Bowel cancer
Cancer occurs when cells in our body multiply out of control, producing lots of abnormal cells. These abnormal cells don't function like they should, and can invade tissues or organs, and can sometimes spread to other parts of the body.
Bowel cancer is also known as colorectal cancer, and it includes cancer of the colon (which is the large intestine) and cancer of the rectum (which is the last few inches of the large intestine before it turns into the anus).
It is the fourth most common cancer in the UK, affecting both men and women, and is more likely as we age. There are certain genetic and lifestyle factors that can increase your risk - we'll talk you through them.
Symptoms of bowel cancer include: blood in the poo, a change in your bowel habits for more than a few weeks, tending towards diarrhoea but may also tend towards constipation too. Another symptom may be abdominal pain or discomfort and bloating.
It is important to note that most people with these symptoms do not have bowel cancer, but if they persist, occur in older individuals, or occur with symptoms like loss of appetite, fatigue and unintentional weight loss - this should be discussed with a doctor urgently.
As bowel cancer is more common in those aged 60 and over, the UK has a bowel cancer screening programme. Those between 60 and 74 years old will be automatically sent a bowel cancer screening test every two years. If you are 75 and over, you can ask for a free test kit every two years.
Using the kit you get a small sample of poo and send it off to be tested for blood, which can be a symptom of bowel cancer, but also other conditions. If blood is found, you will be invited for further tests to find the cause, including bowel cancer. If caught early, bowel cancer can be cured.
There is evidence that you can reduce the risk of developing bowel cancer by eating a high-fibre diet, with lots of fruit and veg and avoiding processed foods. You should avoid smoking and excessive alcohol intake to lower risk, and keep fit and maintain a healthy weight.
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What causes bowel cancer?
The exact cause of bowel cancer is not known, but we do know things that increase your risk of developing bowel cancer. Some factors you have control over, and others you have no control over.
The things you can't change:
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age - the risk increases as you get older, but careful attention should still be noted of younger patients with worrying or persistent symptoms
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family history - if someone in your family had bowel cancer, especially under the age of 50, then that significantly increases your risk, and you should talk to your GP about screening options available to you. Polyps in the colon may run in families and can increase the risk of bowel cancer
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certain medical problems like inflammatory bowel disease including Crohn's and ulcerative colitis, increases your chances, especially if you've been diagnosed for more than a decade
The things you can change:
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poor diet - switching to a high-fibre diet that's low in processed foods and low in red meat consumption is advised
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being overweight or obese - reducing your weight to a healthy range will reduce your chance of developing bowel cancer
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inactivity - increase your activity levels, aiming for at least 30 minutes of moderate activity daily
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alcohol and smoking - aim to reduce and cease these as either will increase your risk of bowel cancer
When should I see my doctor?
If you have any symptoms of concern that persist for more than 3 weeks, you should see your doctor. This includes an unexplained change in bowel habit, persistent abdominal pain or bloating, blood in your poo or unexplained fatigue or weight loss. If you think you have other risk factors or a family history, discuss these with your doctor, as they may consider early investigations.
What will my doctor do?
Your doctor will ask questions about your symptoms, relevant medical conditions and medications, and whether any of your family has suffered bowel problems or cancer. They will have a feel of your tummy and they may suggest doing an intimate examination of your back passage. They may take a measurement of your weight, so they can compare to previous and monitor this.
They will arrange for blood tests, looking for iron deficiency anaemia, as this can indicate if there is any bleeding. If you are low risk they may ask you to do a stool sample looking for blood. If you are high risk, they will refer you urgently for specialist review at the colorectal cancer clinic.
How is it treated?
Bowel cancer has to be thoroughly investigated by the specialists first to decide on the location of the disease and the severity (whether it has spread).
There are many ways of treating cancer, and which is chosen will depend on the area it is in, the stage of the cancer and the patient’s choice and wishes. Options include surgery (where a surgeon cuts out all or part of the cancer), chemotherapy (strong medication that aims to kill cancer cells and stop them multiplying) and radiotherapy (where radiation is targeted at the cancer cells to kill them).
Treatment could be one or a combination of these, and the aim may be to cure the cancer or to improve quality of life by shrinking the cancer to improve symptoms. Surgery alone can be very effective for cancer that has not spread and remains within the bowel.
Everyone always wants to know what their chances of surviving any cancer will be. Bearing in mind that bowel cancer is much more common in the elderly, who may have other serious medical conditions, survival rates a year after diagnosis is 78%, regardless of treatment or how far advanced or spread it is. This declines at 5 years and over after diagnosis, to 58%, and this falls a little further at 10 years or more after diagnosis.
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