1. Radiotherapy Use in Colorectal and Anal Cancer Nikola Hawkins Consultant Cancer Practitioner Macmillan Next Steps Cancer Rehabilitation Lead, Gloucestershire

2. Emergency & symptom Control
Radical
High Dose Palliative
Locally advanced Disease
Single site metastases
Emergency & symptom Control
Metastatic Spinal Cord Compression
Pain
Emergency
Often used in combination with surgery & chemotherapy
Radiotherapy use in colorectal and anal cancer

3. Colorectal Cancer, Anal Cancer & Radiotherapy
Acute Side effects
Chronic Side effects
Rehabilitation

4. Radical Radiotherapy Daily Treatment
Bowel & bladder prep
Positioning & Scans
Treat

5. Radiotherapy Side Effects

6. Radiotherapy Side Effects in treatment area
Acute effects
Inflammation
Late Effects
Fibrosis
Atrophy
Vascular damage
Inflammation occurs in rapidly proliferating tissues:
Radiation induced cystitis, nocturia, urinary retention, urgency
Proctitis
Tenesmus
Pubic hair loss
Impotence
pain
Late effects – Fibrosis – strictures and malabsorption of irradiated bowel
Vascular damage – telangiectasia, friable musosa, bleeding
Fistulae, bowel perforation
Second cancer

7. Dilation & Dressings

9. ‘The realisation that life will never be the same and you will never be the same again – it’s devastating.’

10. ‘They say, “you just have to get used to the ‘new normal
‘They say, “you just have to get used to the ‘new normal.” I don’t want to.’

11. Next Steps On The Road To Recovery
Macmillan Next Steps NHS Cancer Rehabilitation aims to:
Enhance Recovery from the physical and psychological consequences of cancer to improve health and wellbeing
Prevent other health conditions, and
Sustain Health by providing information, knowledge and skills to confidently self-manage
Next Steps On The Road To Recovery