Colon, rectal and anal disorders, such as cancer, crohn’s and colitis may be diagnosed or treated by the Colorectal team at LTHTR. Our specialist colorectal team consists of Colorectal surgeons, Endoscopists, Oncologists, Radiologists, Histo-pathologists and Clinical Nurse Specialists.
Contact us:
The Colorectal Specialists Nurses work from 8am to 6pm Monday to Friday.
If you have any questions or concerns at any time, you can contact the Colorectal cancer specialist nurses on 01772 522371. If we are not in the office at the time of your call an answer machine is available. If you reach this please leave a message. Your calls will be returned as soon as possible, however please be aware this may not be the same day.
Please note that all telephone calls from the hospital are from an anonymised or withheld number. If your telephone blocks anonymised calls, we may not be able to contact you. Please let us know if this affects you.
Please note that this is not an emergency service and does not operate out of hours. You should contact your GP if you need advice on the same day.
Understanding why you have been referred to hospital
Your GP has asked for you to have an urgent appointment or test because you have displayed symptoms which may be caused by cancer
Whilst it is unlikely that you have cancer it is very important that you are seen by a specialist as soon as possible.
The suspected cancer faster diagnosis system has been introduced across the country so that patients with symptoms that could be caused by cancer are seen by a specialist quickly.
Most patients referred under this system turned out not to be diagnosed with cancer, but early diagnosis can increase the success rate of many cancer treatments.
What happens when you have been referred
Your GP will send your referral to Lancashire Teaching Hospitals.
If your GP gives you a blood test performed as part of your referral you will need to arrange to have a blood test through your GP surgery before you attend your first hospital appointment. These blood tests are required as soon as possible for diagnostics to be arranged at the hospital.
If you are unable to access a blood clinic within 24 to 48 hours, then please use the urgent walk-in clinic at Royal Preston Hospital outpatient department.
Opening hours are 08.30am to 4.30pm Monday to Friday
What to expect at your first appointment
Following a referral from your GP you will receive an appointment for a telephone consultation from one of the specialist clinicians. If the patient would prefer a face to face appointment this can also be arranged.
You will be given an approximate time to expect the call and the appointment would be expected to last 10-15 minutes. The clinician will ask you a variety of questions including why you have been referred to the colorectal service, the problems/concerns you have been having, your past medical history, any medications you are taking and any allergies you may have. You may find that you are repeating all the information that you have already told the GP, but it is important for us to try and understand your concerns and address all the problems you are having.
If you are attending the hospital for a face to face appointment, please be aware that the clinician may need to examine your tummy and also examine your back passage. This will depend on the symptoms you are having. Following this consultation you are likely to require specialist investigations to assist in diagnosis. These tests will be done as an outpatient and will be carried out within 2 weeks of your initial consultation.
You can find more information about diagnostic tests and what they involve on the next tab.
Diagnostic Tests
Following your first consultation you are likely to require specialist investigations to assist in your diagnosis, these often include:
- Colonoscopy
A Colonoscopy is carried out as an outpatient in one of our Endoscopy departments at either Preston or Chorley hospital. A colonoscopy looks at the inside of the whole length of the large bowel (Rectum and colon)to help identify abnormalities. You will be given instructions by the endoscopy department about what to eat and drink in the 24 hours before your procedure, and you will receive a prescription for some strong laxatives to empty your bowel prior to the test.
The endoscopy teams at Preston and Chorley will ensure that you are comfortable during the procedure. They will talk to you about having a sedative to ensure you are relaxed while you have the colonoscopy.
You will be assisted to comfortably lie on your side and the endoscopist will gently pass a flexible tube into your back passage. There is a small camera and light on the end of the flexible tube and this helps the endoscopist identify any areas of abnormality, take pictures and take small samples (biopsies) if needed to help with diagnosis.
Most patients can be discharged home following a couple of hours of observation. If you have had sedation you will need someone to collect you following the procedure. You are advised not to drive following sedation for 24hrs.
- Sigmoidoscopy
A Sigmoidoscopy is carried out as an outpatient in one of our Endoscopy departments at either Preston or Chorley hospital. A sigmoidoscopy looks at the inside of the rectum and the first part of the colon (the sigmoid colon).
