Did you know that, largely, bowel Cancer is said to be found in the 60-80 age grouping? We know, however, that here in Somerset we have teenagers through to centenarians who undergo treatment for bowel cancer. Somerset is nationally recognised, along with Dorset, as having a larger than average number of people over the age of 60, and predicted to grow. This therefore means that a lot of the people undergoing treatment are over 60. You may ask yourself "what is so important about that?" Well, the answer is actually in the fact that treating bowel Cancer can be very complex particularly when you consider that most people over the age of 60 will be taking some medication for one or another complaint, or in some cases, quite a lot of medication for various complaints. If we focus on surgery alone, which in itself is a highly complex and skilled treatment option, as a surgeon, you would want to make sure that you had a number of salient facts at your fingertips before you considered operating. Not least of these salient facts would be the details about the cancer, but also about the individual and their health. From a patient point of view the "investigatory phase" of a pathway, where the professionals are obtaining all the information they need about you and your cancer, can be exhausting both mentally and physically, not least because once you have been diagnosed as having a cancer, you just want to get rid of it. This phase however is vital; not only will it tell you whether your bowel cancer is amenable to surgery, radiotherapy or chemotherapy, it will also help the professionals gauge whether you are fit enough to withstand this treatment. No professional takes this phase lightly and, indeed, may request the assistance of a Cardiologist, a Respiratory Physician, a Geriatrician and an Anaesthetist to assist you, and them, in deciding what is best for you. In fact, they will include those people deemed necessary to help them, and you, make an informed decision about treatment. Sometimes, and only sometimes, the best option is actually to do nothing bar manage symptoms. This may not be what many of you expect BUT the aim is to give people quality of life for as long as possible; what good is quantity of life if you have no quality at all. Tough decisions are not easy on patients nor professionals alike and these sorts of decisions are not taken lightly.
The government issued guidelines on timescales for the investigatory and the treatment phases of care for cancer patients which every Trust is governed by. This will also include a discussion of your case at the Multidisciplinary Team Meeting with the aim of getting a consensus of opinion from the multiple professionals present about your individual case. Along your pathway, your case will be discussed a minimum of twice but often many more times than this. Each of you have different sets of requirements to treat your cancer therefore the investigatory phase and the MDT discussion are as vital as the treatment to your care.