What You Need To Know About Bowel Cancer
How Common Is Bowel Cancer?
“Bowel cancer is the fourth most common cancer in the UK. Over 42,000 people are diagnosed every year in the UK and there are around 268,000 people living with bowel cancer today in the UK. Bowel cancer can affect anyone of any age. However, more than nine out of ten cases are diagnosed in people over the age of 50, and six out of ten cases are diagnosed in people aged 70 or over. However, more than 2,500 new cases are diagnosed each year in people under the age of 50. One in 15 men and one in 18 women will be diagnosed with bowel cancer during their lifetime.” – Dr Angela Rai, GP at The London General Practice
How Have These Statistics Changed In Recent Years?
“Recent research suggests that between 2005 and 2014, there was a rise in bowel cancer diagnoses in 20 to 50-year-olds, and in the UK there was a particular jump in cases among 30 to 39-year-olds. However, bowel cancer in under-50s is still very rare, so it’s important to put these figures into context. Researchers aren’t sure exactly what caused this increase – it may be a combination of lifestyle factors, genetic risk and an increased awareness of the symptoms of bowel cancer.” – Mr Shahnawaz Rasheed, consultant general surgeon at Cromwell Hospital
What Symptoms Should You Look Out For?
“The main symptoms are a persistent change in bowel habits – this means anything that isn’t ‘normal’ for you. Blood in your stools or bleeding from your back passage, unexplained weight loss, extreme fatigue for no obvious reason, or a pain, lump or swelling in your stomach are also key signs. However, these symptoms can be linked to other health conditions, so they don’t always mean you have cancer. That said, finding bowel cancer at an early stage makes it easier to treat and will likely lead to a recovery. If you notice any of these symptoms, chat to your GP immediately – they will decide whether you need further tests or need to be referred for investigations.” – Mr Muti Abulafi, consultant colorectal surgeon at London Bridge Hospital
“Try not to be embarrassed – your GP has seen and heard all about bowel problems many times before. Going more often, having looser stools or having alternating diarrhoea and constipation can all be signs. However, constipation itself is rarely a sign of bowel cancer – looser and softer stools are more suspicious. Also look out for blood in your poo – this is usually mixed in the stool, not just a little blood on the surface, which is more likely to be due to piles.” – Dr Deborah Lee, GP at Dr Fox Online Pharmacy
Are There Any Risk Factors?
“Having a first degree relative (mother, father or sibling) with bowel cancer under the age of 50 increases your risk. There are several other lifestyle factors that may put you at an increased risk. First, obesity is associated with an increased risk of bowel cancer, while excessive drinking is a known carcinogen, said to cause one in 17 cases of bowel cancer. Smoking, meanwhile, increases your risk by 7% and inactivity also plays a part. One study found that for each two-hour increase in time spent sitting still, the risk of bowel cancer increases by 8%. We all know a healthy diet is important but it’s particularly important we eat lots of fibre. Fibre bulks out the intestinal contents, puts pressure on the bowel wall and stimulates the muscular contractions of the bowel wall to propel the contents along. Inadequate fibre means intestinal transit is slowed, giving rise to constipation, which means the bowel contents spend longer in contact with the bowel wall. Not eating adequate fibre is believed to cause 30% of bowel cancers.” – Deborah
What Kind Of Screening Programme Is Available?
“NHS bowel cancer screening is offered every two years to all UK adults aged 60-74. In some parts of the country, it starts at 56. In the next few years, the aim is to start screening at 50. You are sent a faecal immunochemistry (FIT) test in the post – it is a simple test which you do at home. The sample is tested for the presence of blood in the stool. If no blood is present, you are sent another test in two years’ time. It is said to be 79% accurate in diagnosing bowel cancer. If blood is present, you will be contacted to discuss having a colonoscopy – a telescope in the bowel to look for the source of the bleeding. Remember, not everyone will have bowel cancer – they may have haemorrhoids, or bowel polyps. It’s important to look for polyps (non-cancerous growths), as these can develop into cancer. Polyps can usually be removed to lower the risk of bowel cancer.” – Deborah
Can You Get Tested Privately?