The endoscopy teams at Preston or Chorley will ensure you are comfortable and talk you through the procedure. You will be assisted to lie on your side and be given an enema to ensure your back passage is clear ready for the sigmoidoscopy.
The endoscopist will gently pass a flexible tube into your back passage. There is a small camera and light on the end of the flexible tube and this helps the endoscopist identify any areas of abnormality, take pictures and take small samples (biopsies) if needed to help with diagnosis.
Most patients can be discharged home as soon as the test is over.
- Gastroscopy
A gastroscopy is carried out as an outpatient in one of our Endoscopy departments at either Preston or Chorley hospital. A gastroscopy looks at the lining of the oesophagus, stomach and duodenum (the first part of the small bowel).
The staff in the department will make you comfortable on the endoscopy bed on your left side. A local anaesthetic spray will be used to numb your throat for the procedure, and you will also be offered a sedative injection. A doctor or specialist nurse will use a thin, flexible tube with a light to look down your oesophagus. They may take biopsies and take pictures to help with diagnosis.
The test often takes less than 15 minutes, and you will be allowed home within a few hours on the procedure.
- CT scan (Computerised tomography)
A CT scan uses x-rays and a computer to create detailed images of the inside of your body. They are carried out by specialist clinicians called radiographers. The scan takes 10-30 minutes and is painless. You will be asked not to eat or drink for at least four hours before the scan.
Before having your scan you may be given a special dye called a contrast to help improve the quality of the images. The contrast is injected into the vein. The scan will take approx. 30 minutes and you will be asked to lie on your back, on a flat bed whilst the bed passes through the CT scanner. It uses a small amount of radiation, which is very unlikely to harm you and will not harm anyone you come into contact with.
- MRI Scan (Magnetic resonance imaging scan)
A MRI scan uses strong magnetic waves to produce a detailed picture of areas of your body. They are carried out by specialist clinicians called radiographers.
The scanner is a powerful magnet and you will be asked to complete a checklist about any metalwork in your body to ensure it is safe for you. You will be asked to remove all jewellery before the scan. Some people are given a special injection into the vein before the scan to help improve the quality of the images.
The scan takes approx. 30 minutes and is painless. You will be assisted to get comfortable on the flat bed and given earplugs/headphones so you can communicate with the person operating the scanner. Some people find they feel a bit claustrophobic but the clinicians are there to help you relax throughout the scan.
Further Tests
The specialist team may ask for further tests to help with your diagnosis. These may include:
- CT Colonogram
A CT colonogram is a test that uses CT scans to check the large bowel (colon) and back passage (rectum). This is also known as a virtual colonoscopy.
For this test your bowel must be completely empty and you will be given strong laxatives to take at home the day before the procedure.
- PET scan (Positron emission tomography)
Our PET scanner is based at our Preston site and are carried out as a outpatient.
A PET scan provides detailed 3-dimensional images of the body. They can help the team look more clearly at the area of the body being investigated and are particularly helpful for investigating cancer.
You will be given instructions by the radiographer before you attend for your scan about how you should prepare. They will advise that you wear comfortable clothing, remove all jewellery and ideally avoid any strenuous exercise for 24hrs before your appointment.
Before the scan you will be injected with a substance called a radiotracer. You will asked to lie on a flat bed and the scanner will take pictures of your body. The scan usually takes up to 30 minutes and is completely painless.
Waiting for Results
We understand that waiting for test results may be difficult. If your investigations are suspicious for a colorectal cancer you will be contacted by a Colorectal Specialist Nurse who will explain the next steps in your treatment pathway. This will include discussion of your investigations in the Colorectal MDT (Multi-disciplinary Team), followed by a clinic appointment with your named consultant and specialist nurse. If you do not have a diagnosis of colorectal cancer you will receive your results in writing.
Receiving a diagnosis
At your appointment with your consultant and specialist nurse we will explain your diagnosis and treatment options. Your consultant will explain the aim of the treatments and whether the aim is to cure or control the cancer. We will make you aware of the benefits and side effects of treatment. All treatment options will be discussed with you and we can also talk through what may happen if you decide against any treatment. You will be guided through these treatment options and supported in making your decision.
