Colon Cancer: NICE Guidelines

The National Institute for Clinical Excellence (NICE) is a special health authority of England and Wales' National Health Service, or NHS. This entity gives specific instructions on how patients suffering from different types of ailments should be treated. NICE's guidelines for cancers of the colon, bowels, and anus (commonly referred to collectively as colorectal cancer) are rather specific.

Endoscopy

• Endoscopy is the insertion of a tube affixed with a light and camera into the anus in order to examine the large intestine, colon, or other part of the digestive system. This procedure is essential for properly diagnosing colorectal cancer.

  There are two specific guidelines with regard to endoscopy. The first is, "People who may have colorectal cancer should be offered rapid referral for endoscopy." This guideline means if a doctor notices symptoms that may be caused by colorectal cancer, he or she should immediately offer options for an endoscopic examination to ensure proper treatment is prescribed.

  The second NICE guideline regarding endoscopy is, "Endoscopy should be available for diagnosis." This guideline means medical facilities should be sure they have the necessary equipment to perform endoscopy on hand so that the procedure will always be available for diagnosis.

Treatment Teams

• There are three NICE guidelines that have to do with teams of health professionals that should treat those that have or could have colorectal cancer. The first is, "People should be treated by a multidisciplinary team." A multidisciplinary team is a group of medical professionals that, collectively, possess all skills necessary to effectively treat colorectal cancer. NICE says multidisciplinary teams should have a lot of experience treating colorectal cancer, and thus should serve an area of no less than 200,000 people so the team has adequate opportunity to gain such experience. A colorectal cancer multidisciplinary team should consist of: at least two surgeons with experience in colorectal surgery, an oncologist, a diagnostic radiologist, a histopathologist, a skilled colonoscopist, at least one clinical nurse specialist, a palliative care specialist, and a support staff to help manage the team.

  The second guideline regarding treatment teams is, "Colorectal teams treating people with rectal cancer should have special training." There are special techniques in treating rectal cancer that need to be utilized to ensure rectal cancer does not return after being removed. Physicians on a multidisciplinary colorectal team should have this training, according to NICE.

  The third guideline involving treatment teams is, "People who need emergency treatment should be treated by a colorectal cancer team." When colorectal cancer has advanced to an emergency stage that requires urgent attention, they should be treated by a colorectal cancer team whenever possible. If there is no possibility of a patient being treated immediately by a colorectal cancer team at one hospital, NICE recommends the patient be transferred to another hospital with an available team.

Improved Information and Support

• The final NICE guideline involving colorectal cancer is, "Information and support should be improved." This guideline dictates that patients should have a good understanding of colorectal cancer and required treatments. This is partly the reason why clinical nurse specialists are assigned to colorectal cancer multidisciplinary teams. This helps patients to be more informed about the situation and prepared to accept proper treatment.