| |
The colon and rectum together are known as the large bowel. Bowel cancer usually affects the large bowel. Cancer of the large bowel is also known as ‘colorectal cancer’.
Illustration above adapted from original illustration, courtesy of the Cancer Council Victoria.
Bowel cancer is diagnosed in more than 3,400 Victorians and over 12,500 Australians every year. It mostly affects people 50 years of age and over, but it can happen in younger people. If bowel cancer or its precursors (polyps) are diagnosed early then in many cases it is curable.
The bowel is the long ‘tube’ that absorbs water and nutrients from food and processes waste products into faeces. It includes the small bowel, colon and rectum.
As people get older, little lumps called polyps may grow inside the colon or rectum and can become cancerous. A polyp looks like small spots on the bowel lining or like cherries on stalks. Not all polyps become cancerous. If polyps are removed, the risk of bowel cancer is reduced.
The development of bowel cancer generally takes many years. It usually begins in the lining of the colon or rectum. Often very small amounts of blood, which may not be able to be seen, are leaked from these cancers long before any symptoms develop. This blood is then passed into the faeces.
If untreated, the cancer 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.
Symptoms
In the early stages bowel cancer does not always cause symptoms. This means that a person could have polyps or bowel cancer and not know it.
The most common symptoms of bowel cancer are:
- Blood or mucus in the faeces (poo)
- An unexpected change in bowel habit (for example, diarrhoea or constipation for no obvious reason)
- General discomfort in the abdomen (feelings of bloating, fullness, pain and/or cramps)
- Constant tiredness
- Weakness and paleness.
Having these symptoms does not mean that you have bowel cancer. People experiencing these symptoms should discuss them with their doctor.
Risk factors
The causes of bowel cancer are not clearly understood. However, we know that some risk factors make it more likely that a person will develop bowel cancer. These include:
- Getting older – bowel cancer more commonly affects people aged 50 and over
- Inheriting one of two uncommon genetic disorders – familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (HNPCC)
- A personal or strong family history of bowel cancer
- Having ulcerative colitis (inflamed colon lining) for more than eight to ten years
- There is also some evidence that having a diet high in red and processed meat and drinking alcohol may be part of the cause of bowel cancer.
People at relatively high risk of bowel cancer can arrange with their doctor to have regular tests to check that everything is OK.
Screening for bowel cancer
Ninety per cent of bowel cancer is curable if it is found early. Bowel cancer is generally more treatable when it is found early, before it has had a chance to spread.
Screening is checking for health problems before they cause symptoms. Bowel cancer screening is looking for early changes in the bowel lining, or signs of a bowel cancer, in healthy people who do not have symptoms. Screening can find polyps so they can be removed before they turn into cancer. It is one of the most effective ways to stop bowel cancer developing.
Bowel cancer screening is now available to Victorians aged 50, 55 and 65 years of age through the National Bowel Cancer Screening Program. The screening test that is used is called the faecal occult blood test (FOBT). This is a simple test involving taking tiny samples from two bowel motions using a test kit. The samples are collected at home and then sent to a laboratory for testing.
Everyone over the age of 50 should talk with their doctor about the screening tests that might be best for them so that any signs of bowel cancer can be picked up early. Doing a screening test every two years can reduce the risk of bowel cancer.
To find out more about bowel cancer screening, contact the Cancer Council Helpline on 13 11 20.
Diagnosis
Several tests can be used to diagnose bowel cancer including:
- Rectal examination
- Sigmoidoscopy/colonoscopy
- Barium enema
- X-ray, ultrasound, rectal ultrasound, CT scan or MRI scan
- Blood tests, including a carcinoembryonic antigen (CEA) test – CEA is produced in high quantities by some cancer cells, especially in bowel cancer.
Bowel cancer stages
Knowing if and how far the cancer has spread is called ‘staging’ of the disease. Staging helps your doctors to work out the best treatment for you. In Australia, the staging system for bowel cancer is the Australian Clinico-Pathological 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.
