Bowel cancer affects the large bowel, which is made up of the colon and rectum. This is why it is also referred to as colorectal cancer. Around 43,000 people in the UK are diagnosed with bowel cancer every year. It is this country’s fourth most common form of cancer. If diagnosed early enough, bowel cancer is often curable. The good news is, the number of people dying from bowel cancer has been reducing steadily since the 1970s which may be linked to earlier diagnosis and improved treatment of the disease.
What is Bowel Cancer?
Bowel cancer mostly affects people over the age of 50 (94% of cases) although the disease can affect you at any age. Most bowel cancers develop from pre-cancerous growths which are called polyps. During bowel cancer screening, your doctor will look for polyps in the bowel wall and remove them to prevent them from becoming cancerous. Not all polyps will develop into cancer, but the medical view is it is better to err on the side of caution.
Symptoms of Bowel Cancer
Common symptoms of bowel cancer can include:
- Blood in your poo and/or bleeding from your bottom.
- Unexplained weight loss or fatigue – bowel cancer can lead to a lack of iron in the body which can cause anaemia and tiredness.
- A persistent change in bowel habit with no obvious cause – this might be needing to poo more or less often or having looser poo than before. Alternatively, you may feel like your bowels don’t fully empty when you go to the toilet.
- Abdominal pain or a lump in your abdomen.
You should see your doctor if you have one or more of these symptoms. It doesn’t necessarily mean you have bowel cancer, as these symptoms can be associated with other conditions But it is important to get checked out as soon as possible because, if it does turn out you have cancer, early diagnosis could save your life.
Diagnosing Primary Bowel Cancer
Sometimes, bowel cancer is diagnosed during screening for the disease. This is a way of testing for the earliest signs of bowel cancer in people who are healthy and have no symptoms.
In the UK we use something called the FIT test (Faecal Immunochemical Test) which looks for tiny traces of blood in your poo.
When you reach eligible screening age, a test will be posted to you which you can do at home and send off. You will be invited to participate in screening every two years up to the age of 75.
If traces of blood are found, you will be invited to undergo further tests to see what might be causing it. You will be given an outpatient appointment at your local hospital where you may have:
- A Flexible sigmoidoscopy – this uses a tiny camera on a flexible tube to look inside your rectum and the lower part of your large bowel (sigmoid colon) where most polyps and bowel cancers develop.
- A Colonoscopy – the whole of your large bowel is examined using a tiny camera on a long, flexible tube. If simply polyps are found they can be removed during the colonoscopy or biopsies may be taken.
- A Colon Capsule Endoscopy – this involves swallowing a small capsule which is similar in size to a large vitamin pill. The camera takes pictures as it travels through your bowel. It passes out of your system within a day or two when you go for a poo.
What is Primary Bowel Cancer, Recurrent Bowel Cancer and Metastatic Bowel Cancer?
When cancer affects the bowel alone we call it primary bowel cancer. In some cases, bowel cancer can return after treatment. This is referred to as recurrent bowel cancer and it may return to the same site as before (local recurrence) or in another part of the body (advanced or secondary cancer). When you have secondary cancer we also refer to it as metastatic bowel cancer.
Diagnosing Recurrent/Metastatic Bowel Cancer
After you have been treated for primary bowel cancer, you will be invited to follow-up appointments. It’s important to attend these as they will look out for new polyps in the bowel, cancer that has recurred in the bowel as well as metastatic bowel cancer. If recurrent or metastatic bowel cancer is suspected you will be invited for further scans, blood tests and colonoscopies so treatment can begin at the earliest opportunity.
Treatment Options for Bowel Cancer
The treatment you are offered will depend on a range of different factors including the type of bowel cancer you have, how advanced it is, and whether it is primary bowel cancer, recurrent bowel cancer or metastatic bowel cancer. Other factors like your age, general state of health and lifestyle will also be taken into consideration.
Reducing Your Risk of Bowel Cancer
While not all cancers can be prevented, you may be able to reduce your risk of developing bowel cancer by:
- Eating a healthy diet with plenty of fresh fruit and vegetables and avoiding too much red meat and processed foods.
- Maintaining a healthy body weight, as being overweight – particularly carrying excess weight around your waist – increases your chances of developing bowel cancer.
- Exercising regularly which can keep you fitter and help you avoid gaining excess weight.
- Keeping alcohol consumption within recommended limits and never smoking.
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