Bowel cancer

Bowel cancer, also known as colorectal cancer, develops from the inner lining of the bowel and is usually preceded by growths called polyps, which may become invasive cancer if undetected. Depending on where the cancer begins, bowel cancer may be called colon or rectal cancer.

 Bowel cancer is a general term for cancer that starts in the colon or rectum (also called colorectal cancer).

Colon cancer refers specifically to cancer that starts in the colon.

Rectal cancer refers specifically to cancer that starts in the rectum.

Small bowel cancer is a rare cancer that starts in the small intestine, which is made up of three parts: the duodenum, the jejunum, and the ileum

If untreated, bowel cancer can spread to other organs, such as the liver or lungs. About 3,000 Queenslanders are diagnosed with bowel cancer each year. It’s the third most common cancer in Australia, and while it mostly affects people over 50, it can occur at any age. Screening and early detection are crucial for improving outcomes and saving lives.

While the exact cause of bowel cancer isn’t fully understood, research has identified several factors that can increase the chances of developing it. Most people diagnosed with bowel cancer are over 50, and the risk tends to grow with age. Having polyps in the bowel or conditions like Crohn’s disease or ulcerative colitis can also increase your risk.

Risk factors, such as being overweight, eating a lot of red or processed meats, drinking alcohol, or smoking can play a role as well. If bowel cancer runs in your family or you’ve had it before, your chances may be higher. A history of ovarian or uterine cancer can increase your chances of getting bowel cancer too. Some inherited genetic conditions, like familial adenomatous polyposis (FAP) or Lynch syndrome, have also been linked to a higher risk

Bowel cancer can begin without noticeable symptoms. Bowel screening can spot the early signs of bowel cancer – when we find bowel cancer early, successful treatment is more likely.

 If you’re aged 50-74, you’ll be sent a screening test every two years as part of the National Bowel Cancer Screening Program. From 1st July 2024, people aged 45-49 can also request a free screening kit to be mailed to them.

 Your screening test is called a faecal occult blood test (FOBT). It looks for traces of blood in the poo which are invisible to the human eye and could be a sign of bowel cancer. The test is quick, simple, and completed at home in four easy steps.

 If you’ve lost or didn’t receive a kit, you can re-order one here. If you’re under 50 but have concerns about bowel cancer, speak to your GP immediately.

Bowel cancer is slightly more common in men, with one in 21 men and one in 31 women diagnosed before age 75. The symptoms of bowel cancer in a woman are the same as in a man.

While some people with bowel cancer have no symptoms and only discover it through screening, many do experience some symptoms of bowel cancer, which may include:

• Blood in your stools or on the toilet paper
• Changes in bowel habits, such as diarrhoea, constipation, or more frequent, smaller bowel movements
• A change in the appearance of stools (narrower or with mucus)
• Fullness or bloating in the abdomen, or a strange sensation in the rectum, often during a bowel movement
• A feeling that the bowel hasn’t emptied completely
• Unexplained weight loss
• Weakness or fatigue
• Rectal or anal pain
• A lump in the rectum or anus
• Abdominal pain or swelling
• Low red blood cell count (anaemia or iron deficiency), causing tiredness or weakness
• A bowel blockage.

If you have one or more of these symptoms, it’s important to know that they’re not always signs of bowel cancer. They can also be caused by other conditions like hemorrhoids, inflammatory bowel disease or anal fissures. If you notice any unusual symptoms, the only way to know if you have colon cancer is by making an appointment with your doctor and investigating further.

Diagnosing bowel cancer can take a number of paths. Some people may undergo testing to investigate symptoms, while others may not have symptoms but have a strong family history or receive a positive result through the National Bowel Cancer Screening Program.

Common tests include:

• Physical examination: Your doctor will check your abdomen for any swelling or unusual signs.
• Blood test: This checks your general health and looks for signs of blood loss in your stools.
• Colonoscopy: A flexible tube with a camera is inserted into your anus to examine your rectum and colon

Less commonly used tests include:

• CT colonography: A CT scan creates detailed images of the colon or rectum, sometimes called virtual colonoscopy.
• Flexible sigmoidoscopy: This test inflates your bowel slightly to help the doctor get a clearer view of the bowel wall.

If further tests are needed, they may include:

• CEA blood test: This checks for a protein called carcinoembryonic antigen (CEA), which is produced by some cancer cells.
• CT scan: X-rays create detailed cross-sectional images of the body.
• MRI scan: Uses a powerful magnet and radio waves to create clear images of the inside of your body
• PET-CT scan: A glucose solution with a small amount of radioactive material is injected to highlight abnormal tissues, combined with a CT scan for clearer images.

It may take up to a week to receive your test results. If you feel anxious while waiting, talking to a friend or family member could help, or you can call Cancer Council 13 11 20 for support. You don’t have to wait for a diagnosis to reach out for help.

There are several ways your bowel cancer might be treated. Your specialist will discuss a treatment plan for you based on the type of bowel cancer you have and factors such as the best possible outcome, the location of the cancer, whether it has spread, your general health, and your personal preferences. You may have one treatment or a combination of therapies.

Treatment options include:

It’s important to have open discussion with your doctor about your options and your outlook. But, while it’s understandable to want to know what to expect, no doctor can predict the exact course of your disease.

When determining your prognosis, your doctor will consider factors like your test results, the type of cancer, how fast the tumour is growing, how it might respond to treatment, and your overall health, including your age and fitness.

While the five-year survival rate for bowel cancer has increased from 46% in the early 1980s to 72 per cent between 2017-2021, early diagnosis generally leads to better treatment outcomes. Bowel cancer research shows us the importance of regular testing. In fact, if national participation in screening programs increases by 20%, around 84,000 lives could be saved by 2043.