One person’s journey through bowel screening

Gateshead Health NHS Foundation Trust South NHS Foundation Trust City Hospitals NHS Foundation Trust This booklet is designed to help you understand bowel cancer screening. It shows one persons journey. The South of Tyne Bowel Cancer Screening Programme invites men and women aged 60 -74, who are registered with a GP, from , and Sunderland for bowel screening every two years. Bowel cancer screening is a process that is used to detect polyps (fleshy growths on the inside of the bowel wall) and bowel cancer, hopefully at an early stage. If changes are found at an early stage there is an excellent chance of full recovery. People over the age of 75 are able to opt into the programme by phoning 0800 707 6060.

2 South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening Meet Fred

Fred is one of the many people invited every two years for free bowel cancer screening.

South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening 3 1

Step 1 Bowel cancer screening home test kit

Everyone 60 – 74 who is registered with a GP will receive the free home test kit to complete every two years. If you are over 75 you can request a kit by phoning 0800 707 6060. The home test kit identifies blood in faeces that can’t be seen with the naked eye. This can be an early sign of bowel cancer.

4 South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening The invitation to take part

Fred receives his bowel screening invitation letter soon after his 60th birthday. The letter tells Fred he will be sent a home test kit the following week. The home test kit identifies blood in faeces that can’t be seen with the naked eye. This can be an early sign of cancer. If Fred has any questions he can call the free helpline 0800 707 6060

South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening 5 The bowel cancer screening home test kit

The following week Fred receives his home test kit. With the kit Fred gets an instruction leaflet, cardboard sticks and a return envelope. If Fred has any questions he can call the free helpline 0800 707 6060 Fred follows the instructions completing the home test kit over a number of days. Once complete the kit is returned in the envelope provided.

6 South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening Results from the test kit explained

It can take up to two weeks to receive your results, although this is often much quicker. Fred receives his results within three days. There are three possible results; normal, unclear or abnormal:

Normal result No further tests needed. Participant invited to take part in screening in two years.

Unclear Result is unclear, participant is sent a repeat home test kit.

Abnormal Participant is offered an appointment to discuss further tests.

Fred receives his results letter. It tells Fred he has an abnormal result.

South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening 7 2

Step 2 Assessment clinic Only 2% of people receive an abnormal result from their home test kit. These people are invited to the assessment clinic where they will be assessed to see if they are fit for a colonoscopy. A colonoscopy is a camera used to look inside the large bowel, it is used to find cancers and polyps (polyps are fleshy growths inside the bowel). If polyps are left over time they could develop into a cancer.

8 South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening Invitation to the assessment clinic

Fred gets his letter telling him of an abnormal test result. He is one of the 2% of people who have an abnormal result. He is invited to an assessment clinic. At the clinic Fred will meet one of the bowel screening practitioners and discuss possible further tests.

South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening 9 Assessment clinicA19 venues

South A1058 A1 Shields

A167 3 Marsden Heburn 2 Gateshead Boldon Colliery A1 Felling Whickham 1 A692 A19 Team Valley A1018 Trading Estate A194(M) Sunnyside 5 lands Springwell ill A1 Washington A1231 Sunderland Birtley 4 Ouston A1(M) A690 A693 North Lodge Doxford Stanley Park

Assessment clinics are offered at a number of venues throughout the area.

1 Queen Elizabeth Hospital 4 Sunderland Royal Hospital Bowel Screening Unit, Sheriff Hill, Kayll Road, Sunderland, Gateshead, NE9 6SX , SR4 7TP

2 The QE Metro Riverside 5 Hospital Unit 6, Delta Bank Road, Newcastle Road, Sunderland, SR5 1NB Metro Riverside Park, Gateshead, NE11 9DJ

3 South Tyneside District Hospital Harton Lane, , Tyne and Wear, NE34 0PL

For further information on any of the venues please contact us on:

10 South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening Arrival at assessment clinic

Fred arrives at his assessment clinic. He is greeted by one of the reception staff and asked to have a seat in the waiting area.

