Colorectal Cancer Surgery

• A persistent change in bowel habit, such as looser stools, more frequent motions or constipation, lasting three weeks or more
• Blood in the stool or bleeding from the back passage
• A feeling that the bowel has not emptied fully after going to the toilet
• Unexplained tiredness or breathlessness, which may be due to anaemia
• Unintentional weight loss
• Persistent lower abdominal pain, bloating or discomfort, often related to eating
• A lump in the tummy or back passage noticed by you or your doctor

The exact cause of bowel cancer is not fully understood, but several factors are known to increase the risk. Age is the most important, with most cases occurring in people over 50. A diet high in red and processed meat and low in fibre, being overweight, lack of physical activity, smoking and drinking alcohol all raise the risk. Long-standing inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, can also increase the likelihood of bowel cancer over many years.

In a minority of people there is a strong family history or an inherited condition, such as Lynch syndrome (HNPCC) or familial adenomatous polyposis (FAP), which markedly increases risk and may warrant earlier and more frequent screening. Having previously had bowel polyps removed is another risk factor. It is important to remember that many people who develop bowel cancer have none of these risk factors, and having a risk factor does not mean cancer is inevitable — it simply means screening and being alert to symptoms are especially worthwhile.

If bowel cancer is suspected, the key investigation is usually a colonoscopy, in which a thin flexible camera is passed into the bowel to inspect the lining directly and to take biopsies or remove polyps. A CT colonography (a specialised CT scan of the bowel) may be used as an alternative for some patients. In the UK, the national bowel screening programme uses a home stool test (FIT, the faecal immunochemical test) to detect tiny traces of blood and identify people who should be offered a colonoscopy.

If a cancer is confirmed, further scans are arranged to determine its stage — how large it is and whether it has spread. This typically includes a CT scan of the chest, abdomen and pelvis, and for rectal cancers an MRI of the pelvis to assess the tumour and nearby lymph nodes in detail. Staging is described using the TNM system and broadly grouped from stage 1 (early, confined to the bowel wall) to stage 4 (spread to other organs). All results are reviewed by the multidisciplinary team so that a personalised treatment plan can be recommended.

If bowel cancer is suspected, Mr Hussain arranges prompt assessment — usually a colonoscopy to inspect the bowel and take biopsies, followed by staging scans (a CT of the chest, abdomen and pelvis, and an MRI of the pelvis for rectal cancers) to show whether and how far it has spread. Private patients can usually be seen within days and investigated quickly.

Every case is reviewed by a colorectal multidisciplinary team (MDT) of surgeons, oncologists, radiologists, pathologists and specialist nurses, who together recommend a personalised treatment plan. Mr Hussain and a specialist nurse explain your diagnosis, stage and options in plain language, and you are supported at every step. Where surgery is needed it is planned carefully, often using keyhole techniques and an enhanced recovery programme to help you recover as quickly and safely as possible.

Mr Hussain follows an Enhanced Recovery After Surgery (ERAS) programme, which is designed to help you recover as quickly and safely as possible. This means good preparation before your operation, careful pain control, early eating and drinking, and getting up and moving on the same day or the day after surgery. Most people who have keyhole bowel surgery stay in hospital for around three to six days, though this varies with the operation and your overall health.

Once home, it is normal to feel tired for several weeks, and your bowel habit may take time to settle into a new pattern — the specialist team will give you tailored dietary advice. Most people gradually return to normal activities over four to six weeks, avoiding heavy lifting in the early period. If you have a stoma, your stoma nurse will support you until you are confident managing it. You will then enter a structured follow-up programme with clinic reviews, blood tests, scans and colonoscopy at intervals to check your recovery and watch for any sign of recurrence.