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Bowel cancer is diagnosed in more than 12,500 Australians annually. It mostly affects people over 50 years of age but it can happen in those younger. Cancer of the bowel is also known as colorectal cancer.
Bowel cancer is diagnosed in more than 12,500 Australians annually. It mostly affects people over 50 years of age but it can happen in those younger. Cancer of the bowel is also known as colorectal cancer.
The bowel is the lower part of the gastrointestinal (GI) tract and absorbs water and nutrients from food and processes waste products into faeces. It includes the small bowel, colon and rectum.
Bowel cancer usually begins in the lining of the colon or rectum. If untreated, it spreads deeper into the wall of the bowel. From there, it can spread to lymph nodes in the area. Later, bowel cancer can spread to the liver or lungs.
The most common symptoms of bowel cancer are: - Blood or mucus in the faeces
- An unexpected change in bowel habit (e.g. diarrhoea or constipation for no obvious reason)
- Discomfort in the abdomen (feelings of bloating, fullness and/or cramps)
- Constant tiredness, weakness and paleness.
The causes of bowel cancer are not clearly understood. However, certain risk factors predispose individuals to develop bowel cancer: - Age – bowel cancer more common in people over the age of 50
- Inheriting one of two uncommon genetic disorders: familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (HNPCC)
- A strong family history of bowel cancer
- Those suffering from ulcerative colitis for more than eight years
People at risk of developing bowel cancer should arrange regular screening tests with their doctor. Such screening tests look for signs of disease in healthy people who currently don’t display any symptoms. It will not always prevent bowel cancer but it can help find cancer or colorectal polyps (which can become cancerous) as early as possible. Bowel cancer is highly (90%) curable if found early. The initial screening test used is the “faecal occult blood test” (FOBT) and involves the collection of tiny samples from two or three bowel motions using a test kit. The samples are collected at home and then sent to a laboratory for testing. Bowel cancer moves through a series of stages. “Staging” helps doctors to work out the best treatment plan. In Australia, the staging system used for bowel cancer is the Australian ClinicoPathological Staging System (ACPS): - Stage A – the cancer is confined to the bowel wall.
- Stage B – the cancer has spread to the outer surface of the bowel wall.
- Stage C – cancer is found in lymph nodes near the bowel.
- Stage D – cancer is found at distant sites: for example, in the liver or lungs.
Another staging system being used is called the TNM system. It records how far the tumour (T) has spread through the bowel wall, if lymph nodes (N) are affected by the cancer and whether the cancer has spread to other parts of the body (M).
Surgery is the main treatment for bowel cancer. The surgeon removes the section of the bowel affected by cancer and then joins the two ends. A stoma (an opening of the bowel onto the abdomen) is sometimes made during the surgery. Your bowel motions will come through the stoma into a bag.
Stomas are usually temporary, while the bowel heals, but some people have them permanently. Many people find this difficult to deal with and are given a lot of education and support about having a stoma.
Chemotherapy or radiotherapy is nearly always used in addition to surgery.
All treatments have side effects they are usually only temporary but some may persist. The treating doctor is the best person to discuss this with. In some instances the disease may not be curable but it can be controlled, sometimes for years, depending on: - Where and how far it has spread – what stage it is in.
- The type of cancer it is and what the prior treatment has been.
Treatment modalities may include chemotherapy, radiotherapy, surgery, immunotherapy and/or pain-relieving drugs. Prevention is better than cure. You can reduce your risk of bowel cancer by: - Eating a diet higher in fruit, vegetables and wholegrain cereals and at the same time lowering your consumption of saturated fat. Such a diet is rich in fibre and helps move debris through the bowel faster.
- Exercise, don’t smoke and maintain a healthy body weight.
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