Bowel cancer – finding the right support in York and Scarborough
Bowel cancer is the fourth most common cancer in the UK, with around 42,000 people diagnosed each year. While 94 per cent of cases are diagnosed in those aged 50 and above, it’s important to remember that bowel cancer can affect anyone.
This is part of the reason that the UK offers free bowel cancer screening as one of three nationwide schemes (in additional to cervical and breast). Cancer of the bowel is the second biggest cancer killer, but early detection can save lives.
How can I get access to bowel cancer screening?
A free bowel cancer home testing kit is available to residents over the age of 60 in England, Wales and Northern Ireland. (The age in Scotland is 50.) Please note, you need to be registered with an NHS doctor to receive this. You don’t need to do anything else – you’ll receive the kit in the post.
The home test involves sending off a small sample of your stool to be analysed for traces of blood. This test invitation is sent out automatically every two years for those aged 60-74.
In some areas, you may be invited to a one-off scope screening test if you’re over 55. This involves a thin, flexible tube that is inserted into the bowel to check for polyps.
If you’re aged 75 and over, you can request a free home testing kit every two years by calling 0800 707 6060. You can also use this number to schedule a scope test if you qualify.
The sooner the disease is diagnosed, the easier it is to treat. Unfortunately, many of the symptoms associated with bowel cancer can also be signs of other conditions. Always speak to your GP if you notice any of the following:
Bleeding from your bottom or blood in your stool
Persistent changes to bowel habits
Unexplained weight loss
A pain or lump in your stomach
What happens if my doctor suspects bowel cancer?
Your GP visit may involve a quick digital examination to check for any lumps in the rectum. He/she may also feel for lumps around the tummy.
If your GP suspects cancer, you’ll be referred to hospital for a test called a flexible sigmoidoscopy. This service is available at York Hospital’s Colorectal Cancer Services unit. It involves using a narrow tube with a light to examine the rectum and lower colon. Sample tissue may also be removed for analysis. It’s better to have an empty bowel for this, so you may need an enema.
Some cases need a more extensive examination, which may involve a colonoscopy or CT colonography. (The former is more common in those with no bowel symptoms.)
A colonoscopy examines the entire large bowel, using a longer tool similar to the sigmoidoscope. A camera will relay images onto a monitor, and again, the doctor may remove some tissue. You may have to follow a special diet and take a laxative before this test. The test takes place under local anaesthetic and can be uncomfortable, but should not be painful.
A CT colonography uses a CT scanner to produce 3D images of the large bowel and rectum. Again, you may need to change your diet and take a laxative. Gas is used to inflate the bowel via a small tube. This is less invasive than a colonoscopy and may be offered as an alternative.
Stages of bowel cancer
If you’re diagnosed, your doctor may run further tests include a CT scan of the chest and abdomen or an MRI scan. This is to ensure that the cancer hasn’t spread.
Similar to breast cancer, bowel cancer is categorised using the TNM system or one of four numerical stages. TNM refers to:
• T: the size of the tumour
• N: spreading to nearby lymph nodes
• M: metastasis (spreading to other organs).
The staging system is numerical or may also be known as Dukes’ A, B, C or D, as below:
Stage 1 - This is when the cancer is contained within the rectum or bowel lining.
95 per cent of men and 100 per cent of women will survive for five years or more.
Stage 2 - By now the cancer has spread beyond the muscle surrounding the bowel. It may have entered the surface covering the bowel, or nearby organs.
Five-year survival rates for men are 80 per cent, and 90 per cent for women.
Stage 3 - This is when the cancer has spread into nearby lymph nodes.
Almost 65 per cent of men and women will survive for five or more years.
Stage 4 - At this stage, the cancer has spread to another part of the body, such as the liver.
Just over 5 per cent of men will survive five years or more, compared to almost 10 per cent of women. Cancer that has spread to the liver can be removed with surgery, pushing the five-year survival rate to 25 to 40 per cent.
