Understanding bowel cancer: symptoms, treatment, prevention

What is bowel cancer?

Bowel cancer, also known as colorectal cancer, is a type of cancer that starts in the colon or rectum. It’s one of the most common forms of cancer worldwide, affecting both men and women. Understanding bowel cancer symptoms, causes, treatment options, and prevention strategies is crucial for early detection and effective management of this disease.

How common is bowel cancer?

Bowel cancer is the fourth most common cancer in the UK. Almost 43,000 people are diagnosed with bowel cancer every year in the UK.

Around 268,000 people living in the UK today have been diagnosed with bowel cancer.

More than nine out of ten new cases (94%) are diagnosed in people over the age of 50. But bowel cancer can affect anyone of any age. More than 2,600 new cases are diagnosed in people under the age of 50 every year.

One in 15 men and one in 18 women will be diagnosed with bowel cancer during their lifetime.

Is bowel cancer curable?

Bowel cancer is treatable and curable especially if diagnosed early. Nearly everyone survives bowel cancer if diagnosed at the earliest stage. However this drops significantly as the disease develops. Early diagnosis really does save lives.

More than 16,800 people die from bowel cancer in the UK every year. It is the second biggest cancer killer in the UK. But the number of people dying of bowel cancer has been falling since the 1970s. This may be due to earlier diagnosis, better treatment options and the start of the national bowel cancer screening programme.

Bowel cancer signs and symptoms

Bowel cancer can present a variety of signs and symptoms, including:

• Change in bowel habits: Persistent diarrhoea or constipation, or a change in the consistency of stools, such as having softer poo.
• Needing to poo more or less often than is usual for you.
• Blood in your poo (it may look red or black). However, it might be visible or only detectable through a fecal occult blood test (FOBT).
• Abdominal discomfort: Cramps, bloating, or pain in the abdomen.
• A lump in your stomach.
• Unexplained weight loss: Losing weight without changes in diet or exercise.
• Fatigue: Feeling unusually tired or weak.
• Anemia: A low red blood cell count, often manifested as weakness or shortness of breath.

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Causes of bowel cancer

While the exact cause of bowel cancer is unknown, several risk factors and certain health conditions increase the chance of developing the disease. These include:

• Age: The risk of bowel cancer increases with age, with the majority of cases occurring in individuals over 50.
• Family history: People with a family history of bowel cancer or certain genetic conditions, such as Lynch syndrome or familial adenomatous polyposis (FAP), are at higher risk.
• Diet: A diet high in red and processed meats and low in fibre, fruits, and vegetables may increase the risk of bowel cancer.
• Lifestyle factors: Lack of physical activity, obesity, smoking, and heavy alcohol consumption are associated with an increased risk.
• Inflammatory bowel disease (IBD): Conditions such as Crohn’s disease or ulcerative colitis can increase the risk of developing bowel cancer.

Bowel cancer diagnosis – main tests to check for cancer

Early detection is crucial for successful treatment of bowel cancer. Diagnosis typically involves a combination of medical history review, physical examination, and screening tests, such as:

• Colonoscopy: A procedure that allows a doctor to examine the entire colon and rectum using a flexible tube with a camera. During the colonoscopy, a small sample of the lining of your bowel may be taken for testing (called a biopsy).
• Fecal occult blood test (FOBT): A test to detect hidden blood in the stool, which may indicate the presence of cancer.
• Flexible sigmoidoscopy: Similar to a colonoscopy but only examines the lower part of the colon.
• CT colonography (virtual colonoscopy): A CT scan to examine the colon for abnormalities.

If you’re told you have bowel cancer

Being told you have bowel cancer can feel overwhelming. You may be feeling anxious about what will happen.

You’ll be helped through your diagnosis and treatment by a team of specialists.

This team will include a clinical nurse specialist who will be your main point of contact during and after your treatment. You can ask them any questions you may have.

Treatment for bowel cancer

Treatment for bowel cancer depends on:

• The stage of the disease
• The size of the cancer and whether the cancer is in your colon or rectum, or both
• If it has spread to other parts of your body
• If the cancer has certain genetic changes
• Your age and general health and may include:

Types of treatment

• Surgery: The primary treatment for early-stage bowel cancer involves removing the tumor and surrounding tissue.
• Chemotherapy: Drugs to kill cancer cells or stop them from multiplying, often used before or after surgery.
• Radiation therapy: High-energy radiation to target and destroy cancer cells, sometimes used alongside other treatments.
• Targeted therapy and immunotherapy: Medications that target specific abnormalities within cancer cells, often used in advanced stages of the disease.

Side effects of bowel cancer

Treatment for bowel cancer can cause side effects, which vary depending on the type of treatment and individual factors. Common side effects may include:

• Fatigue: Feeling tired or weak, which can be temporary or long-lasting.
• Nausea and vomiting: Especially common with chemotherapy or radiation therapy.
• Hair loss: A possible side effect of chemotherapy.
• Diarrhea or constipation: Changes in bowel habits due to treatment.
• Skin changes: Radiation therapy can cause skin irritation or sensitivity.

Living with bowel cancer

Living with bowel cancer can be challenging, but there are ways to cope and improve quality of life:

• Support groups: Joining a support group, such as Cancer Support UK’s Cancer Coach, can provide emotional support and practical advice from others who understand what you’re going through.
• Healthy lifestyle: Eating a balanced diet, staying physically active, and avoiding smoking and excessive alcohol can help manage symptoms and improve overall well-being.
• Open communication: Keep open lines of communication with your healthcare team and loved ones about your concerns, questions, and treatment preferences.
• Follow-up care: Regular follow-up appointments with your healthcare provider are essential for monitoring your condition and addressing any new symptoms or concerns.
• Signposting – Cancer Support UK’s reference resource contains more information about charities/bodies who offer help and support to people affected by a cancer diagnosis.

Preventing bowel cancer

While not all cases of bowel cancer can be prevented, there are steps individuals can take to reduce their risk:

• Healthy diet: Eat a diet rich in fiber, fruits, vegetables, and whole grains, and limit red and processed meats.
• Regular exercise: Aim for at least 30 minutes of moderate to vigorous physical activity most days of the week.
• Maintain a healthy weight: Avoiding obesity through diet and exercise can lower the risk of bowel cancer.
• Limit alcohol: Stick to moderate alcohol consumption, or better yet, avoid alcohol altogether.
• Screening: Participate in regular screening tests as recommended by your healthcare provider, especially if you have risk factors or a family history of bowel cancer.

Bowel cancer is a significant health concern with potentially serious consequences, but early detection, advances in treatment, and lifestyle changes can improve outcomes and quality of life for those affected by the disease. By understanding the signs, causes, treatment options, and prevention strategies, individuals can take proactive steps to protect their health and well-being.