Bowel Cancer

If you or a family member has been affected by bowel cancer, speak to one of our specialist team today. There are a number of types of claims that can be brought about as a result of bowel cancer. However, these are generally categorised into three fields:

• Misdiagnosis – where the health care professional, either with or without investigations, diagnoses the bowel disease as an alternative condition. This is usually IBS, celiac disease, or diverticulitis – however, this list is not exhaustive.
• Delay in diagnosis – often overlapped with the above point. However, more and more often patients are presenting with symptoms and are not being referred on for further investigations. This can lead to significant delays in life-saving treatment being provided.
• Incorrect or inappropriate treatment – once a diagnosis has been made, it is imperative that the patient receives the appropriate treatment. This varies dependent upon the type of cancer and the stage. A failure to implement an appropriate treatment can have devastating effects.

If you feel that you have been affected as a result of any of the above then could be entitled to compensation. The team at Oakwood Solicitors Ltd will be able to give you free advice on the prospects of your case and whether you would be eligible to make a claim.

You have three years from the misdiagnosis to pursue a case, so do not delay.

The affected patient can bring about a claim within three years of the date the diagnosis was made.

However, as is often the case – particularly with delays in diagnosing cancer – the patient has sadly passed away due to their condition. If the patient is deceased, then the executors of the estate have three years from the date of death to bring about an action.

Clinical negligence cases can take over eighteen months to run, as we have to obtain copies of your GP and medical records before obtaining a report from an independent medical professional. We will provide you with regular updates on the progress of your case to ensure that you are kept up to speed.

Numerous cases involving bowel cancer have been settled over the years, and the amount of compensation varies.

One case surrounding a significant delay in diagnosis of the disease, which resulted in extensive surgery and chemotherapy (and unfortunately to the ultimate demise of the patient) resulted in compensation to the amount of £107,087.78.

A further case whereby the patient underwent extended right hemicolectomy, which resulted in an ileostomy and loss of anal function achieved £4,353,474.32 in compensation.

Every case is different, and the amount of compensation awarded is very case-specific. Here at Oakwood Solicitors, we will pursue a claim for both general and special damages on your behalf.

Rest assured that our specialist team has the experience and the tenacity to achieve the highest possible award for you.

The majority of clinical negligence cases are funded by a Conditional Fee Agreement (CFA), more commonly known as a ‘no-win, no-fee’ agreement.

This means that there will be nothing to pay upfront and nothing to pay if the claim has been lost. If you are successful in your claim, a deduction of 25% of damages will be taken to cover the success fee and the shortfall in legal fees.

It may also be the case that an After The Event (ATE) insurance policy will be obtained to cover the costs of expensive medical reports and investigations. If an ATE insurance policy has to be obtained the cost of the same will be discussed with you at the appropriate point.

The cost of the ATE insurance policy is again taken from your damages and only payable if you are successful with your claim.

We have a dedicated team of solicitors and paralegals who have many years’ experience between them in running cases of this nature. They are highly trained to deal with all aspects of clinical negligence.

We want to ensure that clients are not overwhelmed by legal jargon or medical terms they don’t understand, and to allow the claims procedure to be as transparent as possible.

For example cases and settlements that we’ve successfully handled, read this article on our website.

The bowel is part of the digestive system and is located in the lower part. It is divided into the small bowel or small intestine and the large bowel which is also known as the colon and the rectum.

• Bowel cancer starts in the large bowel but it can then spread to all organs and tissues of the body
• Breast, prostate, and lung cancer are the three most common cancers in the UK, followed by bowel cancer
• 41,000 people are diagnosed each year and at present 270,000 are living with it
• It is the second most common cause of death in the UK

The main symptoms of bowel cancer are:

• Blood in stools – this would be continuous and different to the normal nature of the bodyv
• Change in frequency of going to the toilet – looser stools, going more often
• Abdominal pain – loss of appetite or weight loss with associated pain, bloating or discomfort
• Anaemia
• Weight loss
• Rectal bleeding
• Vomiting
• Constipation

The above symptoms do not mean that a patient has bowel cancer as often there are other reasons for these symptoms. It just means that other conditions need to be eliminated before a diagnosis may be made.

As with many cancers, the exact reason as to why a patient gets bowel cancer is not exactly known. There are some factors which may increase the risk of contracting it:

• Chron’s disease – only 2% of people will go onto develop cancer in the small bowel
• Age – older people are more likely to get bowel cancer. The highest age group at risk is 80-84-year-olds
• Coeliac disease – changing the diet to gluten-free can assist the risks
• High fat diet or containing high levels of red meat
• Familiar adenomatous polyposis – a genetic hereditary condition that causes polyps to develop on the bowel lining
• Lynch syndrome – a fault in a gene that increase the risk of cancer
• Smoking and drinking
• Lack of exercise
• Overweight
• Ulcerative colitis

People who have any of the above diseases are already in a high-risk group and can be given regular checks and aspiring to limit the risk. Aspirin and Celecoxib have been shown to decrease the risk of cancer in these groups.

Changes can be made to a lifestyle to try to reduce the risk of bowel cancer such as introducing a high fibre diet with increased fruit, vegetables and whole grains. Take more regular exercise, stop smoking and limit alcohol.

The first stage in any diagnosis is to seek medical advice with your GP if you have had these symptoms for longer than four weeks.

Your doctor will carry out an examination of your stomach and bottom areas to check if there are obvious lumps.

A blood test may be taken if there is any bleeding.