We would advise that you bring a relative/friend to support you at this appointment.
Treatment Options
Treatment may include an operation to remove the cancer and/or relieve your symptoms. This would involve removal of the affected part of bowel and the surrounding lymph nodes. However, surgery alone is not always successful in curing bowel cancer and often chemotherapy or radiotherapy is given before or after surgery, either to shrink the cancer prior to removal or reduce the risk of cancer returning later on.
Lancashire Teaching Hospital specialises in the treatment of early colon and rectal cancers. If you are diagnosed with an early colon/rectal cancer, surgical excision alone can be an effective treatment.
Your Cancer Treatment Plan
- Surgery
Surgery
Surgical operations performed at Lancashire Teaching Hospitals
- Colonic resection
- Minimally invasive surgery
- Right hemi
- Segmental resection
- Left hemi
- Sigmoid colectomy
- Anterior resection
- Abdominal Perineal Resection (APR)
- Transanal Endocsopic MicroSurgery (TEMS)
For more information please visit the cancer surgery page at cancerresearchuk.org
- Radiotherapy
Radiotherapy treatment options
Radiotherapy uses high energy x-rays to treat cancer. It destroys cancer cells in the area that it is given.
During radiotherapy treatment normal cells can also be damaged as well as cancer cells.
This can cause side effects which your Oncologist will discuss with you in detail at your appointment.External beam radiotherapy can be a treatment for some low rectal cancers. This is known as external beam radiotherapy. This form of radiotherapy is given from outside the body (externally) by a radiotherapy machine.
Radiotherapy is always carefully planned by your oncologist. Before starting treatment, you will have a CT scan which your oncologist will use to plan your treatment.Lancashire Teaching Hospital specialises in the treatment of early colon and rectal cancers. If you are diagnosed with an early colon/rectal cancer, surgical excision alone can be an effective treatment.
Chemoradiotherapy
Sometimes chemotherapy is given at the same time as radiotherapy. This is called chemoradiotherapy. Chemotherapy medicine make cancer cells more sensitive to radiotherapy and helps the radiotherapy work better.
Your Oncologist will discuss this treatment with you in detail at your appointment. - Chemotherapy
Chemotherapy treatment options
Chemotherapy is a cancer treatment where medicine is used to kill cancer cells. There are different types of chemotherapy medicine, but they all work in a similar way. Chemotherapy medicine disrupts the way cancer cells grow and divide but they also affect normal cells.
Chemotherapy can be given in 2 different ways. The most common types are:
- Intravenous chemotherapy- This is medicine given into a vein. This will be done in hospital and involves medicine being given through a tube in a vein in your hand, arm, or chest.
- Oral Chemotherapy- This is medicine in the form of tablets. This usually involves taking a course of medicine at home. You will receive regular check-ups in the hospital.
Chemotherapy is usually given over a few months. Your Oncologist will discuss with you how often the chemotherapy will be given and the side effects of treatment.
Chemoradiotherapy
Sometimes chemotherapy is given at the same time as radiotherapy. This is called chemoradiotherapy. Chemotherapy medicine make cancer cells more sensitive to radiotherapy and helps the radiotherapy work better. Your Oncologist will discuss this treatment with you in detail at your appointment.
- Stomas
Stomas
Depending on the extent of the operation and position of your cancer, the two ends of bowel may be stitched together. However with some operations, this is not possible and you may require a stoma. A stoma is an artificial opening created when the healthy part of your bowel is brought out onto the surface of your abdomen. There are various types of stomas, for example:
- Colostomy - A colostomy is where a part of the colon (large bowel) has been surgically diverted onto the surface of the abdomen. The most common location for a colostomy is on the lower left hand side of the abdomen, although this can vary. The output from a colostomy includes liquid or formed stool. The formation of a colostomy may be either temporary or permanent.
- Ileostomy - A Ileostomy is where a part of the small bowel (ileum) has been surgically diverted onto the surface of the abdomen. The most common location for a ileostomy is on the lower right hand side of the abdomen, although this can vary. The output from a ileostomy is generally of a liquid consistency. The formation of a ileostomy may be either temporary or permanent.
