Bowel Cancer
The bowel consists of two parts, the upper part called the small bowel and the lower part called the large intestine, which ends in the rectum just above the anus or back passage. Bowel cancer (sometimes called colorectal cancer) is the third most common cancer in Britain with nearly 31,000 new cases being diagnosed every year.
We don’t know the exact causes of bowel cancer, but diets high in fat or red meat are thought to be implicated. Fresh fruit and vegetables appear to protect against colorectal cancer. About 10% of colorectal cancers may run in families, especially those in whom a number of relatives over the generations have developed the disease at a young age. Diseases such as ulcerative colitis and Crohn’s disease may rarely be complicated by the development of cancer but it is usually the more extensive varieties that behave in this way.
Many of the symptoms associated with bowel cancer may also be associated with other non-malignant conditions such as piles, fissures or imflammations of the large bowel.
Noteworthy symptoms include a change in bowel habit, blood or mucus in the stools, a feeling of incomplete evacuation, or pain around the back passage or in the lower abdomen. If you have any of these symptoms going on for more than four weeks you should consult your own doctor. Your GP may make a diagnosis and start treatment immediately, or may refer for further investigation, or to a hospital clinic for a specialist opinion.
In the hospital clinic you will be interviewed and examined including an internal examination and a small telescope may also be inserted via the anus to see the lower part of the large bowel (the rectum). At this stage the majority of people can be reassured that they do not have anything to worry about. Some may go on to further investigation, which may include a long telescope examination of the bowel (colonoscopy), or an Xray (barium enema).
At this stage most people can be reassured that they do not have cancer, some may have polyps or small benign growths which can be removed at the time of colonoscopy.
The individuals who have cancer diagnosed will be seen in the clinic for information to be given and for the arrangement of further tests, including some special scans to assess the extent of the disease, and to see whether it has spread.
Treatment is tailored to the individual’s requirements based on the site and extent of the cancer. Surgery is the mainstay of treatment but some people may benefit from radiotherapy treatment or chemotherapy or both, before or after surgery.
Following treatment patients are followed up in specialist clinics at intervals from six months to a year. This usually goes on for about five years, at which time patients are discharged from clinic review.
Remember most people with bowel symptoms do not have cancer, but don’t delay in getting yourself checked out.
Professor S H Leveson May 2005