Bowel cancer: do not ignore the warning signs

Every 15 minutes, somebody is diagnosed with bowel cancer in the UK. Mr Stephen Warren (General and Colorectal Surgeon) explains what bowel cancer is and the main symptoms. He also discusses how to reduce the risk of bowel cancer and why it is important to take part in screening.

What is bowel cancer?

Bowel cancer is the fourth most common type of cancer in the UK. It starts with  small, non-cancerous growths called polyps in the lining of the colon (large intestine) or rectum (back passage). These growths may become cancerous over time.

According to the charity Cancer Research UK, there are over 40,000 new bowel cancer cases in the UK every year. Almost 9 in 10 cases affect people aged 60 or over. More than 16,000 people die from bowel cancer every year in the UK. This is equivalent to 45 deaths every day. However, if bowel cancer is diagnosed at an early stage, there are highly effective treatments and most people survive.

 Who is at risk of getting bowel cancer?

Both men and women are at risk of getting bowel cancer. Various things may increase the risk of this condition:

• Age: Most people diagnosed with bowel cancer are over the age of 60. As you get older, the small growths called polyps are more common in the digestive system.
• Diet: If you have a poor diet that is high in fat or red meat and low in fibre, this can increase the risk of bowel cancer.
• Family history: Your risk of bowel cancer increases with the more close family members that you have who were diagnosed with this condition. Close family members are parents, brothers, sisters or children. The younger the age of your family member when they were diagnosed with bowel cancer, the more likely there is to be a genetic (inherited) link. Sometimes there is an obvious genetic link for cancer passed through the generations.
• Other risk factors: You may also have a higher risk of bowel cancer if you smoke, drink too much alcohol, are overweight or do not keep active.

What are the signs and symptoms of bowel cancer?

The signs and symptoms of bowel cancer may include:

• bleeding from your back passage and/or blood in your poo (stools)
• a change in your bowel habit that lasts for three weeks or more, such as looser or more runny poo
• unexplained weight loss
• extreme tiredness for no reason
• a pain or lump in your stomach (tummy) area

Is it possible to prevent bowel cancer?

We do not know the exact causes of bowel cancer, but some things outlined above can increase your risk of getting it. My advice is to make small changes to your lifestyle to help reduce the risk of bowel cancer and many other health conditions. Here are some practical tips:

• Try to eat less red and processed meat.
• Try to eat more fibre, which is found in fruit, vegetables, pulses and grains (such as wholemeal bread and cereals).
• Drink six to eight cups or glasses of fluid a day.
• Aim to keep to a healthy body weight.
• Try to be more physically active.
• Limit how much alcohol you drink. Men and women are advised not to drink more than 14 units of alcohol a week on a regular basis.
• Try to stop smoking. Your GP and local stop smoking service can support you with this.

What else can be done to lower the risk of bowel cancer and diagnose it early?

It is helpful to identify individuals with an increased risk of getting bowel cancer. The condition is more treatable if it is diagnosed at an early stage. At Highgate Hospital, we offer these individuals bowel screening with a colonoscopy. This is when a long, thin and flexible tube with a small camera is used to examine the bowels.

A colonoscopy procedure is carried out under sedation. You are given a medicine to make you feel calm and sleepy. This means that you need to arrange for someone to take you home after the procedure. You also need to take some medicine in advance at home to clear the poo from your bowels. Your doctor can then see the lining of your bowels properly.

If your doctor finds any small growths called polyps, they will remove these during the same procedure and arrange for them to be tested. Some polyps may form bowel cancers over time. When these polyps are removed during a colonoscopy, they cannot progress to bowel cancers.

The NHS bowel cancer screening programme is free and available to all UK adults from 60 to 74 years of age. Your poo is tested for tiny traces of blood, which cannot be seen and might come from a bowel cancer. This is called a Quantitative Faecal Immunochemical (qFIT) test. You are sent a home test kit through the post every two years from the age of 60 onwards.

If any blood is found in your sample, you are offered a colonoscopy. This is because the qFIT test, unlike a colonoscopy, rarely detects polyps. Only a small proportion of people who need a colonoscopy following a positive qFIT test actually have a bowel cancer diagnosed.

Why is it important to take part in the bowel cancer screening programme?

In addition to making positive lifestyle changes, it is important to take part in bowel screening if you are eligible. The NHS bowel cancer screening programme can detect bowel cancer at an early stage in people with no symptoms. If the condition is diagnosed at an early stage, it is easier to treat and there is a better chance of survival.

If you are aged between 60 and 74, you should be sent a bowel cancer screening home test kit automatically every two years. Otherwise, you can request a kit by phoning the free bowel cancer screening helpline on 0800 707 60 60. If you are aged 75 or above, you can also get a free home test kit by phoning the same number.

About Mr Stephen Warren

Mr Stephen Warren (General and Colorectal Surgeon) has specialist interests in bowel cancer, colonoscopy and all forms of keyhole (laparoscopic) surgery. He performs keyhole surgery to remove bowel cancers in a non-invasive way that avoids large cuts. There is more information on his website at: www.stephenwarren.com

To make an appointment with Mr Warren at Highgate Hospital, please call 020 3918 9522 or complete this form online.