“If you do not fit the criteria for screening, you can purchase the FIT test yourself and report to your GP if you have a positive result. This is the same test used by the NHS – it is safe and effective, but no test is 100% accurate. A screening test is a test for well people with no symptoms. If you have any bowel cancer symptoms, you must see your GP. The FIT test could give a false negative result, meaning a possible cancer or serious bowel disease could be missed. The FIT test diagnoses 70% of bowel cancer cases and 30% of large colonic polyps. If you have symptoms, do not buy a kit online and then get false reassurance from a negative test. However, if you have no symptoms and just want the added reassurance at an earlier age that all seems well, you could do a FIT test yourself at home.” – Deborah
Are Some Types Of Bowel Cancer More Common Than Others?
“Yes – and the type of bowel cancer depends on where it starts. The most common type of bowel cancer is adenocarcinoma, which is where cancer cells grow in the lining of the bowel wall. Other rarer types of bowel cancer include squamous cell tumours, cancer of the skin cells that make up the bowel lining; carcinoid tumours, a type of slow-growing tumour which grows in hormone-producing tissue in the digestive system; sarcomas, cancer of the supporting cells of the body, such as bone or muscle; lymphomas, cancer of the lymphatic system; and melanoma, skin cancer that can begin in the back passage.” – Shahnawaz
What Are Your Treatment Options?
“When bowel cancer is caught early, it is highly treatable and can almost always be cured, compared to a late diagnosis, which has a significant impact on treatment. The main treatment for bowel cancer is surgery, as this is the only way to eradicate and cure the disease. Surgery is now done by keyhole, which involves a small scar in the abdomen and a short stay in hospital. For early tumours of the rectum, surgery can be done using an operating telescope. Other treatments include chemotherapy and radiotherapy, which are reserved for advanced disease.” – Muti
Have There Been Any Recent Developments?
“Over the last few years, we have seen real advancements in immunotherapy for bowel cancer. This is a type of treatment that harnesses your own immune system to target cancer cells. However, immunotherapy is only available for certain types of advanced bowel cancer.” – Muti
Here, Dr Deborah Lee Shares Her Advice For Reducing Your Chances Of Bowel Cancer...
Eat A Mediterranean Diet: “Eat a diet full of fresh fruit and vegetables with plenty of fibre. Choose unsaturated plant fats, such as olive oil, and wholegrains. Aim for ten portions of fruit and veg per day. Vegetarians also have a 22% reduced risk of bowel cancer.”
Drink Less: “Reduce your alcohol intake or stop drinking altogether. The current recommendation is to drink no more than 14 units per week. Space these out, with two to three alcohol-free days per week.”
Stop Smoking: “Smokers have a higher risk of colonic polyps than non-smokers – these can lead to bowel cancer. Get help and advice from NHS Smokefree.”
Be Active: “The current recommendation is 150 minutes of moderate intensity exercise per week. This is any form of exercise that makes you feel slightly sweaty and out of breath. Those who exercise regularly have a 40-50% reduced chance of developing bowel cancer.”
Know Your Family History: “This is especially important if someone closely related to you had bowel cancer at a young age. Your GP will discuss this with you and arrange any further genetic testing or contact the bowel specialist team.”
Consider HRT: “If you’re perimenopausal, don’t discount HRT. Studies show HRT may be protective against the development of bowel cancer. In a 2012 study, use of oral HRT lowered the risk of bowel cancer by up to 30%.”
Supplement With Vitamin D: “A recent study found those with the highest vitamin D levels had the lowest risk of bowel cancer. Vitamin D is integral to the immune system and may help protect the gut from cellular damage.”
For more, visit TheLondonGeneralPractice.com, CromwellHospital.com, HCAHealthcare.co.uk & DoctorFox.co.uk. For further information and support, also visit Bowel Cancer UK, Cancer Research UK Bowel Cancer & MacMillan Cancer Support.
You can donate to Deborah James' charity - Bowelbabe Fund - by visiting Bowelbabe.org
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