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Bowel cancer
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Bowel cancer is diagnosed in more than 3,400 Victorians and over 12,500 Australians every year. It mostly affects people over 50 years of age but it can happen in younger people. Cancer of the bowel is also known as colorectal cancer.
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.
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.
Symptoms
The most common symptoms of bowel cancer are:
- Blood or mucus in the faeces
- An unexpected change in bowel habit (for example, diarrhoea or constipation for no obvious reason)
- General discomfort in the abdomen (feelings of bloating, fullness and/or cramps)
- Constant tiredness
- Weakness and paleness.
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 over the age of 50
- 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 10 years.
- In the early stages, bowel cancer often causes no symptoms. 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
Screening means looking for signs of a disease in healthy people who do not have 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. The earlier a cancer is found, the easier it is to treat and the more likely it will be curable. Bowel cancer is highly (90%) curable if found at an early stage.
Bowel cancer screening is now accessible to Victorians aged 50, 55, and 65 years of age. The screening test that is used is called the faecal occult blood test (FOBT). This is a simple test for the early signs of bowel cancer. It involves taking 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.
To find out more about bowel screening, contact The Cancer Council Helpline on 131 120.
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’ 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 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.
- 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 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
- 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
Things to remember
- 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.
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This page has been produced in consultation with, and approved by:
Cancer Council Victoria
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Copyight © 1999/2009 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.
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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.
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Fact sheet currently being reviewed.
Last updated: March 2008
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Bowel cancer - Better Health Channel
Bowel cancer is a serious disease but, if diagnosed early, it 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...
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Bowel cancer - Better Health ChannelBowel cancer is a serious disease but, if diagnosed early, it 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...
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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.
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