Friday, 9 March 2012

Are bowel cancer patients dying because of a lack of surgeons?

A recent study has again confirmed what we already know, that the chance of dying from your surgery is more than 4 times greater if you need an emergency operation for bowel cancer compared with the risks of a planned or elective operation for the disease.

There are several possible reasons for this. Patients who present as emergencies are often sicker. Sometimes their tumours are more advanced in other cases the tumours may be blocking the bowel or in some cases have caused peritonitis. Whilst nearly all planned bowel cancer surgery is carried out by specialist colorectal surgeons, emergency surgery "out of hours" or at weekend may be carried out by non-colorectal specialists. This too may have an impact on the outcome in such cases.

One answer would be to provide specialist on call so that all bowel cancer emergencies are operated on by a specialist colorectal surgeon yet there are simply not enough senior colorectal surgeons in UK hospitals to be able to provide that level of cover.

Earlier identification of the disease and planned treatment may help to reduce the incidence of emergency presentation. It will be interesting to see if the the screening programme has a significant impact of on the numbers of emergency cancer presentations.

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