Transcript of
Bowel cancer: flexible sigmoidoscopy
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FLEXIBLE SIGMOIDOSCOPY
If you've got bowel symptoms
and you're referred to a hospital clinic for investigation,
you should have what I'm about to have.
It's called a flexible sigmoidoscopy.
LYNN FAULDS WOOD
Hi, Lynn, I'm Alison. I'm one of the bowel cancer nurse specialists here.
(Lynn) Flexi sig is the best way
to diagnose the most important symptoms of bowel cancer.
It can reach and find nearly two-thirds of our cancers.
What I need you to do now is roll over on to your left-hand side
and curl up into a little ball.
(Lynn) A narrow tube about the diameter of a finger
is inserted into your bottom.
The tube is fitted with a light and camera
so the nurse can look at the inside of your bowel on a television screen.
The telescope I'm using is about 3-4ft long. OK.
(Lynn) The nurse is looking at the lining of your lower bowel
for signs of cancer or potential cancer
in the form of little growths called polyps.
Because the flexi sig only looks at the lower bowel,
it's much quicker than a colonoscopy and the patient doesn't need to be sedated.
(man) It enables you to examine the inside of the bowel very accurately.
It's a narrow tube which is flexible because the bowel is windy and bent.
MIKE THOMPSON CONSULTANT SURGEON
And it makes it more comfortable
and you can get very high in the bowel and get very good images of it.
It's improved the way we diagnose serious bowel conditions enormously
in a very safe, simple, quick way.
(Lynn) In Portsmouth at the Queen Alexandra Hospital,
consultant surgeon Mike Thompson and colleagues
have been collecting information about bowel cancer symptoms
from people attending their clinics for the last 27 years.
- Hi, Karen. Can we interrupt you? - Certainly.
(Lynn) How many people have you now got on the database here, anonymous cases?
- Approximately 31,000. - (Lynn) 31,000?
Up to which year?
(Lynn voiceover) By comparing people's symptoms
with the incidents of bowel cancer,
Mike has created a database of the key symptoms for the disease.
And the Portsmouth database shows that
flexi sig is by far the most effective way of investigating these key symptoms.
(Mike) The two symptoms that patients most commonly come to outpatients with
are rectal bleeding and a change in bowel habits.
But the key symptom is when you have a combination of rectal bleeding
and a change in bowel habits.
Particularly when you're going more often to the toilet with looser stools
and this has persisted for two or three weeks.
How valuable is flexi sig in finding cancers?
To a doctor, it's incredibly useful.
It is very powerful because it does pick up most of the cancers.
That means that if we get a normal examination
it means that most of those patients don't need any further tests.
So in five minutes you can tell people they haven't got cancer.
Very much so, yes.
(Lynn) And here's even more good news about the flexi sig.
A major trial carried out in this country
has shown that if everybody aged 55 was given a flexi sig,
it would find those who are more likely to develop cancer in the future
and bowel cancer deaths could be cut by a third.
The trial results are so impressive that the government is planning to roll out
a system of national flexi sig screening.
(Alison) You've got a tiny bit of inflammation.
All that means is you've eaten something that's upset your tummy.
That's what's been accounting for your episodic loose motions.
(Lynn) Trevor had been having diarrhoea
and came in for testing on the same day as I did.
(Alison) Going around a bit of a corner
so you're going to feel a bit of pushing, OK. But it won't last.
As soon as we're around the bend, it will be fine.
(Lynn) A major advantage of flexi sig
is that it can be carried out by nurses, not just doctors.
Alison has been giving flexi sigs for 12 years.
(Alison) I see all sorts of people that come to me for varying problems
with their bowels. Bleeding, change in bowel habits.
But the biggest reason I think that people come here
is for them to be told that they are healthy
and they haven't got any bowel cancer
because, of course, everybody thinks that as soon as they start to bleed
they've got bowel cancer.
But in actual fact, the majority of people that we see
that come through our clinics actually don't have.
It's very good to tell them that news.
What do you do if you see a cancer?
I tell them because people don't like to be fobbed off with any rubbish.
They like to know what's going on and they like to know the truth.
And if I'm able to be able to tell them that that is what the problem is,
then I tell them. And then we take care of it.
Last little corner and then if we can do that
then we can bring the telescope out and finish. It's all been perfect.
(Lynn) It takes only a few minutes with the flexi sig
for Alison to be able to reassure Trevor that he does not have bowel cancer.
(Alison) So, no polyps, nothing untoward, nothing nasty.
Which is exactly what we wanted.
(Lynn) The Portsmouth database shows beyond doubt
that flexi sig is the best way of investigating
the key symptoms of bowel cancer.
If this test is normal and the patient doesn't have anaemia,
or any lumps in their tummy,
then the risk of them having a cancer
outside range of the flexible sigmoidoscope is one in 500.
That's what we've learnt by the very large database
we've collected over 27 years.
As long as their symptoms settle completely,
then we don't need to do any further tests.
(Lynn) So, if you have bleeding from the bottom and a change of bowel habit,
to going more often or looser stools,
and that's been going on for a few weeks,
then you should definitely be asking for a flexi sig.
And the results of my flexi sig?
So, what I'm looking at here is really healthy tissue.
It's all pink. There's nothing untoward to be seen.
So I've got a lovely healthy colon.
- You've got a perfectly healthy bowel. - Great.
Well, I hope we encourage a lot of people to come and have this done.
I think it's a very worthwhile test.
For the sake of a few minutes' embarrassment, it can save a life.
I think it's well worth it, so well done.
- Thanks. - OK.
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