Bowel cancer

by DR GEORGIA PAGE MBBS, FRACGP, BSc (Biomedical)

Bowel cancer is Australia’s second deadliest cancer. It claims more lives than breast cancer, prostate cancer, and melanoma. 1 in 13 Australian’s will be diagnosed with bowel cancer in their lifetime and it claims the lives of 5,375 people per year. The good news is that if detected early, more than 90% of bowel cancers are treatable. 

What is bowel cancer?
Bowel cancer, also known as colorectal cancer, occurs in the lining or wall of the bowel anywhere between the large intestine (colon) and the rectum. It often starts from benign lesions in the lining of the intestine called polyps. Some polyps can become cancerous and if undetected can grow into a larger cancerous tumour through the intestinal wall and spread to other parts of the body. 

Symptoms 
During the early stages of bowel cancer you may not have symptoms. This is why it is important to participate in the bowel screening program or talk to your doctor if you are at higher risk of bowel cancer. 

Symptoms can include;

  • A persistent change in bowel habit, such as constipation or diarrhoea.
  • Blood in your stools or bleeding from the back passage.
  • Change in the colour or appearance of your stools
  • Abdominal pain, bloating or cramping.
  • Anal pain or the presence of a lump in the anus. 
  • Unexplained weight loss
  • Unexplained anaemia causing tiredness or weakness

Bowel cancer risk
The risk of bowel cancer is higher in;

  • Smokers
  • Those with a family history of bowel cancer
  • High red meat consumption (especially processed meat) 
  • Inflammatory bowel disease 
  • Polyps (growths in the lining of the intestine) 
  • Obesity
  • Alcohol 
  • Age over 50 (however young people can get bowel cancer too) 

30% of bowel cancers can have a hereditary component which means the other 70% don’t have a family history of bowel cancer. The risk of bowel cancer rises with age and is more common over the age of 50 however there has been a rise in younger cases which is why it is important to see your doctor if you have any symptoms irrespective of age. 

Reducing your risk of bowel cancer
You can’t change your family history or how old you are, but you can change your lifestyle. You can reduce your risk by not smoking, abstaining from alcohol and eating a healthy, high fibre diet. Maintaining a healthy weight and participating in regular physical activity can also reduce your risk of colon cancer. 

How is bowel cancer diagnosed?
Bowel Screening 
The National Bowel Cancer screening program is a government funded initiative that sends out testing kits (called a FOBT – Faecal Occult Blood Test) in the mail to those aged between 50 – 74 every 2 years. It is recommended for those at average risk, with no symptoms. The screening test is easy to do, comes with clear instructions, and involves collecting small samples of poo and placing it on the supplied cards, and sending them back in the reply paid envelope to the lab to process. The results will be sent back to you and your GP. If you are unsure if you are due to do your bowel screen test or haven’t received a kit you can call the National Bowel Cancer Screening Program Infoline: 1800 118 868

A positive result means blood in poo has been detected when the card is analysed in the laboratory. This does not mean that you have bowel cancer as other conditions can cause blood in the stools, but it does mean you need to see your GP and be referred for a colonoscopy to exclude bowel cancer. 

A negative results means blood in poo has not been detected in the samples, however, it doesn’t completely exclude bowel cancer which is why it is important to see your doctor if you have any symptoms and have the test done every 2 years. 

Despite the test being free of charge, only 38% of eligible people in NSW take part in the program so if you still have your bowel cancer screening test sitting on your desk at home we encourage you do the test. Remember early detection and treatment is what saves lives.

If you are at higher risk of bowel cancer e.g family history of bowel cancer or if you have any symptoms please discuss with your doctor as you may need extra testing such as a colonoscopy. 

Colonoscopy
If you have a positive bowel screen result, are experiencing symptoms or have a family history of bowel cancer you will likely be referred for a colonoscopy. A colonoscope is a flexible tube with a camera at the end that can examine the inside of your intestine. The camera enters via the back passage and looks for any polyps, possible sources of bleeding and bowel cancer. Don’t worry – you are sedated during the procedure so it isn’t a painful. 

CT scan 
CT scans are sometimes used to identify the cause of a blockage of the bowel that can be caused by bowel cancer as well as detecting if there is spread of bowel cancer to other parts of the body. Other scans such as MRI’s or PET scans are also used in confirmed cases of bowel cancer to stage the disease. 

Treatment
Treatment depends on the type and stage of bowel cancer and could include surgery, chemotherapy, radiotherapy or a combination of all. Treatment is individualised for each person by the medical team.

  • Summary 
    Australia has one of the highest rates of bowel cancer in the world, with 1 in 13 Australians affected in their lifetime
  • Bowel screens are recommended every 2 years for those 50 – 74 at average risk of Bowel Cancer
  • A colonoscopy is recommended for those who have any symptoms or a family history of bowel cancer 
  • If detected early 90% of bowel cancers are treatable. 

Resources
National Bowel Screening program
www.cancer.nsw.gov.au/how-we-help/screening-and-early-detection/bowel-screening/do-the-test
Cancer Council
www.cancer.org.au/about-cancer/types-of-cancer/bowel-cancer/
Bowel Cancer Australia
www.bowelcanceraustralia.org/

Georgia enjoys all aspects of general practice and has been working at Your Family Doctors at Erina for the last 12 years. The practice has a fabulous team and they pride themselves on delivering good quality health care, with that special personal touch. For more information call 43654999, check the website www.yourfamilydoctors.com.au or like them on facebook. 

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