Bowel cancer FAQs
Bowel cancer is a very common cancer that occurs in the intestines, particularly the colon or rectum. Because of how bowel cancer progresses, it can remain undetected for quite some time, and treatment in its later stages is more challenging and more taxing on the patient, lowering the chances for a positive prognosis. In this article, a colorectal surgeon explains the symptoms of bowel cancer, and how it can be treated.
What are the symptoms of bowel cancer?
Bowel cancer symptoms can look like:
- Blood in stool (appearing as red or dark brown/black stool, or blood in the water when passing)
- Bleeding from the rectum
- A dramatic change in bowel habits, i.e. going to the bathroom more or less often, or sudden and recurring diarrhoea or constipation
- Unexplained weight loss
- Constant fatigue
- Abdominal pain or lump
These symptoms aren’t always indicative of bowel cancer and can be caused by different conditions like IBS or IBD. However, because of this, patients who do have bowel cancer may think that they are experiencing a different condition instead, and thus it can remain undetected for quite some time, and treatment in its later stages is more challenging and more taxing on the patient, lowering the chances for a positive prognosis. It is recommended that patients who have any of these symptoms or notice any concerning changes should visit their doctor for a check-up and testing.
How is bowel cancer diagnosed?
Catching the bowel cancer as early as possible has the best outlook for a patient because treatment can be started sooner and the cancer will be in a smaller area and may not have spread as much, therefore requiring less intensive treatment.
Even without any symptoms, patients over the age of 45, and those who are known to be high-risk like those with family history of bowel cancer and IBDs, are recommended to undergo regular bowel cancer screening as it can help not only detect bowel cancer, but alert the patient of pre-cancerous conditions in their colon and rectum, such as inflammation and polyps.
Bowel cancer screening typically involves stool tests, where samples of stool are analysed for traces of blood and unusual cell activity and which can be done in a clinic or at home with a kit, and colonoscopies, where a flexible tube with a camera at the end is inserted into the rectum so that the inside of the colon can be examined or a tissue sample can be taken for later analysis.
With a colonoscopy, a doctor can view all the tissue walls of the colon and rectum in high definition, real-time, and vivid colour, making it easier to see inflammation, abnormal tissue, and other signs of cancer. Patients are often asked to cleanse their gastrointestinal tract before the procedure by taking a special laxative. There can be some pressure and discomfort during the procedure, but it should not be excessively painful.
Further investigations may include imaging tests like CT, MRI, or ultrasound scans.
How is bowel cancer treated?
Treating bowel cancer depends on how advanced it is, and where in the large bowel it is located. All treatments are tailored to the individual patient. The decisions about treatment are made at a Multi-Disciplinary Team Meeting (MDT). At the meeting the surgeon, oncologist, radiologist and pathologist all discuss each case to ensure the best treatment option is recommended. All cancer cases should be discussed through an MDT.
The usual forms of treatment for bowel cancer are:
- Surgery is the most effective way of treating colorectal cancer, and in many cases, no further treatment will be needed. Surgery involves removing the cancerous growth from the colon or rectum. Surgery can be done either laparoscopically (which can include robotic methods) or open. Depending on how much tissue has to be removed, the patient may need a stoma bag.
- Chemotherapy and radiotherapy may be used in different ways in the treatment of colorectal cancer. Firstly, chemotherapy may be given after surgery in more advanced cancers to increase the chance of cure. Sometimes chemotherapy may be given first to help shrink a large tumour before surgery, this is usually done in conjunction with radiotherapy. This chemo-radiotherapy combination is most commonly used for rectal cancers.
In some cases, a combination of all the different treatments may be used to destroy the cancer. The earlier the cancer is diagnosed, the higher the chances that treatment will be a success. It is important to realise that treatment is tailored specifically to each individual patient based on that patient`s own medical history, the type and extent of cancer and the various treatment modalities that are available.