Patient Contribution to Case Notes (PCCN)
The PCCN is your voice to help us improve our services. You will receive the booklet at pre-op and are encouraged to start filling it in before you come into hospital
It is a document for our patients and families to use which encourages the conversation to be around what is important and what matters to you.
The booklet gives you space to write about what you want to know, about your progress and what questions you might have that you want to discuss.
See our Patient Contribution to Case Notes page.
Your Colorectal and Stoma Care Clinical Nurse Specialist (CNS)
Our Colorectal and Stoma Care Nurses Specialists are here to offer advice and support to you and your family following a colorectal diagnosis of both malignant (cancer) and benign (non-cancer). They have expert knowledge and experience in Colorectal disease and may sometimes be referred to as your key worker.
How can we help?
We can provide an opportunity to discuss your diagnosis, disease and treatment plan, including a chance to talk through information you have been given. We can explain what investigations are for and what they involve, making sure you understand what is happening at each stage of your treatment.
We can put you in touch with other services in the hospital and in the community. There are a number of support agencies that you may like to know about.
If you are experiencing any problems or symptoms at home then please contact us. If we are unable to answer your questions we will endeavour to help you find the information you need, or put you in touch with the right person.
It is often when you have left hospital that you think of things you should have asked, or would like more explanation. We are available to help at this time. If you are admitted to any hospital for any reason, please ask someone to let your specialist nurse know.
We are also available to speak to your family (with your consent). They may have their own questions about your illness or treatment.
The CNS can provide information, advice and support for patients and their families, from diagnosis onwards, in areas including:
- Surgery
- Chemotherapy
- Radiotherapy
- Clinical trials
- Fistula Management
- Ileo-anal pouch advice
- Dietary advice
- Psychosexual issues
- Support agencies/groups
- Fertility and infertility advice and information
- Finance
- Hospice Care
- Symptom Control
- Local and national services
You may meet your nurse specialist:
- At the outpatient surgical clinic
- At the outpatient oncology clinic
- On the ward
The role of the Colorectal CNS team:
We provide support for patients and their families and to act as a link between health care professionals.
We provide a point of contact for patients and carers from diagnosis onwards. This can be a very uncertain time in your life. By providing clear information we hope to reduce some of the fears and anxieties you may be facing.
- To act as your key worker
- To make sure your care runs smoothly
- To act as a point of contact about any aspect of your care
- The service is confidential. You can discuss your worries and / or concerns directly
- To provide a link between you and your doctors
Who can access this service?
- Any patient who has a diagnosed UGI cancer
- Family and carers of any diagnosed UGI cancer patients
- Other health professionals to access information and to provide a seamless pathway of care for the patient
What is a Holistic Needs Assessment (HNA)
A cancer diagnosis can affect you in many different ways.
A holistic needs assessment is a discussion between a you and a healthcare professional in which concerns can be identified and a personalised care and support plan can be put in place. It is a way to start a conversation about any needs or concerns that you may have and allows the team to signpost these concerns to relevant services that can assist and support accordingly. This could include; Practical, emotional, spiritual or physical concerns as well as identifying areas where more information or further support is needed.
Clinical Trials
Research can give you access to treatments which are otherwise unavailable. Clinical trials will lead to faster results and quicker improvements in cancer treatment for future cancer patients.
We have a core team of doctors, nurses, radiotherapists and data managers to support patients to participate in clinical trials and research studies.
At Lancashire Teaching Hospitals we offer a range of research studies and clinical trials at any one time for most cancers, ranging from brain to breast cancer, prostate to pancreas and many more. Research can lead to better prevention, detection and treatment of cancer.
Some helpful organisations:
Cancer Research
PO Box 123 Lincoln’s Inn Fields London WC2A3PX
Tel 020 7121 6699 www.cancerresearchuk.org
Oesophageal Patients Association
22 Vulcan House Vulcan Rd Solihull West Midlands B91 2JY
Tel 0121 704 9860 www.opa.org.uk
Cancer Help Preston
Vine House 22 Cromwell Road Ribbleton Preston PR2 6YB
Tel 01772 793344 www.cancerhelppreston.co.uk
Contact us:
The Colorectal Specialists Nurses work from 8am to 6pm Monday to Friday.
