The good news about bowel cancer is that if it is 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. According to Bowel Cancer UK, over 16,000 people die because of bowel cancer every year.
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.
It’s very important to be aware of the symptoms of bowel cancer and to go to your GP without delay if you have any concerns. Embarrassment of talking about bums and poo can often put people off talking about their symptoms to their GP. But if you show any of the signs it’s vital to get them checked out.
If you feel at all embarrassed about talking to the doctor, write down as many details as possible and give the notes to the doctor. This also ensures that you don’t forget anything of importance during your appointment.
Bowel cancer screening
Depending on your age you could qualify for free screening through the NHS Bowel Cancer Screening Programme. People aged 60 (50 in Scotland) to 74 are offered screening every two years, and are sent a home test kit to collect a small amount of a poo sample.
If you’re 75 or over, you can call the free bowel cancer screening 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%.
The test is done in the privacy of your own home and involves collecting small samples of your bowel motion which you wipe on a special card. It's completed over the course of a few days and then returned in the post to a central laboratory for results. You are then contacted with the results.
The test may sound embarrassing and unpleasant but it's quick and easy and it could save your life, so please don't put it to one side and forget about it.
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.
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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.
- diarrhoea or constipation
- weight loss that you can’t explain
- extreme tiredness that you can’t explain
- 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 your risk of bowel cancer if you have had them for some time.
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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.
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.
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, ccan’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.
Support for family
A bowel cancer diagnosis can have a devastating impact on everyone involved; not only on the patient but their family and friends too.
The closest person is usually the partner or spouse and it can appear that they are doing well because they are getting through each day, doing the washing, sorting the bills out. It appears that they are coping. But the emotional level hasn’t even been touched because they haven’t had time to deal with that side of things
Many people find it difficult to get help and support for themselves – and thinking ‘what about me’ can seem perverse when your loved-one is going through so much.
But in fact looking after yourself and seeking support will be beneficial to the patient too.
If a loved-one has recently been diagnosed with cancer or a serious illness there are several ways you can help yourself, and those around you.
- Ask for help with day-to-day tasks. It is very easy for the closest person to the cancer patient to get caught up in lots of necessary physical tasks, which then takes away the time they need to actually reflect on what has just happened to them as well as their partner. Always accept help from whoever offers it. People do feel appreciated and if you say no once they may not ask again.
- Allow yourself time: Try to carve yourself some ‘down-time’. You need time to grieve for the life you thought you were going to have and re-calibrate for the future. Plans for the future can still be creative and positive.
- Be honest. It’s ok to say to your partner or family member ‘I’m finding it tough’. You can cry together and talk together. Crying releases anxiety – holding it in is not good for your body.
- Do consider a support group or therapy. Whatever you think about them, try and keep an open mind. And go not just once but two or three times because it could be the second or third time before you get something from it. Whatever your judgement is before, when you’re in it it’s a completely different ball game. But make sure you find something that works for you. A support group may not work for everyone. If you find a walk in the countryside helps you, then do that instead.
Bowel Cancer UK
NHS Bowel Cancer Screening Programme
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