Referral routes
Please make an appointment with your GP if you notice a change in your bowel habit. You may also be referred to our service following a positive bowel screening test.
Safe, effective care
Our aim is to provide you safe effective care, given by the right people, at the right time in the right place.
Practical Information
Use the section below to help you find answers to some of the common practical questions that you may have. Click on the blue panel and it will expand to give more information on the relevant section.
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Getting here & maps
Many initial consultations will take place in the outpatients department or in the colorectal unit. The colorectal unit is on Level 6 in the tower block of Victoria Hospital. If you have been informed that your appointment is in the colorectal unit please make your way to Level 6 and book in at our reception desk.
What happens next
Why have I been referred to hospital?
If you have had a colonoscopy and a cancer is suspected then you will require to have a CT and/or MRI scan. We will need the biopsy results from your colonoscopy and your scan results before we can discuss your case at our Multi disciplinary team meeting (MDT).
Does this mean I have cancer?
No, there are many common conditions that symptoms could be linked to, including the possibility of cancer. Nine out of 10 people referred to the hospital do not have cancer.
Why do I need to be seen?
Although it is most likely that you do not have cancer, it is important we carry out the necessary assessments and tests as quickly as possible. This is done to reassure most of those referred, but also to quickly diagnose and start treatment on the small number that do have cancer. It is important that you attend all the appointments we offer you to ensure there are no delays.
How many appointments do I need?
It is difficult to say how many appointments you will need to attend, If you have an emergency and cannot keep your appointment, please let us know as soon as possible by calling the number on your appointment letter so that we can rearrange your appointment. Some patients will go straight for tests and investigations. You should receive instructions prior to your appointment. Please follow the instructions carefully otherwise it can lead to tests and investigations being delayed or cancelled. If you are unclear, please call the number on your appointment letter.
What happens at my first appointment?
Your first appointment will usually be with one of the colorectal surgeons. At this meeting your biopsy results and any scan results will be discussed with you, if they are available. You will have the chance to ask any questions that you have. We aim for this appointment to take place prior to the Multi-disciplinary team meeting. The surgeon will assess your fitness and wishes for any treatment that is likely to be offered.
Your multidiscipilary team meeting (MDT)
The MDT takes place on Friday morning. The meeting involves the colorectal surgeons and specialist nurses along with the oncology consultants, radiologist and pathologist. Your scans will be reviewed along with any biopsies. It is then a joint decision by the team about what happens next, which may be further investigations prior to treatment if required.
Most patients are happy to get their results and plan over the telephone. We would aim to contact you on the day of the MDT meeting.
Treatment and Investigations
After the MDT we often require to undertake further scans eg PET or MRI then will offer you one of the following treatment options.
Surgery
There are a number of different operations for bowel cancer depending on where your cancer is in your bowel. Surgery may be keyhole, open (larger cut) or robotic.
Radiotherapy
You may require radiotherapy prior to surgery. You will see the oncologist in Queen Margaret Hospital but your radiotherapy will be performed at the Western General Hospital in Edinburgh.
Chemotherapy
You may require chemotherapy prior to surgery or after surgery. You will see the oncologist in Queen Margaret Hospital who will assess your fitness for chemotherapy. Your chemotherapy will take place in Queen Margaret Hospital.
Prehabilitation
All patients will be offered an appointment to attend a prehabilitation session. This is held at the Maggie’s centre at Victoria Hospital. It is a group session and gets you ready for any treatment offered. You will be given advice on diet, exercise and coping mechanisms. You can bring a friend or family member to this meeting
Best Supportive Care
Best supportive care focuses on quality of life and aims to help you live as well and as comfortably as possible, rather than curing the cancer. Best supportive care can:
- Help with symptoms such as pain, sickness or problems eating.
- Help you and the people you care about come to terms with the diagnosis and what it means.
- Help you talk about the future and plan ahead. This can be hard to do, but can help you feel more prepared and in control.
- Support you to manage at home.
Your Cancer Nurse Specialist can discuss with you how your own Best Supportive Care might be provided. For people living at home, their GP and District Nurse are usually the main point of contact.
Your care team
The Colorectal Cancer team includes consultant surgeons, specialist nurses and oncologists. We are here to support throughout your diagnosis and treatment. If you need to contact us please call 01592 6443355 extension 21047, 21051 or 20466. If we are not available please leave a message on our answering machine and we will contact you as soon as we can.
What can you do to prepare
We will ask you to make an appointment to attend the prehabilitation session at the Maggies centre.
This is a getting started session and helps you to prepare for any treatment you will be offered.
Handy hints
- Think about arranging transport, time off work or childcare for the day of your appointments.
- Make sure you know where you are going.
- Bring a pen and paper to take notes.
- Try to bring a friend or family member with you.
- Allow extra time in case it takes longer than expected.
- Make sure your mobile phone is charged.
- Don’t be afraid to ask questions. The BRAN questions may be useful at your appointment.
What are the Benefits?
What are the Risks?
What are the Alternatives?
What if I do Nothing?
Services useful to you
If you are diagnosed with cancer, you may find the following Improving Cancer Journey services helpful:
SIGN Scottish Intercollegiate Guidelines Network
Useful leaflets
Here are some leaflets about Colorectal surgery you may find useful.
Provide feedback via Care Opinion
The most effective way to feedback about your patient experience is to use the Care Opinion website. Care Opinion allows you to truthfully share your experience with us and with others. This site is moderated and your comments will be both seen and reviewed.
Accessible formats
If you require this information in a community language or alternative format such as Braille, audio, large print, BSL, or Easy Read, please contact the Equality and Human Rights Team at: email: fife.EqualityandHumanRights@nhs.scot or phone 01592 729130. For people with a hearing or verbal impairment you can also contact the team through the NHS Fife SMS text service number on 07805800005.
