Of course nobody wants cancer, and you may believe it’s easier not to think about it. But bowel cancer doesn’t go away just because you ignore it. And if you do have it, getting treatment early can save your life. It also means you’re likely to need less extreme treatment, with fewer side effects.
Bowel cancer – the symptoms to know
Bowel cancer is the third most common cancer in the UK – one in 19 women and one in 14 men will be diagnosed with it at some point. Some cancers are hard to spot until a very late stage – pancreatic cancer and lung cancer are good examples. Sadly, the later your cancer is diagnosed, the worse the outcome is likely to be.
Bowel cancer usually starts in your colon (large bowel) or rectum (just inside your bottom) and symptoms include:
- Bleeding or passing mucus from your back passage
- A change from your usual bowel habit, particularly to looser or more frequent stools (poos)
- Tummy pain
- Losing weight, being tired or losing your appetite for no reason
Why screen for bowel cancer?
By screening people at high risk of bowel cancer, treatment can be offered at a much earlier stage, when it’s less invasive, has fewer side effects and is more likely to offer a cure. That’s why the NHS has introduced a national bowel screening programme.
In England, Wales and Northern Ireland, everyone is invited to take part in NHS bowel screening every two years from the ages of 60-74. In Scotland everyone from 50-74 is invited to take part. There are two ways people are invited to have bowel screening. The standard one is a test called FOB (faecal occult blood) which looks for tiny traces of blood in your stool.
One of the early signs of bowel cancer can be tiny amounts of blood, too small for you to see. They happen because tumours are made up of abnormal cells which don’t have the same protective cover as normal bowel. That means they’re more likely to bleed when your stool rubs against them. Blood from just inside your back passage tends to be bright red, and you see it on the outside of your stool, on toilet paper when you wipe yourself or in the pan. Blood from higher up in your bowel turns dark red or black by the time it comes out – large amounts can lead to black, tarry stools. But small amounts may not be visible – and that’s where the FOB test comes in.
The invitation for FOB screening will come in the post every two years, and includes everything you need to do the test. It usually involves collecting three tiny samples of separate stools onto a special card (some cancers don’t bleed all the time, so three samples from different days gives a more accurate result). You then pop the card into the hygienically sealed freepost envelope provided and send it off. It’s estimated if everyone invited took the NHS bowel screening test, we could cut death rates from bowel cancer by 16%!
Aspirin - should I or shouldn't I?
Taking a regular 'baby aspirin' (75 mg) tablet a day may cut your risk of colon cancer. Recent studies suggest that taking this dose daily for 10 years between the age of 50 and 65 could reduce your risk by a third. If you've had a heart attack or stroke, you should definitely be taking this anyway unless there's a medical reason you shouldn't. However, aspirin does carry a risk of bleeding from the stomach, so for some people the risks might outweigh the benefits. Speak to your doctor before you start on a regular dose.
What does an abnormal FOB test result mean?
About 49 out of 50 will have a normal result, which you’ll receive in the post within around two weeks. Sometimes the result is uncertain and you’ll be asked to repeat the test – most people who do this end up having a normal result. If you’re one of the remaining few who have an abnormal result, you’ll be invited to see a specialist for a procedure called a colonoscopy – this involves taking medicine to clean your bowel out and putting a thin flexible telescope into your bowel through your bottom. About 90% of people who have this are found not to have cancer.
Bowel scope screening
The other screening test is a bowel ‘scope’ which is being rolled out in England as a one-off test at the age of 55. It’s rather like a colonoscopy but is even quicker and easier. You empty the lower end of your bowel using an enema just before the scope, and don’t need an anaesthetic.
Because it allows small polyps that could turn cancerous to be removed, it does even more than pick up cancer early, when it’s more treatable. It actually prevents cancer. People who have a one-off bowel scope are 35% less likely to be diagnosed with bowel cancer and 40% less likely to die from it – and the benefits last at least 17 years. It’s all over in under ½ an hour and most people say it’s only mildly uncomfortable. I’d call that a very small price to pay for peace of mind.
With thanks to ‘My Weekly’ magazine where this article was originally published.