Bowel Screening

More treatment needed after an initial colonoscopy

If polyps are found in the bowel they are often removed during the initial colonoscopy but sometimes the doctor removes small tissue samples for analysis without removing the polyps. If the tissue samples are found to be benign, and major surgery is not needed, the doctor may ask the patient to return for another colonoscopy so that the polyps can then be removed. 

If the tissue samples are found to be cancerous, or if the doctors think that the polyps are potentially malignant, or if the bowel wall looks diseased, more extensive surgery may be needed. This woman had had part of her bowel removed because her polyps seemed to go deep into the bowel wall and would probably become malignant (cancerous) within five years. She had a right hemi-colectomy (part of the bowel was removed and the two ends of the bowel then joined together).

Other people had further treatment because the tissue samples clearly showed cancer. The three main treatments for bowel cancer are surgery, chemotherapy and radiotherapy. The main treatment is surgery, but if the cancer is not detected at an early stage two or more of these treatments may be used together, or in sequence (the Bowel Cancer part of our website has much more detail).



Before surgery people were told what might happen. Some were warned that they might need a colostomy (stoma) bag, at least temporarily, to allow the bowel to heal. They were also admitted for a 'pre-operation assessment' and various investigations, such as a CT scan. They also received instructions about pre-operative food restrictions.

Once in hospital some people were given laxatives to prepare the bowel for surgery; others were given an enema.

Some of the people we talked to described what happened on the day of their operation. They recalled quite major surgery. Some described a drip in the arm, drains from the wound and a catheter. One man mentioned the colostomy (stoma) he had to have for a few months. (For more on experiences of stoma see Bowel cancer).

However, one man seemed surprised that the operation to remove a cancerous growth from part of his bowel seemed relatively minor. He had to have the surgery postponed because when he was anaesthetised he developed atrial fibrillation (an abnormal heart beat), but after taking medication for his heart he was able to have the operation. He only had a small incision, did not need a drain or a temporary colostomy, and was only in hospital for a week after the operation.

Many people described the care they received in hospital as excellent.

Everyone praised the care provided by the nurses involved in the screening programme and the specialist cancer nurses, but some people criticised the nursing care they received on the wards after their operations. One woman, for example, commented on the excellent continuity of care provided by the specialist cancer nurses but said she was disgusted by the dirty hospital and lack of nursing care on the ward. She developed a wound infection and had to stay in hospital for 10 days. After she got home the wound was treated by the district nurses, who were also excellent.

Another woman said that she thought communication between hospital staff on the ward was poor, and a man said that some nurses seemed to have their minds on other things all the time. 



A few people we talked to had also had some chemotherapy after their surgery. One man, for example had about eight inches of his bowel removed. Three months later he started weekly chemotherapy, which continued for thirty weeks.

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For much more about experiences of bowel cancer, treatments (surgery, radiotherapy and chemotherapy) and living with stoma see the Bowel Cancer part of our website.

Last reviewed October 2012.

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