Bowel cancer is also known as colorectal cancer and is the third most common cancer in Britain. Roughly one in 20 people in the UK will develop this form of cancer and the risk increases with age. Like many cancers, the incidence of bowel cancer is higher in people over the age of 50.

Bowel cancer treatment and diagnosis has improved in recent years. However, the most commonly-used form of bowel cancer treatment is still surgery. How successful this is depends on the stage of the cancer. If it is diagnosed at an early stage, there is a good chance that this will be successful. If the cancer is advanced, i.e. it has grown very large or has spread, surgical bowel cancer treatment may not be curative but may still slow the progress of the cancer.

Generally, the life expectancy of people who are diagnosed with bowel cancer is relatively good. There is plenty that can be done.

This article on bowel cancer symptoms and treatment is by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

What is bowel cancer?

Bowel cancer is cancer of the colon, which is also known as the large intestine, or the rectum. Bowel cancer can develop either from a previously benign polyp or from cancerous cells in the lining of the colon or rectum. From these small beginnings, a cancerous tumour can grow very large. Early bowel cancer treatment is important because it is particularly dangerous if the cancer invades the wall of the colon or rectum. Some cells may break away from the tumour and move into the lymph channels or the circulation, causing the cancer to spread.

This is a process that can happen with all cancers and is called metastasis. If a cancer has metastasised, it is already at an advanced stage. It is therefore vital to recognise the risk factors and symptoms, so that you can begin bowel cancer treatment before the cancer becomes too advanced.

Symptoms and risk

The early symptoms of bowel cancer include rectal bleeding, passing mucous with bowel movements, or a change in bowel ‘habits’. In more severe cases, bowel cancer symptoms can include weight loss, anaemia, fatigue and severe abdominal pain. If the cancer has spread to other tissues in the body, this can lead to other symptoms not related to the bowel.

You are at an increased risk if you have a family history of bowel cancer or if you take little exercise and drink a lot of alcohol. However, age is by far the most important risk factor: 80% of people who are diagnosed with colorectal cancer are over 60. This means that most bowel cancer treatment is carried out in older people.

How is it diagnosed?

Bowel cancer may be diagnosed when you have a check up after noticing symptoms. It can also be discovered during screening, which is usually offered to people between the ages of 60 and 69 years or those with a history of bowel disease. Detecting bowel cancer early is an important step in ensuring that bowel cancer treatment is initiated as soon as possible.

Your doctor will discuss your symptoms and may perform a physical examination. Following this, you may need to undergo further tests such as:

  • a colonoscopy or sigmoidoscopy – where your doctor uses a small camera to view the bowel.
  • a barium enema – a fluid that can be viewed using an X-ray is inserted into the large bowel.
  • a virtual colonoscopy – a series of X-rays to produce a detailed image of the bowel.

If bowel cancer is diagnosed, you may need to undergo further tests such as scans, X-rays or blood tests to assess the status of the cancer before you undergo bowel cancer treatment.

What types of treatment are available?

The type of bowel cancer treatment your doctor recommends will depend on several factors, including:

  • The type of cancer
  • The size of the tumour
  • Your general health
  • Your age
  • The stage of the cancer (whether it has spread)
  • The grade of the cancer (the appearance of the cancer cells under a microscope

Surgery to remove the cancer is the mainstay of bowel cancer treatment, and is performed in around 80% of patients. In some people, surgery alone will be sufficient. The surgeon removes the cancer completely and it does not come back, so you won’t need any further bowel cancer treatment. In others, especially if the cancer has already spread to the lymph nodes, a course of chemotherapy and/or radiotherapy may be needed to shrink the tumour before surgery, or you might be given ‘adjuvant’ chemotherapy alongside surgery to kill any cancer cells that may be left behind.

Some patients may be suitable for newer bowel cancer treatments, known as monoclonal antibodies, which are currently being introduced in clinical trials. These bowel cancer treatments aim to shrink the tumour before surgery in the same way as chemotherapy and/or radiotherapy, but with better efficiency and fewer side effects. Your doctor will discuss this option with you.

If you are eligible for this type of bowel cancer treatment, you may be accepted onto one of the ongoing clinical trials. The process of a clinical trial will be explained in detail to you and you can then decide whether to go ahead. If you do, you will be helping other people as well as yourself and will be improving bowel cancer treatment for the future.

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