What are the early symptoms of bowel cancer?

Lesley Dobson / 26 March 2014

Every 15 minutes someone learns that they have this disease, the third most common cancer in the UK, so it's vital to spot the early signs of bowel cancer.



The good news about bowel cancer is that it if diagnosed early it is very treatable. At the moment only 9% of patients in the UK are diagnosed at the earliest stage. Of these people it’s estimated that about 90% will survive for five years or more.

Survival rates for patients diagnosed at later stages are lower, which is why it is so important to know about bowel cancer, and see your GP if you are worried.

Bowel cancer screening

Depending on your age you could qualify for free screening through the NHS Bowel Cancer Screening Programme. People aged 60 to 69 are offered screening every two years. If you’re over 70, you can call the freephone helpline – 0800 707 6060 – to ask for a screening kit. It’s worth following up – research has found that regular bowel cancer screening reduces the risk of dying from bowel cancer by 16%.

Bowel Cancer UK is campaigning for those who are at higher risk of bowel cancer (see below) to have better surveillance screening and improved services.

Bowel cancer symptoms

Probably the most obvious symptom of bowel cancer in men and women is bleeding from your bottom and blood in your poo. This doesn’t always mean that you have bowel cancer. If it is bright red, fresh blood, it could be from piles, which can be damaged when you have a bowel motion, and bleed a little.

If blood is coming from higher up in your bowel it goes dark, almost black and can make your bowel motions look very dark. This can be a sign of bowel cancer, but could also mean that you have a bleeding ulcer.

If you have any bleeding from your bottom see your GP. The sooner bowel cancer is diagnosed, the better your chances are of recovering.

Other symptoms include a change in bowel habits lasting for three weeks or more- for instance diarrhoea or constipation, weight loss that you can’t explain, extreme tiredness that you can’t explain, and a pain or lump in your tummy.

If you have any of these symptoms see your GP. Catching bowel cancer early means you have a better chance of survival.

Next step - seeing your GP

Before you see your GP it’s a good idea to keep a diary of your symptoms and bowel habits so you can answer their questions accurately. Bowel Cancer UK has a ‘Keeping a bowel symptom diary’ factsheet, that you can download from their website.

Your GP will ask you questions relating to your symptoms, such as:

  • Are you going to the toilet less or more often?
  • Does it hurt when you go to the toilet?
  • Do you have symptoms that wake you up at night?
  • Do you have indigestion or feel sick?
  • What medication are you taking?
  • Have you had bowel problems previously?
  • Have any close relatives been diagnosed with bowel cancer?

At risk groups

There are three different categories of people who are regarded as being at higher risk for bowel cancer, at a younger age, than average. These include people who have a strong family history of bowel cancer. For instance, if you have one or more first degree relatives who have been diagnosed with bowel cancer under 50.

Some bowel cancers are caused by genetic conditions. These are familial adenomatous polypositus (FAP) and Lynch syndrome. Having either of these conditions dramatically increases your chances of developing bowel cancer, by nearly 100% and 80% respectively. So if you have either condition in your family you must talk to your GP.

The third group is people who have Irritable Bowel Disease, (IBD), caused either by Crohn’s disease, or by ulcerative colitis. These conditions can almost double you risk of bowel cancer if you have had them for some time.

Bowel cancer tests

There are a number of tests that your medical team can carry out to find out whether or not you have bowel cancer. Your GP will carry out the first, a digital rectal examination (DRE). They will put a gloved finger into your anus and then further up, into your rectum. They are checking to see whether there is a lump in your rectum. Lumps are found in 40 to 80% of rectal cancer cases.

If they think you may possibly have bowel cancer, or are uncertain, your GP will refer you to your local hospital. The specialists in hospital use two different tests to find out if you have bowel cancer.

Sigmoidoscopy

This test is carried out with a sigmoidoscope, a thin, bendy tube with a small camera and light attached to it. The sigmoidoscope goes up through your rectum, to your bowel, relaying images to a screen. Your doctor will check the images to see if there are any signs of cancer. They can also use the sigmoidoscope to carry out a biopsy. This means they take small samples of any tissue they suspect may be cancerous, which are then tested in the laboratory.

Colonoscopy

This test is similar to the sigmoidoscopy, but uses a longer tube – called a colonoscope. This test examines your whole bowel. Before this test is carried out you will be asked to eat a special diet, and will be given a laxative on the morning of the day you have the test carried out.

You’ll also have a sedative, which will help you to relax. This examination is carried out in a similar way to the sigmoidoscopy, and your doctor can take biopsies while doing it. However, because it involves looking at the whole bowel, it does take longer to carry out.

With both tests you should be able to go home on the same day. If the test results show that you do have bowel cancer you are likely to have other tests, such as magnetic resonance imaging (MRI) and ultrasound scans, to see the extent of the cancer.

Bowel cancer treatment

The treatments available for bowel cancer vary depending on whether the cancer is in your rectum, or in your colon. They will also vary depending on the stage of your cancer.

If the cancer is in your rectum, and hasn’t spread, radiotherapy is usually the first part of the treatment, and should shrink the tumour. This may then be surgically removed.

Stage 1 bowel cancer is the earliest stage. If caught at this point it may be possible to remove the cancer with surgery alone. With stage 2 or 3 bowel cancer, surgery may be the first course of treatment, aiming to remove the cancer, and possibly, lymph nodes in the area of the cancer. You cancer specialist (oncologist), may well recommend chemotherapy after the surgery, to reduce the risk of the cancer returning.

Advanced (stage 4) cancer, can’t usually be cured, but using a range of treatments, including surgery, chemotherapy and radiotherapy, the cancer’s spread can usually be slowed down. And symptoms can usually be kept under control.

Useful websites

Beating Bowel Cancer

Beating Bowel Cancer

Bowel Cancer UK

NHS Bowel Cancer Screening Programme

NHS Choices

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