At Home with Chris Jessen 2018 - 86
▲ G E N E R A L H E A LT H
A NEWER TREATMENT FOR SOME CANCERS
IN THE RECTUM IS BRACHYTHERAPY, A
HIGH DOSE OF INTERNAL RADIOTHERAPY
practitioners can operate via small incisions, which leads
to a shorter hospital stay, faster recovery and less trauma
for the patient. A laparoscope - a thin, flexible, telescopelike instrument with a light at one end - is passed
through a small incision in the abdomen and the images
are displayed on a screen, allowing physicians to examine
the abdominal organs or take tissue samples (biopsy).
Where a tumour is larger or was diagnosed later,
patients may have a colectomy, which means part of
the colon is removed. The ends will then be joined
back together or a colostomy bag will be fitted.
Chemotherapy may be administered after surgery.
Radiotherapy uses high-energy rays to kill cancer
cells. It's usually given at the same time as certain types
of chemotherapy, as chemo makes cancer cells more
sensitive to radiation. Pre-operative radiotherapy can
help to shrink tumours so they are easier to remove.
It also reduces the risk of the cancer coming back.
A newer treatment for some cancers in the middle
or lower third of the rectum is brachytherapy, a high
dose of internal radiotherapy. Again, it aims to shrink
the tumour to enable its complete removal. For this
procedure, a doctor will gently insert a tube into
the patient's back passage, place it close to the tumour
and then deliver the correct dose of radiation.
Patients who didn't have radiotherapy pre-operatively
may need external radiotherapy after the operation,
particularly if the cancer wasn't completely removed,
or if it has grown through the bowel wall or spread to
nearby lymph nodes.
While radiotherapy destroys cancer cells, it also
affects normal cells nearby. For some people the side
effects are mild, but for others, reactions may be severe.
Generally, side effects include tiredness, weakness,
sore skin and loss of hair in the area treated.
Radiotherapy to the pelvis can cause diarrhoea,
sickness and bladder changes.
NHS hospitals are now using state-of-the-art
radiotherapy technology, such as TrueBeam, a device
developed by Varian Medical Systems (varian.com)
to treat a moving tumour with speed and accuracy.
It synchronises imaging, patient positioning,
motion management and treatment delivery during
radiotherapy or radiosurgery procedures. Such
pioneering advances help medical teams to view
and treat tumours with precision.
After surgery and chemotherapy have been completed,
patients will need to attend regular follow-up
appointments for several years to check the cancer hasn't
086 | FEBRUARY 2018
returned. The patient's care plan is based on a holistic
needs assessment (HNA), in which the patient is asked
about all areas of his or her life, including wound healing,
changes in bowel habit, diet and energy levels. Using this
information, the care team will put a specific strategy in
place to ensure the best possible chance of recovery.