Referral to the local hospital for further tests. These tests could include:

• Colonoscopy
• CT Colonoscopy
• Sigmoidoscopy
• CT Scan
• MRI
• Molecular testing

The NHS offers two different types of bowel cancer screenings, offered people from 60 to 74 years old:

• Faecal Occult Blood (FOB) test – a test is sent every two year to 60-74 year olds to collect a stool sample
• Bowel Scope Screening – offered to men and women at the age off 55. A medical professional would use a thin instrument to look inside the lower part of the bowel

Both screening options limits and reduces the chance of bowel cancer and allows for treatment a lot earlier.

There are certain kinds of Bowel Cancer and others in the associated areas:

• Rectal cancer – this begins in the large bowel. This part of the body stores faeces until it is ejected via the anus.
• Anal cancer – this starts in the anus which is located at the end of the bowel. It is found to be more common in men than women. Depending on where the cancel is located will depend on the different kind of cancer.
• Squamous cell cancer – affect the lining of the anal canal.
• Adenocarcinoma – glandular cells are located in the anus and assist in making mucus which moves the stools through the anus. Cancer can develop in these calls.
• Melanoma – this cancer starts in cells called melanocytes.
• Cancer of the small bowel – there are a few varieties of small bowel cancers that can either be malignant or benign.
• Sarcoma – they grow mostly in the ileum and come in a variety of different kinds. The most common is the leiomyosarcoma but rarer types include gastrointestinal stromal tumours which grow in the connective tissue.
• Lymphomas – they grow in the jejunum of the bowel (15%).
• Neuroendocrine – develop in hormonal cells in the appendix or ileum (40%).
• Adenocarcinomas – they start in the cells that line the bowel and manifest in the duodenum (40%).
• Secondary cancers – these are tumours that develop elsewhere in the body but then spread to the small bowel.

Treatment will depend on the part of the bowel and how progressed the cancer is. Symptoms can be controlled and the cancer slowed. A cure is possible but not in every situation.

Various treatments can be used, such as:

• Surgery
• Biological treatment
• Chemotherapy
• Radiotherapy

Treatment will be from a variety of different medical professionals, such as:

• Cancer Surgeon
• Oncology team
• Radiologists
• Nurses

Colon Cancer

If the cancer is still localised, it may be possible to remove a piece of the colon wall. If the cancer has spread, the whole colon may need to be removed by way of a colectomy. There are three different ways that a colectomy can be performed:

• Laparoscopic – the medical professional uses a probe attached to a camera that is inserted in to the abdomen and will remove a part of the colon. As it is keyhole surgery, it allows for better and quicker recovery time. It is now becoming the norm
• Open colectomy – a large cut is made into the abdomen and a section of the colon is then removed
• Robotic surgery – a robot is inserted that is then controlled by the surgeon to remove the cancer by way of keyhole surgery. This is rate at present
  rectal cancer

There are various types of operations that can be carried out, which will depend on how far the cancer has spread:

• Local Resection – if the rectal cancer is still small in nature a resection could occur to remove the cancer. An endoscope would be inserted through the anus to remove the cancer from the wall of the rectum

Total mesenteric excision – if a larger area of the rectum needs to be removed from around the bowel then this treatment would be used. When the cancer is located would depend on the TME operation carried out:

• Anterior resection – this treatment is used for cancers that are away from the sphincters controlling bowel action. An incision is made into the abdomen and part of the rectum is then removed including part of the surrounding tissues. The colon is then attached to the rectum and upper per of the anal canal. A temporary stoma may also be utilised to allow healing which will then be removed at a later date.

• Abdominoperineal resection – this treatment is used for cancers located in the lowest section of the rectum. The whole of the rectum then needs to be removed plus the surrounding tissues to prevent regrowth of the cancer cells. Patients then have to have their anus closed up and a permanent stoma fitted.

Stoma Surgery

If part of the bowel has to be taken away the surgeon may have to redirect the faces away to allow the areas to heal. This is called a stoma and a bag is worn to protect the bowel and collect the faces. There are two kinds of stoma:

• Ileostomy – stoma made from the small bowel.
• Colostomy – stoma made from the large bowel or colon.

A nurse will assist with showing a patient how to care for the stoma and to how to empty and attach it. In some cases, the stoma can be removed once healing has occurred. Other times it may be permanent.

These include monoclonal antibodies such as cetuximab and panitumumab which attack proteins on cancer cells.

There are three ways to treat bowel cancer:

• Before surgery – shrink the tumour
• After surgery – prevent the cancer from recurring
• Palliative chemotherapy – prevent the spread of cancer

It usually involves taking either a tablet or a drip of chemicals or both. Courses are usually 2-3 weeks long but can last up to 6 months.

There are several ways that radiotherapy can be used to treat bowel cancer:

• Before Surgery – to shrink rectal cancers and chance of complete removal
• Instead of surgery – stops the spread of early stage cancer
• Palliative radiotherapy – slow the spread of cancer in advanced cases

Radiotherapy can be administered in two ways:

• External radiotherapy – high energy waves are beamed onto the rectum. It is normally given daily over 5 day period. A patient may require 1-5 weeks of treatment.
• Internal radiotherapy – a tube is inserted into the anus to release radiation into the anus. This may take several sessions.

Some of the treatments, especially chemotherapy, can give rise to a whole host of side effects, including:

• Fatigue
• Nausea
• Mouth ulcers
• Vomiting
• Hair loss
• Diarrhoea
• Tingling in hands, feet and neck
• Weakened immune system
• Temporary or sometimes permanent damage to sperm and eggs
• Risk to foetus