Lower Gastrointestinal (GI) cancer

We treat and care for patients with cancer affecting their lower digestive system including small bowel (Small intestine) and large bowel (colon, rectum and appendix).

Our services
Type of treatments available
Research and clinical trials
For patients
For clinicians
Sources for further information
Meet the team

Our services

At Barts Cancer Centre, we provide state-of-the-art treatment for patients with all types of cancer affecting their lower digestive system (also known as the lower gastrointestinal tract). This includes the small bowel (small intestine) and the large bowel (colon, rectum and appendix).

Nearly all bowel cancers develop in the large bowel and these are also known as colorectal or colon cancer. This is the third most common form of cancer in the UK. However, if diagnosed at the earliest stage, bowel cancer is highly treatable and has a good survival rate.

Cancer of the small bowel is rare with just over 700 people diagnosed with this disease in the UK every year.

Type of treatments available

The treatments and equipment used at our centre are at the forefront of modern healthcare. As with all of our services at Barts Cancer Centre, treatments offered will depend on individual cases and the stage of cancer. This will be discussed in detail with every patient by one of our medical team once a diagnosis has been made.

We provide a range of treatments including surgery, chemotherapy and radiotherapy.

Surgery is usually the most common treatment for patients with colon cancer, although chemotherapy and radiotherapy may also be options following surgery. These depend on the stage and size of the cancer, and whether it can be completely removed during surgery.

Our consultant surgeons are some of the best in their field and offer the very latest surgical treatments. Wherever possible our surgical approach to treatment will be minimally invasive (also known as key hole surgery) using tiny incisions to remove the tumour, and this can result in faster recovery times and shorter stays in hospital. In 2009, our surgeons were the first to use an innovative technique called single incision laparascopic surgery (SILS) to successfully access and remove a bowel cancer tumour through a small incision in a patient’s belly button.

Depending on the position, size and spread of the cancer, surgical treatment may be more intensive and involve the partial removal of areas of the colon or bowel. If this is required, our team of specialists will explain all the options and the implications of this type of surgery.

We also offer a full radiotherapy and chemoradiotherapy service, which is particularly relevant for patients with rectal cancer.

Research and clinical trials

Our clinical trials include;

Scot - adjuvant chemotherapy trial evaluating 6 vs 12 cycles of MdG/5FU or 4 vs 8 cycles of XELOX new epoc. This is a prospective randomised open label trial of oxaliplatin/irinotecan plus fluoropyrimidine versus oxaliplatin/irinotecan plus fluoropyrimidine and cetuximab pre and post operatively in patients with resectable colorectal liver metastases requiring chemotherapy.

Piccolo - palliative treatment measuring the addition of Panimutumab in recurrent metastatic colorectal cancer patients who failed initial treatment.

Velour - comparing the efficacy of Aflibercept once every two weeks versus placebo in patients with metastatic colorectal cancer treated with Irinotecan/5-FU combination (FOLFIRI) after failure of an oxaliplatin based regimen.

BIBW 1200.74 - an open label, partially randomised phase 2 trial to investigate the efficacy and safety of BIBW 2992 as second or third line treatment for patients with metastatic colorectal cancer who never received prior anti-EGFR treatment.

For patients

At Barts Cancer Centre, we have three clinical nurse specialists who specialise in caring for people with colorectal cancer. These nurse specialists provide information and support for patients at all stages of their cancer pathway.

Kim Martin-Lumbard and Veronica (Ronnie) Winslow meet patients before or at diagnosis and support them whilst they are undergoing investigations prior to treatment. They counsel patient prior to surgery and support patients whilst they are in hospital undergoing surgery.

Marilyn (Mal) Anderson provides information and support for patients who require chemotherapy or radiotherapy as part of their treatment. This can either be before or after surgery.

Some patients may require a stoma as part of their treatment. This is when the bowel is brought to the surface of the abdomen so that waste products can be drained into a bag. This may be either permanent or temporary. If there is a potential risk of stoma formation, or if it is certain that this will be required, at the request of the consultant, the patient is counselled by either Kim or Veronica pre-operatively. Following surgery, the patient is supported both practically and psychologically to enable them to adapt to having a stoma.

For clinicians

We consistently achieve national access targets for patients with suspected cancer and for treatment following diagnosis. Referral criteria and forms are all available on our website, please click here for referral forms.