If you have any questions or concerns at any time, you can contact the Colorectal cancer specialist nurses on 01772 522371. If we are not in the office at the time of your call an answer machine is available. If you reach this please leave a message. Your calls will be returned as soon as possible, however please be aware this may not be the same day.
Please note that all telephone calls from the hospital are from an anonymised or withheld number. If your telephone blocks anonymised calls, we may not be able to contact you. Please let us know if this affects you.
Please note that this is not an emergency service and does not operate out of hours. You should contact your GP if you need advice on the same day.
Sources of further information
Get to know your multidisciplinary cancer care team
If you have been told you have cancer or are under investigations for cancer, your care and treatment will be overseen by a multidisciplinary team of specialist healthcare professionals also known as an MDT.
Cancer care can be complicated and there can be a number of health care professionals involved in your diagnosis, treatment and ongoing care. As an MDT they work together and meet regularly reducing the time needed to reach a diagnosis and plan the treatment they feel is best for you.
The Colorectal MDT consists of:
- Colorectal Surgeons
- Colorectal Specialist Nurses (CNS)
- Advanced Specialist Practitioners (ASP)
- Specialist Stoma Nurses
- Oncologists
- Histopathologists
- Radiologists
- Endoscopists
You can find more information about our colorectal team and the individual roles in the drop downs below…
- Consultant Surgeons
Consultant Surgeons
We have a team of 8 colorectal surgeons whom are vastly experienced and respected in their specialist areas
- Colorectal Cancer Nurse Specialists (CNS)
Colorectal Cancer Nurse Specialists (CNS)
These experienced professionals support you throughout your care. They will be there at clinics when we meet you for the first time, as well as during the follow-up periods. They work very closely with the colorectal surgeons and the oncology teams to ensure all patients are supported throughout their journey.
- Sr Catherine Boyle
- Sr Maria McEneaney
- Sr Helen Brookes
- Sr Sarah Tomlinson
- Sr Rebekah Hitchon
- Advanced Specialist Practitioners (ASP)
Our Advanced Specialist Practitioners support patients from referral to the service, and through the investigation process. These experienced practitioners will ensure your investigations are carried out in a timely manner and results sent to you and your GP.
- ASP Claire Stephens
- ASP Corrie Rosenburg
- Consultant Radiologists
Our expert radiology team work closely with the rest of the team to diagnose and treat colorectal conditions using medical imaging. They are crucial in the diagnosis process of our patients. Medical imaging investigations include x-ray, MRI, CT and ultrasound.
Dr Gagan Thind
Consultant Radiologist
- Consultant Histopathologists
Histopathologists study tumours by examining biopsies using microscopes. The histopathologists within the team are responsible for making tissue diagnosis and helping the team manage a patients care.
- Consultant Oncologists
The oncology team provides medical treatment for people diagnosed with cancer. Oncologists treat cancer using chemotherapy, radiotherapy and other medications. The Rosemere Centre at Preston is home to all our oncology teams. It provides a calm and supportive environment in which you will attend for appointments with your oncologist and receive your treatment.
Dr Deborah Williamson
Consultant Histopathologist
- Dr Sin Lau
- Dr Beaumont
- Dr James Haston
- Consultant Endoscopist
The endoscopy team care for you before, during and after an endoscopic procedure. These investigations include colonoscopy, flexible sigmoidoscopy and gastroscopy. They work closely with the rest of the multidisciplinary team in diagnosing colorectal conditions.
- Mr Rob Hart
- Specialist Stoma Nurses
We have a dynamic team of stoma nurses that support and care for patients that require surgical resections and stomas.
- Sr Diane Sheard
- Sr Carol Prescott
- HCA Debra Paxton
- Secretarial and Admin Support-MDT Co-ordinator
Our dedicated admin team collect all the relevant information required for us to plan your care. They help us communicate effectively with you and your doctor.
- Debbie Hall (MDT Co-ordinator)
- Louise Curwen (Mr Hany/Mr Bhowmick secretary)
- Jill Slater (Mr Peristerakis/Miss Jadav secretary)
- Helen Wilding (Mr Mitchell/Mr Beverdige secretary)
- Jane stone (Mr Parkin/Mr Barrow secretary)