You may also hear about the ‘Dukes’ system, which is like the ACPS. Dukes Stage A equals ACPS Stage A, and so on.
Another staging system being used more often 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 (metastasised) to other parts of the body (M).
Ask your doctor to explain the stage of your cancer in a way you can understand. This will help you to choose the best treatment for your situation.
Treatment
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 (poo) 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. You will be 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. These will vary depending on the type of treatment you are having. Many side effects are temporary but some may be permanent. Your doctor will explain all the possible side effects before your treatment begins.
Sometimes a cure is not possible
If the bowel cancer has spread to other parts of the body, it is not always possible to cure. However, in a lot of people, it is still likely that the cancer can be kept under control for quite a long time. This depends on:
- Where and how far the cancer has spread
- What treatment you have had in the past
- The type of bowel cancer you have.
Treatment for control of cancer may include chemotherapy, radiotherapy, surgery, immunotherapy and/or pain-relieving drugs. You may hear your doctor call your treatment ‘palliative’. This simply means treatment that is designed to relieve symptoms rather than cure.
Reducing your risk
You can help to reduce your risk of bowel cancer by:
- Eating a healthy diet, including plenty of vegetables and fruit and only small amounts of animal fat
- Eating moderate amounts of lean red meat as part of a mixed diet including carbohydrates (breads and cereals), vegetables and fruit, and dairy products
- Eating limited amounts of processed meats
- Maintaining a healthy body weight
- Exercising regularly
- Not smoking.
Following this advice doesn’t mean that you will never get bowel cancer, but it can reduce your risk and has other health benefits too.
Where to get help
- Your local doctor
- Colorectal specialist
- Cancer Council Victoria Helpline Tel. 13 11 20
- Multilingual Cancer Phoneline – see CCV website for contact details
Things to remember
- If you are 50 years of age or over talk to your doctor about bowel cancer and screening.
- Most bowel cancers diagnosed at an early stage are curable.
- If you are at risk of bowel cancer, discuss with your doctor whether you need to have regular tests.
- You can reduce your risk of bowel cancer by eating a healthy diet, maintaining a healthy body weight, exercising regularly and not smoking.
You might also be interested in:
Cancer and food.
Cancer and heredity.
Cancer screening.
Fibre in food.
Palliative care - help for the terminally ill.
Palliative care explained.
Rectal cancer.
Want to know more?
Go to More information for support groups, related links and references.
|  |
|
| |
This page has been produced in consultation with, and approved by:
Cancer Council Victoria
|
|
Copyight © 1999/2010 State of Victoria. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.au) at no cost with permission of the Victorian Minister for Health. Unauthorised reproduction and other uses comprised in the copyright are prohibited without permission.
|
•
|
This Better Health Channel fact sheet has passed through a rigorous approval process. For the latest updates and more information visit www.betterhealth.vic.gov.au.
|
|
|
Last updated: December 2009
Linking to the Better Health Channel
It's easy to link to this page |
Close
If you would like to link to this fact sheet on your website, simply copy the code below and add it to your page:
<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Bowel_cancer?OpenDocument">Bowel cancer - Better Health Channel</a><br/>
Bowel cancer is a serious disease but, if diagnosed early, is often curable. Bowel cancer is also called colorectal cancer. Blood or mucus in the faeces (poo) may be a symptom of bowel cancer. Other symptoms may include diarrhoea or constipation, bloating or cramps and constant fatigue. Regular health checks and screening for bowel cancer from the age of 50 is recommended...
The link should appear like this:
Bowel cancer - Better Health ChannelBowel cancer is a serious disease but, if diagnosed early, is often curable. Bowel cancer is also called colorectal cancer. Blood or mucus in the faeces (poo) may be a symptom of bowel cancer. Other symptoms may include diarrhoea or constipation, bloating or cramps and constant fatigue. Regular health checks and screening for bowel cancer from the age of 50 is recommended...
© State of Victoria. All rights reserved
The information published here was accurate at the time of publication and is not intended to take the place of medical advice. Please seek advice from a qualified health care professional.
|
|
