What is Bowel Cancer?
Bowel cancer (also known as colorectal, rectal or colon cancer) is a type of cancer that commonly develops in the large bowel. The first stage of bowel cancer is thought to arise from a polyp, a fleshy new growth in the bowel or rectum. This is usually benign but if left alone can develop into cancer. For this reason, if polyps are discovered in your bowel then you will need to have them examined and removed to prevent progression to bowel cancer.
How do I know if I have a bowel polyp?
Most people are unaware that they have polyps. If you have family members who have had polyps or bowel cancer then it is recommended that you undergo tests for polyps.
Smaller polyps don’t cause any symptoms so you’re unlikely to discover you have them unless you have a bowel or rectal investigation for another reason.
However, if polyps grow to a large enough size then you may notice the following symptoms:
- Bleeding from the back passage – you may notice this in your stools or on the toilet paper when you wipe your bottom
- A change in your bowel habits, such as diarrhoea or constipation
A procedure called colonoscopy is the best way to diagnose and treat polyps.
If polyps are discovered then they can be removed at the same time using special instruments.
Is my polyp likely to be cancerous?
After the polyp has been removed, it will be sent to a laboratory to check if it is cancerous. If cancer cells are found in the polyp, then it’s likely you’ll need further investigations and treatment for cancer. If the polyps are reported to be benign then further examination will be planned depending on the size, number and nature of the polyps.
There are certain risk factors which could increase your chance of developing bowel cancer –
- Age - the older the age the higher the risk. However younger people can also develop bowel cancer depending on the number of risk factors- every year over 2,000 younger people are diagnosed with bowel cancer, some as young as teenagers.
- Diet high in red meat and low in fibre
- Drinking too much alcohol
- Family history of bowel cancer
What are the other signs of bowel cancer?
Many of the symptoms of polyps are similar to those of bowel cancer, the difference is that the symptoms (blood in the stools, abdominal pain and diarrhoea or
constipation) will be persistent. For example, blood in your stools could be piles or anal fissures (a small tear in the anus), but if these are treated and the problem persists then it could indicate something more serious.
Other symptoms to look out for include:
- Not feeling as though your bowel is fully emptied after going to the toilet
- Unexplained weight loss
- Pain in the back passage
- Anaemia (which is diagnosed via a blood test)
Sometimes cancerous growths can block the bowel, causing bloating, constipation and vomiting.
Cancer screening for people between 60 and 74 is available on the NHS but if you are younger than this, or are particularly worried about your symptoms then you can speak to your GP or a private GP or consultant about your symptoms and diagnostic options.
How is bowel cancer diagnosed?
There are numerous ways you can be tested for bowel cancer and although it might be embarrassing to speak to someone about your symptoms, it’s in your initial consultation where your GP will be able to assess your risk based on your symptoms, age and medical history. They will also examine your back passage to see if they can feel any lumps, this will be painless but will feel uncomfortable and you may have a similar sensation to when you pass a stool.
After an initial consultation, you may be referred to see a consultant or referred for further tests. Or if you prefer, you can speak to a consultant in the first instance by at Pall Mall Medical.
During a private colonoscopy, a doctor will pass a thin, flexible tube down your back passage which has a small video camera attached so the doctor can take images of the inside of your rectum, colon and small intestine. Before a Colonoscopy, your colon will need to be empty so you will have to follow a special liquid diet for a couple of days before the examination so you can expel any matter from your bowel. During this time you can expect to experience loose bowels. You may also have to have an enema on the day of the procedure and/or be asked to take a laxative the day before the procedure.
A Sigmoidoscopy is a similar procedure to a colonoscopy but the procedure only looks at the bottom part of the bowel (known as the sigmoid colon) and the rectum. Like a colonoscopy, you will need to follow a special diet before the procedure and take laxatives and/or have an enema.
A Virtual Colonoscopy (also known as a CT Colonoscopy), allows doctors to take detailed pictures of the colon from outside the body, with no need for an internal examination. The advantage of a virtual colonoscopy is that it is a much more comfortable experience than traditional methods, it also enables the radiologist (who will carry out the examination) to have a detailed look at other organs such as the liver, kidneys, pancreas, gallbladder and spleen. Again, before this test you will have to ensure your bowels are clear, you will also have air pumped into your back passage to open up the bowel.
Like a virtual colonoscopy, a barium enema enables doctors to see the inside of the bowels without an internal examination, by using an X-Ray. After taking laxatives the day before and following a special diet, you will be given a mixture of water and barium which will be passed into your rectum through a tube. Once the barium liquid is in place, the doctor or radiologist will then take X-Ray images of your bowels.
Screening for Bowel Cancer
Bowel cancer screening involves taking a sample of your faeces with a kit provided. Once you have taken a sample, you will need to send the sample to the laboratory in the envelope provided. The test looks for blood in the faeces which can indicate bowel cancer. It’s important to remember that this test only picks up 50% of all bowel cancers so if you are concerned about your symptoms to speak to a GP.
If you are diagnosed with bowel cancer then it will be categorised into one of the following stages:
- Stage 1 – The cancer is only in the bowel lining or the rectum. At this stage, the cancer is relatively easy to treat with >93% of people with stage 1 cancer surviving for 5 years or more.
- Stage 2 – The cancer has spread to the muscle around the bowel and possibly the bowel surface. It is still relatively straightforward to treat at this stage and around >77% of people diagnosed with stage 2 bowel cancer will live for at least 5 years.
- Stage 3 – The cancer has reached the lymph nodes near the bowel. Survival rates at this stage depend on how many lymph nodes have been affected and >post-surgery survival rates are just under half.
- Stage 4 – the cancer is no longer confined to the bowel area and has spread to other areas of the body, such as the nearby liver. Thankfully, only 9% of people with bowel cancer experience stage 4.
How is bowel cancer treated?
Most people who have bowel cancer will be treated with surgery and potentially chemotherapy and radiotherapy depending on the stage and location of the cancer. During surgery, a consultant will remove the cancer, where possible, in which case the cancer will be cured.
For later stage cancers, one surgery alone is unlikely to be enough to treat the cancer as it may have already spread to other areas of the body, which may also need operating on. Some cancers such as rectal cancer will need to be treated with radiotherapy or chemotherapy.
During your treatment, you will also receive advice and further treatment from a dietician, physiotherapist and you may also receive counselling to support you during and after your treatment.
If you would like to find out more about investigations for colon cancer from Pall Mall Medical, contact the team today to book your appointment.