Colorectal Cancer Services | UCLH NHS Foundation Trust

We provide fast-tracked tests and investigations for people who may have bowel or anal cancer. We are also the North London centre for the national bowel cancer screening programme.

If you are diagnosed with cancer, we offer a full range of treatments. These include surgery, radiotherapy, chemotherapy and other specialist treatments.

During and after treatment our nurse-led service will help you to manage your treatment, recovery and any side effects that you have.

Your GP may refer you to UCLH if:

you have a positive bowel screening (FIT) test
you have symptoms that worry your GP, such as bleeding from your bottom or if change in bowel habits

Once we receive your referral:

you’ll get an appointment in our ‘Straight to test telephone clinic’
a clinical nurse specialist (CNS) will call to discuss your symptoms
if needed, we will book a colonoscopy
if we suspect you may have cancer, you may have a biopsy and a scan. They type of scan depends on where the cancer may be.

More details of the steps involved are on our lower gastrointestinal suspect cancer pathway page.

We know waiting for test results can be stressful. If you’d like someone to talk to about your worries, you can contact the UCLH Macmillan Support and Information Service. They can support you in person, by phone or by email.

After your tests, our multidisciplinary team (MDT) will discuss your results. You’ll then meet a doctor to go through your results and, if needed, your treatment options.

You’re welcome to bring a friend, family member or carer when you come to get your results. If we find cancer, we’ll explain:

the type of cancer
stage and grade
treatment options

Helpful resources

Bowel Cancer UK:

Macmillan Cancer Support:
- Bowel cancer

The colorectal healthcare team includes surgeons, doctors and clinical nurse specialists (CNSs). They all specialise in treating colorectal cancer. You may also meet other healthcare professionals during your care, such as:

nurses
support worker
dietitians
pharmacists
radiographers

The MDT meets regularly to make sure you get the best care and treatment. Learn more about them on our Colorectal cancer MDT page.

Role of clinical nurse specialists (CNSs)

Your CNS is your main contact. They can:

answer your questions about tests, diagnosis and treatment
offer emotional support to you and your family
advise you on managing symptoms at home 
discuss your side effects, health worries or medicines
coordinate your care at UCLH and at home   
refer you and your family to support services, such as psychology, complementary therapy, or for benefit advice  
share information about clinical trials that may be suitable

We provide a full range of treatments, including innovative options and clinical trials.

Surgery
We offer expert surgery, using traditional and keyhole techniques. Find out more on our colorectal surgery page.

Radiotherapy
We use advanced radiotherapy techniques to target the cancer and protect healthy tissue, helping to reduce long-term side effects. Find out more on our radiotherapy to the pelvis page.

Cancer drugs (chemotherapy, targeted therapy and immunotherapy)
We usually give cancer drugs in our outpatient department, chemotherapy daycare.

Each type of cancer drug works in a different way:

chemotherapy – slows down or kills cancer cells by damaging the DNA. This stops the cells from replicating and growing
immunotherapy – helps your immune system to find and kill cancer cells
targeted therapy – blocks specific processes that cancer cells need to survive. This slows and stops cancer cells from growing

There are several different medicines used to treat colorectal cancer. Your healthcare team will talk with you about which treatment is best for you.

You can use the links below to learn more about each medicine, including:

how it works
how it is given
possible side effects

Ipilimumab and Nivolumab

Lonsurf

Mitomycin

Pembrolizumab

Raltitrexed (Tomudex)

Regorafenib

Radiofrequency ablation

This uses heat to destroy cancer cells. We use it to treat cancer that has spread.

TACE

We can deliver chemotherapy directly to cancer found in the liver, targeting the cancer while reducing effects on the rest of your body.

Colon stents
If cancer blocks your bowel, a stent can relieve the obstruction and improve your symptoms.

Preparing for your treatment

Surgery: watch our having surgery at UCLH videos.
Chemotherapy: watch our videos at the bottom of our chemotherapy daycare page.
Learn ways to prepare for treatment on our prehabilitation page. It includes links to advice on staying active, eating well and looking after your emotional wellbeing.
Macmillan Cancer Support also offer tips on things to consider before starting treatment.
Speak to your CNS for advice on staying active safely, eating well and support with your emotional wellbeing.

Managing side effects

Cancer treatment can affect people in different ways. Your healthcare team will:

explain possible side effects
advise on managing them at home
support your physical, emotional and daily needs

Contact your healthcare team if you’re struggling to manage treatment side effects, or if you notice a new symptom.

The UCLH Macmillan Support and Information Service runs regular online talks with advice on managing common cancer treatment side effects. You can also find helpful information on our health and wellbeing resources page. If you would prefer personalised support, you can speak to a support and information specialist in person or contact them by phone or email.

After treatment, you’ll have regular follow-up appointments. These will include scans, blood tests and colonoscopies, usually for five years. This helps monitor your health and catch any changes early.

We understand that finishing treatment can be a challenging time. The following pages offer helpful information and support to guide you during this stage of your recovery:

Bowel Cancer UK – Living with and beyond bowel cancer
UCLH – Living with and beyond cancer

Support during your care

As well as your healthcare team, you can also get support, information and advice from the following places:

UCLH Macmillan Support and Information Service
Bowel Cancer UK – information about bowel cancer, online communities, peer support line, podcasts, videos, real life stories
Holistic needs assessment – helps you to identify extra support you may need

Support groups