The main treatment for bowel cancer is to cut out the cancer entirely with an operation (surgery), if this is possible. With successful surgery, the outlook can be very good, but there remains a risk that the cancer will return.

Careful examination of the tumour, surrounding tissue and lymph nodes removed during the operation, will help your doctors to decide whether to recommend any additional treatment.

Before the operation

Sometimes radiotherapy or a combination of drugs and radiotherapy are given before surgery. This is to shrink the tumour to make it easier to carry out the operation, and it may reduce the risk of the cancer returning.

There are a number of different surgical options and techniques. The choice depends on your condition. You will meet your surgeon face-to-face before your operation, so ask him or her to explain. She or he will also explain the possible complications that can happen following the chosen operation. You will be admitted to hospital one or two days before the operation, to allow for your bowel to be prepared. You will stay in hospital for 7 to 14 days.

The operation

In most cases (but depending on the position of the cancer), the surgeon will operate to remove the tumour and part of the healthy bowel on either side of it. To help assess and reduce the risk of spread, the surgeon will remove surrounding lymph nodes as well. The two cut ends of the bowel may be stapled or stitched together, which enables the bowel to work normally afterwards.

You may, however, need to have a stoma formed. This is usually temporary, but it may be permanent. A stoma is an artificial opening made when the healthy part of your bowel is brought out onto the surface of your abdomen.

The type of stoma you will have formed will be either a colostomy (from the large bowel) or an ileostomy (from the small bowel).

Your stools or waste products will pass through this opening instead of through your rectum as before. You will need to wear a bag to collect your stools.

A temporary stoma is formed so that your bowel can rest while healing takes place. A section of your bowel is looped to the surface of your abdomen, where an opening can be created. This is usually only for two to three months. Later, the stoma can be closed.

In some cases, especially if the tumour is sited near your anus, there may not be enough bowel left to rejoin. In this case you may need to have a permanent stoma formed, as food waste will no longer be able to pass out in the normal way. Only about 10% of patients need a permanent stoma.

If it is possible to say before your operation that you may need to have a stoma, a stoma care nurse will see you before your operation. She or he will explain exactly what will happen and what to expect. You can see the appliances (bags) that will be used, and ask any questions you may have.

After the operation

After your operation, you will spend time in a recovery room for observation. Within hours you will have recovered enough to go to the ward or to a 'high-dependency' unit.

You may feel sore, uncomfortable or sick. Your nurse can give you an injection to relieve the pain and you can also have drugs to stop you feeling sick.

Within 24 hours of your operation, staff on the ward will encourage you to move and walk about.

If you now have a stoma, a stoma nurse will visit you soon after your operation. She or he will show you how to care for your stoma and help you to adapt to living with a stoma. You will be able to rely on his or her support for as long as you need it.

The section of your bowel tissue that was removed in the operation will be sent to the laboratory for investigation under a microscope. This may take up to three weeks. A report will be sent back to your bowel cancer team. They will use it to help decide on your treatment plan.