or áfrequency) over 40 years

 Persistent (>6 wks) rectal bleeding without anal symptoms over 60 years

 Definite right sided abdominal mass. All ages.

Definite palpable rectal mass. All ages

Unexplained Fe â anaemia (Hb ≤11g/dl in men and ≤ 10g/dl in non menstruating women)

How is it treated?

There are several different options for treating colon cancer.

  • Surgery to remove the cancer along with part of the colon either side of it.
  • Chemotherapy to shrink the cancer and kill off cancer cells left after the operation.  There are treatments to ease any blockage without treating the underlying cancer.
  • Forming a stoma (opening of the bowel onto the skin).
  • Inserting a stent (metal mesh tube) across the cancer to hold the colon open.

Your doctor will help you decide which treatment, or combination of treatments, is best for you.

How do I know what is the best treatment for me?

Removing the cancer by surgery gives the best chance of you being free of colon cancer.  In some circumstances, combining surgery with chemotherapy will further improve the chances of you being free of colon cancer.  However, in some people the cancer has spread outside the colon and is no longer possible for surgery to lead to you being cured.  Treatments may control the cancer for a long time and improve your quality of life.  Chemotherapy can improve your quality of life even with widespread disease (palliative chemotherapy).

Some people who have other medical problems may not be strong enough to have major surgery and so non-surgical treatments would be better.

To decide on the best treatment for you and if surgery is likely to help you.  You may need to have a number of tests, they will not need to be repeated.

CT scan of the chest and abdomen:

This scan shows if the cancer has spread to your lungs or liver.  Sometimes you will have chest x-ray and an ultrasound scan of your live instead.


This involves passing a flexible telescope into the back passage to look at the inside of the colon.  This allows the doctor to see the cancer and perform biopsies (removing small pieces of tissue) to send to the laboratory for analysis.  It also allows the doctor to look at the rest of the colon to find out if there are any other growths (1 in 20 people has another growth elsewhere in the bowel).

Barium Enema:

This involves using a small, soft tube to place liquid barium sulphate, which shows up on x-rays, into your colon.  This allows the doctor to see the rest of the colon and to identify any other growths before the operation.  It is not possible to perform any biopsies with the barium enema.

Blood tests:

To check anaemia, and how well your liver and kidneys are working.

Heart & Lung functions tests:

These tests show if you are fit enough for surgery and will be carried out if you have problems with your heart or chest.

Once all the information is available, your doctor will discuss the results at a team meeting with the other specialists involved in your care.
Colorectal surgeons – Surgeons who specialise in diseases of the large bowel.
Oncologists – Doctors who specialise in treating cancer with medicines (chemotherapy)
and radiotherapy.
Radiologists – Doctors who specialise in x-rays and scans.
Histopathologists – Doctors who examine tissue to confirm the diagnosis.
The team will decide on the best treatment for you.  Your doctor will discuss the recommendation with you and will give you further written information to help you decide what to do.

Videos of Interest

Laparoscopic Right hemi colectomy:

YouTube Preview Image

Laparoscopic Low Anterior Resection:

YouTube Preview Image