DR Zak urges people to know the signs of bowel cancer - and to know it is treatable and beatable...

DISCUSSION of bodily functions is not usually considered appropriate in many situations, but if more people are aware of the symptoms and signs of bowel cancer, then hopefully fewer lives will be lost.

As the fourth most common cancer in the UK, it affects over 40,000 individuals every year.

Statistics show that the majority of bowel cancers occur in the older age group, with more than 4 in 10 cases being diagnosed in those over the age of 75.

However, there is no such thing as being too young for cancer, this applying to the majority if not all cancers.

Colorectal means the colon and rectum, also referred to as the large bowel.

The commonest site for cancer to arise is the rectum, the last section of the large bowel before it becomes the anus.

It is thought that many large bowel tumours arise from a polyp or polyps, which may be present for ten years or even longer, before becoming cancerous.

While this may suggest that you are sitting on a ticking time bomb, being bowel aware, and indeed not shy about seeking medical advice, are key to early diagnosis and more lives being saved.

A change in bowel habit is the most reported symptom, either with a tendency to diarrhoea, or alternating constipation and diarrhoea.

If the cancer is in the rectum, you may feel that you haven’t emptied your bowels fully, or have the sensation that you still need to go. Persistent rectal bleeding should not be ignored, or simply assumed to be due to haemorrhoids.

If the cancer is in the right side of the bowel, symptoms may be less obvious, unless you can feel a lump in your tummy.

The only complaint may be fatigue, as a result of blood loss from the tumour. Even if you can’t actually see blood in your poo, feeling exhausted all the time is enough of a reason to see your GP urgently.

While colonoscopy is the gold standard for diagnosing bowel cancer, at the present time it is not routinely used as a screening test in the UK. Bowel screening involves the Faecal Immunohistochemistry Test (abbreviated to FIT), to detect tiny amounts of blood in your poo, that would not be visible to the naked eye.

If this is positive you will be referred for a colonoscopy under the two-week cancer rule. Not all those with a positive FIT will have bowel cancer.

Two genetic conditions are associated with an increased risk of bowel cancer, these being Familial Adenomatous Polyposis (FAP) and Hereditary Non-Polyposis Colon Cancer (HNPCC)

Severe inflammatory bowel disease can progress to colorectal cancer.

Those in high-risk groups may be offered regular colonoscopies starting at an early age.

Yet according to leading charity Cancer UK, over half of bowel cancers in the UK are preventable.

A poor diet, high in meat and fat, is a risk factor. Smoking and excess alcohol consumption will put you at greater chance of most illnesses, not just bowel cancer. It seems beer may be worse than other forms of alcohol.

Obesity has been linked with several disease both cancerous and non-cancerous.

Recent research has shown that the length of time a person is overweight or obese for has a bearing on their risk of bowel cancer, in the same way the likelihood of lung cancer is increased the more an individual smokes. This increased risk may persist even once the weight is lost.

Despite bowel screening being a relatively straightforward procedure, done in the comfort of your own home, uptake is nowhere near as high as it could be. The case for screening can be demonstrated when you consider two statistics. Over half of bowel cancers are diagnosed at a late stage. In a fifth to a quarter of patients, the cancer will have already spread at the time of diagnosis.

The field of cancer diagnosis and treatment is continually advancing. One of the latest developments is a blood test that may potentially be able to screen for bowel cancer. A recent study showed that abnormal or tumour DNA was present in the blood of 671 of 699 patients, already known to have colorectal cancer. While this is far from ready to be used as an actual screening test, it does show promise.

At the present time, the best advice is look after your general health, not to ignore any persistent changes in your bowels, and to participate in screening.

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