Bowel (Colorectal) Cancer
Tests and examinations for bowel (colorectal) cancer
Diagnosing bowel (colorectal) cancer usually requires an examination followed by certain tests such as a simple examination of your abdomen (tummy) and your bottom - a digital rectal examination (checking for lumps or swelling within reach of a finger). If the GP feels there is reason to investigate further they will refer a person for referred for further tests and more than one investigation may be needed to confirm or exclude a diagnosis of bowel cancer. Tests can include:
- a flexible sigmoidoscopy or colonoscopy
- colonoscopy (examinations of the bowel using instruments inserted into the back passage) or
- a computerised X-ray examination (CT colonography) and sometimes
- a gastroscopy endoscopy (examination of the stomach with a special instrument).
In the past a barium enema X-ray was the standard test for bowel cancer, but it has been replaced by flexible sigmoidoscopy, colonoscopy and CT colonography in most parts of the UK.
If you are diagnosed with bowel (colorectal) cancer you may also have an ultrasound scan, a CT scan or an MRI scan which provide your doctor with more detailed information about the size and position of the tumour and whether it has spread to other organs. Detailed descriptions of these examinations are available on from Cancer Research UK and Macmillan Cancer Support.
Most people who underwent diagnostic tests for bowel cancer found them uncomfortable or embarrassing rather than painful. Many were relieved to be undergoing tests because they were anxious to know the cause of their symptoms. Several people who faced a long wait for a test such as a colonoscopy paid to have it done privately because they feared the consequences of delaying diagnosis and treatment. Since 2000, the “2 week wait” system for suspected cancer referrals in the UK means all patients should be seen by a specialist within two weeks of referral if their GP suspects cancer.
This man describes his experience of a barium enema.
He describes his experience of a barium enema.
He describes his experience of a barium enema.
But there are two nurses there all the time looking after you, they will turn on that side, "Yes, you'll need to turn on this side. You will need to sit up and the thing will go straight up, it'll go back down that way."
And um, the only thing is that after, when they've finished they said "Right, now go to the toilet but hold it within yourself 'til you get to the toilet to get rid of the barium meal."
The difficulty is that as with, when you've got rid of it in the hospital, you think you've got rid of all of it, you haven't, because it was what, about two days, two or three days after that every time you went to the toilet it was lying in the bottom of the toilet like concrete! It was.
Huh, a souvenir.
A souvenir, yes a souvenir that you brought home with you, that's right. But after that it was OK, but there was no problem with it as I say. Uncomfortable yes. Not an experience you'd want to go through everyday sort of thing.
No. But uncomfortable rather than painful?
Oh it was uncomfortable, it wasn't painful as such, no, no.
How long does the whole procedure take?
Oh a couple of hours I think.
A couple of hours of lying on the table?
No, from going into the hospital to coming out, so it, about an hour on the table.
A woman explains what it was like having an endoscopy (examination of the stomach).
She describes her endoscopy.
She describes her endoscopy.
So, the nurse there, you know, they was all lovely and she said um, "Do you want the," thing that sort of you know puts you out the way for a little while you know like the local anaesthetic, "or you can have a throat spray."
So I said "What would you have?" So she said um "Oh you know well I can't tell you really," she said "but I can tell you the difference. If you had the like little injection thing you've gotta stop in a couple of hours afterwards till it wears off. But if you have the throat spray, when it's finished you can go straight away." So I said "I'll have the throat spray." I thought well I can go then, you know.
Anyway, so I had the throat spray, I had that. Once again, didn't hurt but it was a funny sensation but it, it really, I mean they, they were so nice with it and they was explaining to me all the time you know and as long as I've got a tissue in my hands, like the doctor says like, "bite the bullet" with me, I must have, and...
What's the tissue for?
I just hold it.
You just hold the tissue?
Yeah, I can, they can do anything with me as long as I've got a tissue in my hand. I don't know why, I just, just something, I wouldn't mind even if it was somebody to hold, like I could hold their hand, I wouldn't mind that even, but I must have something.
These people describe their colonoscopies.
She describes her colonoscopy.
She describes her colonoscopy.
I think, I think I was fairly well prepared for that, um I, I did not enjoy the days leading up to it and it isn't a very pleasant experience, to have to clear one's system.
How do you do that?
I was given sachets of, of a, a liquid to mix, a drink to clear my system and that is, I think, uncomfortable as time goes on, but I think I was reasonably well prepared for that.
Everybody was very kind, I was very sore this time by the time I had cleared my system.
