Cancers arise when abnormal cells divide uncontrollably, then invade surrounding tissues or organs and eventually spread to other parts. Cancer that grows from within the large intestine (colon) or back passage (rectum) is termed colorectal cancer.
Bowel cancer is the 4th most common bowel cancer in the UK. It can affect men and women at any age but is more common in older people. It is often more common in those with a family history of bowel cancer, underlying bowel conditions (e.g. inflammatory bowel disease like Crohn’s or ulcerative colitis), particular diets, smokers and obese people.
Bowel Cancer Symptoms
The symptoms of bowel cancer include a recent change to your regular bowel habit, seeing blood in your stools and sometimes abdominal pain or weight loss. Occasionally, bowel cancer presents with iron deficiency anaemia (low blood count combined with low iron levels) caused by blood loss into the stools. If you have these symptoms, we will assess you with a careful history and clinical examination, including an examination of your abdomen, a digital rectal examination. We can also perform a telescopic examination of the rectum (proctoscopy) or the lower part of the colon (rigid sigmoidoscopy). Further tests to exclude or identify a bowel cancer may involve a colonoscopy, a camera test to visualise the entire colon and perform biopsies if necessary directly or a CT virtual colonoscopy. If you have iron-deficiency anaemia, then usually a gastroscopy (camera test to examine the oesophagus, stomach, and first parts of the small bowel are typically recommended. We also use the quantitative faecal immunohistochemistry test or qFIT test to identify microscopic blood.
Bowel Cancer Diagnosis
If bowel cancer is diagnosed, it must be fully staged. Initial staging usually includes a CT scan of your chest, abdomen and pelvis and for cancers in the rectum, an MRI scan of your pelvis. Once these tests have been conducted, we will discuss your case in our multi-disciplinary team (MDT) meeting, consisting of colorectal surgeons, radiologists, pathologists, oncologists and specialist cancer nurses. Sometimes further scans are requested at this point if required.
Once your bowel cancer has been fully staged, we can discuss the treatment options with you.
If you have bowel cancer at a potentially curative treatment, the treatment can involve a mixture of surgery and chemotherapy and/or radiotherapy. If surgery is part of your treatment plan, we will discuss this in detail with you. Most cases these days can be performed using keyhole surgery.