Symptoms & Questions

What is Bowel Cancer

Bowel cancer - also known as colorectal cancer or colon cancer - is any cancer that affects the colon (large bowel) and rectum (back passage).

Most bowel cancers start as benign innocent growths - called polyps - on the wall of the bowel. Polyps are like small spots or cherries on stalks and most do not produce symptoms. Polyps are common as we get older and most polyps are not pre-cancerous.

One type of polyp called an adenoma can become cancerous (malignant). If left undetected the cancer cells will multiply to form a tumour in the bowel.

If untreated, the tumour can grow into the wall of the bowel or back passage. Once cancer cells are in the wall, they can travel into the bloodstream or lymph nodes; from here the cancer cells can travel to other parts of the body. For bowel cancer, the most common places for bowel cancer cells to spread to are the liver and the lungs. The process of spread is called metastasis.

The earlier bowel cancer is caught, the easier it is to treat. 75% of bowel cancer is curable if caught early. This why it is so important to know the symptoms and causes of bowel cancer.
 

Act quickly if you develop symptoms of bowel cancer.

Symptoms

The first step you can take to protect against bowel cancer is to be aware of the symptoms. And most importantly, see your GP if you are at all concerned.

• Bleeding from the bottom (rectal bleeding) without any obvious reason. Or if you have other symptoms such as straining, soreness, lumps and itchiness.
• A persistent change in bowel habit going to the toilet more often or experiencing looser stools for several weeks.
• Abdominal pain especially if severe.
  
• Any lumps or mass in your tummy.
  
• Weight loss and tiredness (a symptom of anaemia).

Questions to ask your Doctor

If you have been experiencing any of the symptoms of bowel cancer, make an appointment to see your GP. Remember, GPs are used to people talking about bottoms and other intimate subjects - whatever you have to say, they will have heard it before.

The more information you can give to your doctor about your bowel habits, the easier it will be for them to make an accurate diagnosis - so don't be shy.

At the doctor's surgery

Below is a list of routine questions which your doctor may ask you to establish a diagnosis for your symptoms.

• Have you had a recent, persistent change in bowel habit to looser, more diarrhoea- like motions, going to the toilet more, or trying to go?
  
• If you haven't had a change of bowel habit, but have bleeding from the bottom,
  Have you any other symptoms like straining, soreness, pain and itchiness? (If the answer to this is yes, it may be that you have piles but it's still important for you to get this confirmed by your GP).
• Have you experienced any abdominal pain?
• Have you lost weight or become more tired recently?

Your doctor may also ask you other questions about:

• your lifestyle and diet (to determine any other possible risk factors)
• your past medical history
• current medications (including pain killers, indigestion remedies, antibiotics and laxatives)

Examinations/ Investigations

In addition to asking questions about your symptoms, your GP should undertake a rectal examination (also known as a 'PR') which is a painless examination with a gloved finger to feel for any suspicious lumps in the bottom or rectum.

If your GP does not examine you, you may ask why they have chosen not to.

Your GP may also choose to undertake a blood test to see if you have anaemia or anything else that may help with a diagnosis.

Your doctor may ask you to provide a sample of your bowel motion (a stool sample) so they can send it away to see if there is blood in your bowel motion.

What next?

If your GP can confidently rule out piles (following a rectal examination) and you are experiencing symptoms of concern, you should be referred to your local hospital for further investigations.

Being referred to the hospital

Many people referred for further investigation will not turn out to have bowel cancer.

You may wish to ask your GP:

• Are they sending an urgent or routine referral request?
• Why they have chosen the referral type they have (urgent or routine)?
•  How long they think it will be before you hear from the hospital?

Remember:  While bowel cancer is more common in the 60 years + age group, bowel cancer affects people of all ages.

If you have symptoms of concern, do not accept 'you're too young to have bowel cancer' as an explanation for your symptoms - ask your GP to be referred for further investigations.

Remember if you are still concerned - you can seek a second opinion from another doctor.

 
More Information:

World Cancer Research Fund's Colorectal Cancer Report 2010 Summary - Food, Nutrition, Physical Activity, and the Prevention of Colorectal Cancer