And then I had fluid pumped into my bowel from the outside, from the rectum and I remember feeling, putting, being moved on a, on a bed and tipped and I remember that being quite a peculiar feeling and feeling quite sort of sea sick I think. And feeling quite strange about that.
Is that so they could see different angles?
Yes.
Yes.
Yes, and I was shown the results of that I, they were told that I could see the results and I was, so I felt I was a bit more involved by then, and I was quite happy to see that. I mean I could see there was something misshapen and then I, just waited for the results of that. But that was done very quickly, I saw, I went back to my specialist very quickly after that.
Was it painful?
No, I think it was weird. I think the feeling was weird and I think I felt, I felt a little out of control when I was being moved on a bed and I felt a little bit strange, it was a bit like being on a fairground ride I think, but not a very pleasant one. I don't think that bothered me particularly.
So, and I think again, when I think back to that period of my life I think I was quite glad that somebody was taking seriously something that was worrying me.
He describes his colonoscopy.
He describes his colonoscopy.
You went to the, the hospital, everybody was very nice and kind. You were shown into a room, I think it was only, just simply trousers and underpants that had to come off. And you climbed up on to the, sorry, and you climbed up on to the table on to one side, up with your knees. They told you that they were going to insert a tube in, into your rectum and that it would be a bit uncomfortable. Which it was. It was uncomfortable, but it wasn't painful.
They then sort of inflate you a little bit and, and that is probably the worst part of it because it's a, it sounds very much like blowing up a tyre on a bicycle! You can hear the air being pumped in and you get a distinct urge to, to want to go to the toilet but you know, you know you can't and you know you're not likely to either. And it's all over in a few minutes.
Do they give you any, did they give you anything to relax you or?
No. No.
No. No medication.
No, no, no medication, no, no. No medication, no the only thing that was used apart from the, the instrument which, which I asked to see, I said "Can I have a look at it?" to see what it is and they showed it me willingly.
What is it like?
What did it look like? It looked like a piece of garden hose.
People who had CT or MRI scans did not generally find them a problem apart from one man who is claustrophobic. He explains how he had his scan assisted by the nurses.
Having an MRI scan worried him because he is claustrophobic.
Having an MRI scan worried him because he is claustrophobic.
For two days before going down my, my wife, she said I wasn't fit to live with. I was really worried because I felt I wasn't going to be able to uh undertake this.
And I phoned them and from home two days before and explained my problem. I presumed they must have had this before and she said "Well, don't worry," she said "We'll help you, we'll sort it out." She said "We'll put you feet-first in so that you don't have to go right through the tunnel um, and I'll send you a leaflet about it." and what have you. This was the nurse in the MRI section. So this, this information came and I read it, I still felt very uncomfortable.
This nurse came to lead me to get undressed and to put the uh smock on. Now she said "Don't you worry," she said "I'll hold your hand all the way." And she said, "In fact we'll probably bring you a gin and tonic you know, to keep you, to keep you going." So of course that was her humour.
So I got into this machine, I was lying on it, very apprehensive and I went through and I could see they sort of check, you know, "are you going to be alright?" And fortunately my head uh did come out of this area and I was in the open of the room, but this machine was just above me like that, but I could see the ceiling and I could see around me so I said "I think I'm going to be alright."
They pulled me out of the machine and I was glowing, I felt wonderful, it was like going on holiday almost, it was over and I'd coped and as it happened it was a good thing I had coped because the professor got a lot of information that he needed from the results of that scan.
Some people did find it painful to have a biopsy taken. This woman describes what she experienced.
She found having a biopsy taken painful.
She found having a biopsy taken painful.
No pain relief?
No pain relief, nothing. And he put the tube inside, then he started to fill it up with air so it separated everything so he could see more clearly, apparently.
What, fill your gut up with air?
Yeah, my bowel yeah, around that area and then he proceeded to put the knife in and cut a bit off the tumour to take away to be looked at under the microscope. For me it was really painful, really, really painful and I wouldn't like to have it done again - well I can't have it done again because it's all gone now.
How long did it take?
Oh about 15 minutes maybe, but it, it was total shock, total shock to the system and after that point just, embarrassment just doesn't come into it you know. I never get embarrassed about anything now, it just doesn't bother me.
Yeah, it was horrendous, I wouldn't lie and say it was easy because it wasn't, not for me. But whether that had something to do with because I was quite sore there anyway, I don't know.
Last reviewed August 2016.
Last updated August 2016.
Copyright © 2024 University of Oxford. All rights reserved.