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Suspected Bowel Cancer Pathway

Why have you been referred?

You have been referred for investigations at Derriford Hospital on the Suspected Bowel Cancer Pathway. Whilst this does not mean that you have cancer, the symptoms and history you have reported to your GP are suspicious enough to warrant fast tracking.
Most people with bowel symptoms do not have cancer but it is important to have your symptoms checked out. The cause is usually something minor like piles or Irritable Bowel Syndrome (IBS). If you have any concerns or questions, please ask us; we are here to help you.

 What happens next?

The Colorectal Pathway Navigator will call you to explain the next steps and give you instructions on the Quantitative Faecal Immunochemical Test (qFIT). The qFIT detects tiny amounts of blood in your stool (poo) that cannot be seen by the naked eye. The test enclosed is an important investigation to guide if further investigations are required.
If you have received this letter but have not yet received a call from the Colorectal Pathway Navigator, please call us urgently on 01752 432938.

Telephone Assessment Appointment

A telephone assessment appointment will be arranged for you by the Outpatient Appointment Centre. A Cancer Nurse Specialist (CNS) will call you at the specified date and time on the telephone number that you supplied when your GP arranged the referral. Please ensure that you are available and free to talk at the time of this phone call.
During this telephone call the Cancer Nurse Specialist will ask you questions about your health, your symptoms and your personal circumstances and advise which investigation(s) you need. Try not to feel embarrassed or uncomfortable about discussing your symptoms or asking them questions; the specialist colorectal team are very used to this subject.

What happens if you are referred to Radiology for investigations?

If the decision is been made to refer you to Radiology, the Radiology admin team will contact you by telephone to arrange the appointment for you. The admin team will also make arrangements for any bowel preparation medication to be sent to you via a specialist courier service with directions on how to take this and any diet restrictions.

CT Colonography: This is a specialised scan that uses a CT scanner to produce detailed images of the colon and rectum. A narrow Foley catheter will be inserted into the rectum and a small balloon inflated to keep the catheter in place whilst carbon dioxide is used to inflate the colon. You may feel some discomfort, but this should not be painful. Subject to any allergies you will be given an injection of contrast (x-ray dye) and an injection of muscle relaxant.

What happens if you are referred to Endoscopy for investigations?

If the decision is been made to refer you to Endoscopy, the Endoscopy admin team will contact you by telephone to arrange all appointments for you. This will consist of a telephone pre-assessment appointment, a COVID swab appointment and an appointment for the procedure itself. The admin team will also make arrangements for any bowel preparation medication to be sent to you via a specialist courier service with directions on how to take this and any diet restrictions.

Colonoscopy: This is a procedure that allows the endoscopist to look directly at the lining of your large bowel (colon). A long, thin, flexible and soft tube (colonoscope), approximately the same size as the average index finger, with a bright light and a camera at the end, is passed through the anus and rectum and around the colon.

Flexible Sigmoidoscopy: This is a procedure that allows the endoscopist to look directly at the lining of your lower large bowel (colon). A long, thin, flexible and soft tube (sigmoidscope), approximately the same size as the average index finger, with a bright light and a camera at the end, is passed through the anus and rectum and around the lower part of the colon.

Colon Capsule Endoscopy: This painless procedure uses a camera to examine the large bowel (colon). The capsule which you swallow contains two tiny cameras inside which take pictures of the lining of the bowel. A few days before your test you will be asked to change your diet to consume food and drinks which help soften your stools. You will need to take some strong laxatives the day before your test and again on the morning of the test. The capsule will normally pass out of your bowel in the evening before you go to bed and will just be flushed safely away down the toilet.

What if you choose not to have the investigations we recommend?

You will have an opportunity to discuss this with the Cancer Nurse Specialist at your telephone assessment appointment. Following this, if you do not feel you want to proceed with the recommended investigation you should discuss this with your referring GP.

What happens after your investigation?

In some cases we will be able to tell you there and then what we think has been causing your symptoms and offer you treatment straight away or refer you on for treatment. For some people we may need to refer you for further investigations. The specialist colorectal team will contact you or your G.P. about the results and any follow-up appointments you may require.

Contact Details

Colorectal Pathway Navigator 01752 432148

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