Colorectal cancer: An expert guide

Although colorectal cancer is more common amongst people over fifty years of age, the disease can affect anyone at any time of life. In this informative article, highly respected consultant colorectal and general surgeon Mr Amir Ghanbari shares his expert insight on the key risk factors and symptoms of colorectal cancer. The revered specialist also sheds light on how colorectal cancer is most commonly diagnosed and treated.

What are the first signs of colorectal cancer?

The most common symptoms of colorectal cancer that are considered red flags are:

• a sudden change in bowel habit, in particular towards diarrhoea rather than constipation, but both are important
• rectal bleeding
• weight loss
• in some cases, associated pain

What can cause colorectal cancer?

There are various causes of colorectal cancer and of course, our understanding of the disease is still developing. The most common cause of developing colorectal cancer is having polyps, in particular adenomatous polyps, which can turn cancerous if they are larger than one centimetre.

Another reason people develop bowel cancer is age and it is much more common in people above the age of fifty. However, more recently we are seeing much younger patients with bowel cancer so symptoms should be taken seriously in anybody at any age.

Other risk factors are obesity, type two diabetes and some inflammatory bowel diseases, particularly if the history is greater than ten years. There is also a genetic risk so family history of bowel cancer is a very important factor.

Some lifestyle factor can also increase a person’s risk of developing bowel cancer, such as alcohol consumption and smoking. Eating a very meat-rich diet, particularly including lots of red meat, can also increase a person’s risk of developing bowel cancer.

How is colorectal cancer diagnosed?

The most common way to diagnose bowel cancer is with a colonoscopy, which is an endoscopic examination of the bowel.

Nowadays, there are various other investigations including a CT pneumocolon, which is a specialist CT scan which can diagnose bowel cancer. More recently, a procedure called capsule colonoscopy has been developed which involves swallowing a pill which takes a series of images of the colon.

Although other types of investigations can make the diagnosis, colonoscopy is still the gold standard diagnostic tool for bowel cancer. This is because it allows us to take biopsies which can be sent for histology (further analysis) whereas CT scanning and capsule colonoscopy procedures only provide images.

What treatments are available for colorectal cancer?

Overall, colorectal cancer has a very good outcome but this depends on the stage at which it is diagnosed. The most common treatment would be surgery (bowel resection), depending on which part of the bowel is involved. Sometimes surgery needs to be supplemented by chemotherapy or radiotherapy, either before or after the operation takes place, for the best long-term outcome of treatment.

How fast does colorectal cancer spread?

This is a difficult question to answer because there are many different types of colorectal cancer which vary in how rapidly they metastasise and spread. The most important thing is trying to identify and diagnose the cancer as early as possible to prevent it spreading. As a rough figure, I would say that bowel cancer can start to spread probably in the region of six months.

If you wish to schedule a consultation with Mr Ghanbari, you can do so by visiting his Top Doctors profile.