Lower Gastrointestinal Cancer

Services

Bedford Hospital NHS Trust

Lower Gastrointestinal Cancer Services

Lower Gastrointestinal cancer services at Bedford Hospital are provided by the Lower Gastrointestinal Team which consists of Consultants and Clinical Nurse Specialists. 

The Colorectal Team

The Consultants and Clinical Nurse Specialists are:

Consultants
Mr M Wilde 01234 355 122 ext:2195  Max.Wilde@bedfordhospital.nhs.uk
Mr A Eldin 01234 355 122 ext:5505  Ahmed.Eldin@bedfordhospital.nhs.uk
Miss K Bevan 01234 355 122 ext: 5692 Katharine.bevan@bedfordhospital.nhs.uk
Mr D Skipper 01234 355 122 ext: 2199 David.Skipper@bedfordhospital.nhs.uk

Nurses
Karen Richards 01234 355 122 ext: 2887 Karen.Richards@bedfordhospital.nhs.uk
Adailia Paul 01234 355 122 ext:2887 Adailia.Paul@bedfordhospital.nhs.uk

Outpatient Appointments

Following referral under the 2 week rule, patients will be seen in outpatients by a Consultant Colorectal Surgeon or another member of the team with 1-2 weeks.

In May 2010, a dedicated breast and bowel cancer centre was created to offer patients a 'one stop' service.  The purpose built facility, based in main outpatients, contains diagnostic and clinical facilities meaning that patients with suspected breast or bowel cancer can have diagnostic tests, results and consultations in the same place and in many cases, on the same day.

The new centre makes the service more efficient and convenient for anxious patients, and means that any treatment required can begin as soon as possible.  The new clinic also creates extra capacity which will reduce waiting times for patients with suspected breast or bowel cancer

Outpatient clinics take place:

Day Morning Afternoon
Monday Mr Wilde Mr Wilde
Tuesday Miss Bevan Miss Bevan
Wednesday Mr Skipper -
Thursday Mr Eldin -
Friday - -

Who to Refer

All patients can be referred; particularly those covered by the Anglia Cancer Network area - NHS Bedfordshire residents in North and East Bedfordshire.

Urgent referral within 2 weeks (under 2 week rule)

Refer urgently patients:

  • Aged 40 years and older, reporting rectal bleeding with a change of bowel habit towards looser stools and/or increased stool frequency persisting 6 weeks or more.
  • Aged 60 years and older, with rectal bleeding persisting for 6 weeks or more without a change in bowel habit and without anal symptoms.
  • Aged 60 years and older, with a change in bowel habit to looser stools and/or more frequent stools persisting for 6 weeks or more without rectal bleeding.
  • Of any age with a right lower abdominal mass consistent with involvement of the large bowel.
  • Of any age with a palpable rectal mass (intraluminal and not pelvic; a pelvic mass outside the bowel would warrant an urgent referral to a urologist or gynaecologist).
  • Who are men of any age with unexplained iron deficiency and a haemoglobin of 11g/100 ml or below.
  • Who are non-menstruating women with unexplained iron deficiency anaemia and a haemoglobin of 10g/100ml or below.

Risk Factors

Offer patients with ulcerative colitis or a history of ulcerative colitis a follow-up plan agreed with a specialist in an effort to detect colorectal cancer in this high risk group.

Investigations

  • Always carry out a digital rectal examination in patients with unexplained symptoms related to the lower gastrointestinal tract.
  • Where symptoms are equivocal a full blood count may help in identifying the possibility of colorectal cancer by demonstrating iron deficiency anaemia, which should then determine if a referral should be made and its urgency.
  • When referring, a full blood count may assist specialist assessment in the outpatient clinic.
  • When referring, no examinations or investigation other than abdominal and rectal examination and full blood count are recommended as this may delay referral.

Macmillan Cancer Support Rapid Referral Guidelines

Macmillan Cancer Support Rapid Referral Guidelines

Who not to Refer

Patients outside of the Anglia Cancer Network area are usually referred to Hospitals within their Cancer Network area.  NHS Bedfordshire residents living in North and East Bedfordshire are included under the Anglia Cancer Network.

South Bedfordshire patients are included under the Mount Vernon Cancer Network and usually referred to the Luton & Dunstable Hospital.

Resources

Map of Medicine Patient Pathway

Map of Medicine Patient Pathway

NICE Guidelines:

CG27 Referral for suspected cancer: full guideline
http://guidance.nice.org.uk/CG27/Guidance
CG27 Referral for suspected cancer: quick reference guide
http://guidance.nice.org.uk/CG27/QuickRefGuide/pdf/English
CG27 Referral for suspected cancer: information for the public
http://guidance.nice.org.uk/CG27/PublicInfo/pdf/English
CG27 Referral for suspected cancer: NICE guideline
http://guidance.nice.org.uk/CG27/NICEGuidance/pdf/English

Website Resources

Lower Gastrointestinal Cancer NHS Choices:
http://www.nhs.uk/conditions/Cancer-of-the-colon-rectum-or-bowel/Pages/Introduction.aspx
Beating Bowel Cancer:
http://www.beatingbowelcancer.org/
Bowel Cancer UK:
http://www.bowelcanceruk.org.uk/
Cancer Research UK - Bowel Cancer:
http://cancerhelp.cancerresearchuk.org/type/bowel-cancer/
Health Talk Online:
http://www.healthtalkonline.org/Cancer/Colorectal_Cancer
Health Talk Online - Screening:
http://www.healthtalkonline.org/Cancer/Bowel_screening
Lab Tests Online:
http://www.labtestsonline.org.uk/understanding/analytes/fobt/tab/glance
Lynn's Bowel Cancer Campaign:
http://www.bowelcancer.tv/
Macmillan Cancer Support - Bowel Cancer:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Bowelcancer.aspx
NHS Cancer Screening Programmes
http://www.cancerscreening.nhs.uk/
World Cancer Research Fund
http://www.wcrf-uk.org/cancer_prevention/types_of_cancer/index.php
Bowel Cancer Campaign
http://www.nhs.uk/bowelcancer/Pages/bowel-cancer.aspx
Beating Bowel Cancer Website
http://www.nhs.uk/bowelcancer/Pages/bowel-cancer.aspx
Bowel Cancer UK Website
http://www.bowelcanceruk.org.uk/
South Asian Cancer Awareness Campaign
 http://www.bowelcanceruk.org.uk/
Be Clear on Cancer Campaign
http://www.dh.gov.uk/health/2011/12/campaign-to-promote-earlier-diagnosis-of-bowel-cancer/

Cancer Network

Anglia Cancer Network - for residents from Norfolk, Suffolk, Bedfordshire and Cambridgeshire
http://www.angliacancernetwork.nhs.uk/



Last updated: 10/10/2012

Update due: 10/10/2013