Treatment for bowel cancer in York
Treatment options will vary depending on the stage and specific parts of the body affected, for example:
The rectum (the last five inches of the large intestine)
The colon (deeper into the large intestine).
York Hospital offers a multi-disciplinary team to look after you, including a colorectal cancer nurse specialist. The main treatment is usually surgery to remove the tumour, though this may be combined with chemotherapy, radiotherapy or targeted medicines.
Colon cancer surgery
This may involve removing just a small section of the colon wall, or an entire section, depending on the stage. Procedures include:
Open colectomy: a large colonic incision to remove a section
Laparoscopic (keyhole) colectomy: a number of small incisions help the surgeon to remove a section of the colon, guided by a camera.
Robotic surgery is also available, but is very limited across the UK.
Rectal cancer surgery
These may be carried out through the bottom, often with no need for incisions:
Local resection: early cancers can be removed with an endoscope
Total mesenteric excision: this removes a larger section of the rectum, and can lower the risk of a recurrence
Anterior resection: this involves an incision, tissue removal, and then a re-attachment of the rectum to the upper part of the anal canal. It may need a temporary stoma, which helps to redirect your stool as the wound heals.
Abdominoperineal resection: this removes the sphincter muscles, requiring a permanent stoma.
This can be used before surgery to shrink rectal cancers, as an alternative to surgery (for early-stage cancers) or to control symptoms in palliative cases. External radiotherapy uses high energy waves to kill cells, while internal involves radiation inserted into the rectum to shrink cells.
Courses of treatment may take one to five weeks, and are available at the Bexley Wing of St James’ Hospital in Leeds. We offer a minibus service for York residents.
Just like radiotherapy, this can be used before surgery, during surgery or to stop the spread in advanced cancer patients. It’s available in two to three-week cycles, administered as a tablet or intravenously.
These are medicines such as cetuximab or panitumumab, which can help to shrink tumours. They’re available in conjunction with chemotherapy, or if the cancer has spread to other parts of the body.
What bowel cancer support is available in York?
York Hospital Cancer Care Centre - offer complementary therapies including massage and reflexology, plus a chaplaincy service and wig support.
The following groups are available in the Yorkshire area, for both bowel cancer and stoma support.
Airedale Stoma Support
Informal meetings for those with stomas on the second Thursday of every month. Meetings take place at the Clarke Foley Centre, Cunliffe Rd, Ilkley, LS29 9DZ, from 2pm – 4pm.
Colorectal Carers Support Group
A support group for patients, carers and family members affected by bowel cancer. Meetings on the third Monday of every month at the Sir Robert Ogden Macmillan Centre, Willaston Cres, Harrogate, HG2 7RY, from 11am – 12:30pm.
Harrogate Stoma Support Group
Occasional meetings at Harrogate Hill Methodist Church Hall, Otley Road, Harrogate, HG2 0AG. Call 01423 555786 for meeting details.
Leeds Bowel Cancer Support Group (patients and carers)
Meet-ups on the first Tuesday of every month from 10am – 11:30am at the Robert Ogden Centre, St James’s University Hospital, Beckett Street, Leeds, LS9 7TF. Informal chats with patients and specialists.
Wakefield Colorectal & Urology Cancer Support Group
Bi-monthly meetings on the third Thursday from 2:30pm at Brooke House, 221 Barnsley Road, Sandal, Wakefield, WF2 6BJ.
Scarborough Stoma Care Support Group
March to November meetings on alternate Saturdays from 2:30pm – 4pm at The Post Graduate Centre, Scarborough Hospital, Woodlands Dr, Scarborough, YO12 6QL. Contact the Stoma Care Team on 01723 342 388.
Here when you need us
The support network for bowel cancer patients in York and beyond is ever-growing. While every diagnosis is frightening, early detection could save your life. Please contact us for more information on screening or finding a support service near you.