Bowel cancer

Bowel cancer can develop without any obvious symptoms. However, symptoms of bowel cancer may include:

• bleeding from the rectum
• blood in bowel motions
• changes to normal bowel habits which last for more than two weeks
• unexplained tiredness or weakness (a symptom of anaemia)
• ongoing abdominal pain or cramping
• unexplained weight loss.
  

If you notice any of these symptoms, it does not mean you have bowel cancer, but it is very important that you discuss them with your doctor as soon as possible.

Both men and women are at risk of developing bowel cancer. The risk is greater if you:

• are over 50 years of age
• have a family history of bowel cancer or polyps
• have a personal history of polyps or adenomas (pre-cancerous growths)
• have a history of inflammatory bowel disease such as Crohn's disease or chronic ulcerative colitis.

If you are at an increased risk of developing bowel cancer, it does not necessarily mean you will develop the disease. It is recommended that you discuss your individual risk and appropriate screening options with your doctor.

While no cancer is completely preventable, you can lower your risk of bowel cancer by:

• being physically active
• limiting alcohol intake
• avoiding smoking
• eating a healthy and balanced diet high in fibre and low in processed meat products
• participating regularly in bowel cancer screening.

It is recommended that all people of average risk for bowel cancer, who are aged 50–74 years with no symptoms be screened every 2 years. Those with a higher risk of bowel cancer may be advised by their doctor to undertake more specific monitoring, such as earlier testing or regular colonoscopy.

Screening involves testing for bowel cancer in people who do not have any obvious symptoms of the disease. The aim is to find any polyps or cancer early when it is easier to treat and cure. Bowel cancer can develop without any early warning signs. The cancer can grow on the inside wall of the bowel for several years before spreading to other parts of the body. Often very small amounts of blood leak from these growths and pass into the bowel motion before any physical symptoms are noticed.

A test called a Faecal Occult Blood Test (FOBT) can detect tiny amounts of blood in the bowel motion or poo. Although no screening test is 100% accurate, the FOBT is the best screening test for bowel cancer. If you develop any symptoms or discover a family history of bowel cancer you should contact your doctor as soon as possible to discuss the type of testing that is most suitable for you.

Testing and follow-up options:

• FOBT: A simple test that looks for tiny amounts of blood in the bowel motion, but not for bowel cancer itself. The National Bowel Cancer Screening Program sends a free screening kit to eligible people aged 50–74 years every 2 years. It involves taking a small sample from two separate poos which are then sent to a laboratory for testing. If you receive a positive result, this means that traces of blood were found in your poo and you should have a colonoscopy to find the cause of the bleeding. A positive result does not necessarily mean you have bowel cancer, but you need to discuss this with your doctor as soon as you can.
• Colonoscopy: This procedure is generally used to investigate bowel symptoms and as a follow-up for a positive FOBT. It is a day procedure, and you will need to drink special fluid to clear out the contents of your digestive system so that the lining of your bowel is clean and can be seen. While you are gently sedated a long, thin, lighted tube with a camera at the tip is gently inserted through the anus to allow a visual examination of the colon. If a polyp or early bowel cancer is detected, the doctor can remove it during the examination. You will not be able to drive afterwards and will need to have someone stay with you overnight following the procedure since you will be affected by the sedation.
• Sometimes people are unable to have a colonoscopy and there are other options available to follow up a positive FOBT result, such as Flexible sigmoidoscopy, CT Colonography, or Double-Contrast Barium Enema (DCBE).

Bowel cancer is one of the most curable types of cancer if found early, and the best way to reduce your risk of developing bowel cancer is to participate in regular screening by doing an FOBT every two years, from the age of 50 to 74 years.

• National Bowel Cancer Screening Program or call the helpline: 1800 627 701
• Bowel Cancer screening in Queensland
• Cancer Council Queensland
• Bowel Cancer Australia