South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening 11 Assessment clinic

The bowel screening practitioner collects Fred from the waiting area, they go to the clinic. The practitioner explains Fred’s test kit results and assesses his fitness for a colonoscopy. Fred is able to ask any questions he may have. Fred is fit for a colonoscopy. He is offered an appointment within 14 days. Fred is given his bowel preparation, this is a laxative that is taken the day before the colonoscopy to clean the bowel.

12 South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening 3

Step 3 Colonoscopy investigation The majority of people are assessed suitable for a colonoscopy and move forward to step three. Anyone not suitable for a colonoscopy will discuss alternative assessments with the bowel screening practitioner at the assessment clinic.

South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening 13 Preparing for colonoscopy

The day before the colonoscopy, Fred follows the instruction given to him in clinic and takes his bowel preparation at home. This will help clean his bowel.

14 South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening Arrival for the colonoscopy

Fred arrives at the Endoscopy Unit, his details are checked by reception and he is shown to the waiting area.

South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening 15 Preparing for colonoscopy

Fred is collected by a nurse. He is taken to a room where his details and blood pressure are checked. Fred then changes into a gown.

16 South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening Preparing for colonoscopy

The specialist practitioner collects Fred, they discuss the procedure, Fred can ask any questions. Once Fred is happy he completes the consent form. The practitioner then takes Fred to the procedure room; he is introduced to the endoscopy nurses and consultant. The consultant offers Fred a sedative to help him relax.

South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening 17 The colonoscopy test

Fred lies on his left side. Once ready the consultant will insert the scope into Fred’s bottom. The consultant can then see, via a screen, the inside of the bowel. During the test the consultant asks Fred to change position. The consultant can remove tissue samples and polyps for testing. Some people find a colonoscopy uncomfortable. It can feel like trapped wind. The test can take up to 45 minutes.

18 South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening After the colonoscopy

After the colonoscopy Fred goes to the recovery area, here the nurse checks Fred is comfortable. Once Fred is ready to leave the specialist practitioner explains what was found during the colonoscopy. Fred had tissue samples removed for testing. His final results will be ready within seven days.

South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening 19 Follow up phone call

The following day the specialist practitioner calls Fred to check how he is feeling. The practitioner offers Fred an appointment to receive and discuss his results.

20 South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening Results clinic

The practitioner meets Fred and takes him to the clinic room. Fred is informed of his results, he had a low risk polyp removed. Fred needs no further treatment. Fred will be invited to take part in screening again in two years using the home test kit.

South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening 21 Results explained

There are a number of possible results from the colonoscopy, these are:

Normal result No polyps or bowel cancer were detected. Bowel screening is offered again in two years time using the home test kit. Results are given following the colonoscopy, during the follow up phone call and in writing.

Polyps removed If tissue samples are taken, you are invited to a results clinic to discuss results and any follow up. Polyps could either be low, intermediate or high risk. Low risk – invited again in two years to complete the home test kit. Intermediate risk – Surveillance check up colonoscopy in 3 years time. High risk – Surveillance check up colonoscopy in 1 year.

Cancer found If a cancer is found you will be told at the results clinic. You will be introduced to the colorectal nurse specialist who will co-ordinate, support and advise you during treatment.

22 South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening Being bowel aware

Being bowel aware means knowing what is normal for you, if you have any bowel symptoms you should see your GP. • Persistent change in bowel habit, especially going to the toilet more often or diarrhoea for four to six weeks • Bleeding from the bottom • Abdominal pain especially if severe • A lump in you abdomen If you have one or more of these symptoms for 4 – 6 weeks you should visit you GP.

South of Tyne Bowel Cancer Screening Centre One person’s journey through bowel screening 23 Queen ElizabethHospital,Sheriff Hill,GatesheadNE96SX If youhaveanyquestionspleasecontact

Publication date: January 2012