BOWEL CANCER

This is the condition which many people worry about, coming to a colorectal clinic with new bowel or abdominal symptoms, but which is actually
one of the more unusual findings. Regardless, it is often a treatable condition, and if it is detected at an early stage has a high cure rate.

How do I know if I have bowel cancer?
In the UK now there is a national bowel cancer screening programme which comes in two forms:
1. A one-off flexible sigmoidoscopy at 55 years of age;
2. A test to look for blood in the stool sent via the post every 2 years between 60 and 74 (although those age 75 and older can continue screening by
requesting the kits)
Screening is not a replacement for tests like colonoscopy, and indeed those who have a positive faecal blood tests are referred for colonoscopy to
definitively rule in or out bowel cancer. People with new or persistent bowel symptoms should not use the screening programme as a diagnostic service
given the inaccuracies, and if concerned you should always report such symptoms to your GP. Although many bowel cancers do not give symptoms,
the commonest symptoms we look out for are changes in bowel habit, especially towards looser stools and persistent bleeding from the back passage.
These are, however, very common symptoms and although the presence of either or both of these symptoms should be taken seriously and checked out
properly, most of the time they turn out to be caused by something else.

What is the cause?
Most cases of bowel cancer are isolated and the cause unknown. Some people have a strong family history of bowel cancer, but within this group only
a tiny number have proven genetic abnormality which can be identified as the cause. Although there are many risk factors thought to increase the risk
of bowel cancer such as lack of exercise or poor diet, nobody really knows why some of these factors are related.

What can be done about bowel cancers?
If people are found to have a suspected bowel cancer then they will have several tests designed to assess the suspected cancer as well as to detect
evidence of potential spread elsewhere. Most cancers, however, present before this happens. Once all the information is collected, individual cases
are discussed at a regular multi-disciplinary meeting between colorectal surgeons, oncologists (cancer specialists), radiologists (X-ray specialists) and
pathologists. We look at each case to compile all the information to arrive at a recommendation for the sequence of treatment for that individual. I
would then discuss the results and the recommended treatment in person with the affected person and their family/supporters, with enough time set
aside to deal with any and all queries which may arise. Each case is dealt with in such a way as to tailor the treatment package to the individual, taking into account the wishes of the person involved as well as their unique circumstances.