Tests for bowel cancer

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Your doctor may recommend a number of tests for bowel cancer before, during and after treatment of your disease.  In general, tests for bladder cancer are performed for the same reasons as cancers in general:-

Before treatment

• Find out if patients have cancer (make a diagnosis)
• Assess the extent of disease
• Assess damage to other organs
• Assess function of organs and fitness for treatment

During treatment

• Assess whether treatment is working
• To investigate new symptoms
• Assess function of organs and fitness to continue treatment

After treatment

• To assess whether the disease remains in remission
• To investigate new symptom

For bowel cancer following tests may be recommended by your doctor:

• Rectal examination - the doctor will insert a lubricated gloved finger into your anus to feel for any abnormalities in your rectum; the test may feel a little uncomfortable but should not be painful
• Proctoscopy/ Sigmoidoscopy - the doctor will use either a short tube that just goes into your rectum (proctoscope) or a flexible longer tube that can be passed further into the large bowel (sigmoidoscope) to examine your bowel. One of these instruments will be gently passed through your anus to your rectum (proctoscopy) or large bowel (sigmoidoscopy). The tests may feel a little uncomfortable but are not usually painful. Before the test, your bowel should be cleaned so all areas can be clearly seen. This is done by putting a fluid into your rectum which results in emptying your bowel completely - this preparation is called enema. If necessary, a small sample of the abnormal cells can be taken to be examined under a microscope (biopsy).
• Colonoscopy - a test which allows the doctor to look directly at the lining of the large bowel (the colon) using a long flexible tube (colonoscope) which is gently passed through the anus into the colon. Looking down the tube, the doctor gets a clear view of the lining of the bowel and can check whether or not any disease is present. Sometimes the doctor takes a biopsy – a sample of the lining for examination in the laboratory. You will have a bowel preparation to clean your bowel before the test.
• Barium enema and X-ray - a test that involves inserting a fluid containing barium (which shows up on X-ray) into the bowel through the rectum. The inside of the bowel then shows more clearly on the X-ray.

Other tests may include:

• PET scan (positron emission tomography) - this scan produces three-dimensional picture of the internal body structures. Before the test you will be injected with a solution containing a very small amount of radioactive material which results in a clearer picture on the PET scan. This gives the experts a more detailed information about the part of body which is being examined.

• Ultrasound - uses high-frequency sound waves that reflect off the soft tissue structures in the body to form an image.
• CT (computerised axial tomography) scan -  a type of X-ray that builds up a three-dimensional picture of the bowel to show the position of the tumour.
• MRI (magnetic resonance imaging) scan -  similar to a CT scan but uses magnetic fields, instead of X-rays, to build up a picture of the bowel.
• Blood test - to asses your liver function, to check for anaemia
• Chest x-ray - to check overall condition of the heart and lungs prior to the surgery, to check whether the bowel cancer has spread to the lungs

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.