FOB testing will only detect around 25 per cent of cancers, so health education to reinforce protective measures and symptom awareness is vital to lower the incidence of sporadic bowel cancer. Individuals at high risk of developing bowel cancer should be offered regular colonoscopic surveillance. The first line treatment for primary bowel cancer is surgery. See Table 1. Chemotherapy is offered as an adjuvant therapy, usually to patients with a Dukes' C tumour, although sometimes to patients with Dukes' B tumours.
Numerous appliances are available on prescription to suit the individual needs of the patient.
It is important that the appliance fits snugly and correctly. All patients requiring appliances on a permanent basis are exempt from prescription charges irrespective of age. A temporary stoma is not classed as a category for prescription exemption. Seventy per cent of stomas are temporary and reversed in the period between six weeks and two years after the initial surgery. Patients experiencing problems with their stoma should see their stoma nurse or contact the British Colostomy Association.