See validated screening tools mentioned in Principle 4 ‘Supportive care’. A number of specific challenges and needs may arise for patients at this time: assistance for dealing with emotional and psychological issues, including body image concerns, fatigue, quitting smoking, traumatic experiences, existential anxiety, treatment phobias, anxiety/depression, interpersonal problems and sexuality concerns potential isolation from normal…

Rehabilitation may be required at any point of the care pathway. If it is required before treatment, it is referred to as prehabilitation (see section 3.6.1). All members of the multidisciplinary team have an important role in promoting rehabilitation. Team members may include occupational therapists, speech pathologists, dietitians, social workers, psychologists, physiotherapists, exercise physiologists and…

Some patients may benefit from radiation therapy: patients with high-risk rectal cancer (neoadjuvant therapy) patients with symptomatic, non-resectable locally advanced rectal cancer who may benefit from radiation therapy with or without concurrent chemotherapy given with palliative intent patients with colon cancer where the tumour has penetrated a fixed structure. Timeframe for starting treatment Neoadjuvant radiation…

Surgery is recommended for many patients diagnosed with colorectal cancer. Timeframe for starting treatment Colorectal cancer – surgery should be completed within five weeks of completing investigations and the MDM if no neoadjuvant therapy is required. Rectal cancer with neoadjuvant therapy – surgery should be completed in eight to 12 weeks after completing neoadjuvant therapy.…

The lead or nominated clinician should take responsibility for these tasks: discussing treatment options with patients and carers, including the treatment intent and expected outcomes, and providing a written version of the plan and any referrals providing patient and carers with information about the possible side effects of treatment, managing symptoms between active treatments, how…

Some patients may benefit from systemic therapy: those at high risk of relapse and who may benefit from adjuvant therapy those with locally advanced (high-risk) rectal cancer, treated with neoadjuvant chemoradiation therapy those with non-resectable, locally advanced or metastatic disease. Timeframes for starting treatment Neoadjuvant chemotherapy should begin within three weeks of the MDM. Adjuvant…

Rehabilitation may be required at any point of the care pathway from the pre-treatment phase through to disease-free survival and palliative care (Cormie et al. 2017). Issues that may need to be dealt with include managing cancer-related fatigue, coping with cognitive changes, improving physical endurance, achieving independence in daily tasks, returning to study or work…

The general practitioner plays an important role in coordinating care for patients, including helping to manage side effects and other comorbidities, and offering support when patients have questions or worries. For most patients, simultaneous care provided by their general practitioner is very important. The lead clinician, in discussion with the patient’s general practitioner, should consider…

The lead clinician (themselves or by delegation) should take responsibility for these tasks: explaining the model of post-treatment care and the roles of health professionals involved in post-treatment care including the role of general practice explaining the treatment summary and follow-up care plan discussing the development of a shared follow-up and survivorship care plan where…