Bowel Cancer Q&A with Lee Dvorkin, Colorectal Surgeon

Men and women in the UK aren’t seeking advice or help around bowel cancer symptoms out of fear of embarrassment. According to new research, 40% of people would feel embarrassed to tell someone if they had irregular bowel habits or blood in their stool – the two key warning signs of the cancer.

The new figures raise concern that men and women are putting themselves at increased risk of late diagnosis because they are too embarrassed to tell anyone about their bowel habits.

The research was conducted independently on behalf of BMI Healthcare as part of the April Be Bowel Aware campaign. It revealed as many as 3 in 10 of the UK public have or may have had symptoms similar to those of bowel cancer, yet a third have not discussed their symptoms with anyone.

The research also reveals that over half (57%) of the UK are not confident that they would know the signs and symptoms of bowel cancer.

Since bowel cancer can affect both men and women of any age, is the 4th most common cancer in the UK, and the 2nd biggest cancer killer, we decided to speak to Lee Dvorkin, Consultant General and Colorectal Surgeon at BMI Healthcare, to find out more about bowel cancer, the signs of the disease and the ways it is treated.

What is bowel cancer?

Bowel cancer, also known as colorectal cancer, is a cancer situated anywhere in the large bowel (the colon or rectum). Bowel cancer is the 4th most common cancer in the UK and the second most common cause of cancer death with over 41,000 new cases diagnosed each year1. Bowel cancer is most common in the over 60’s and is rare in people younger than 40 years old. The majority of cases develop from pre-cancerous polyps (tiny growths in the bowel), which if left untreated can, over years, develop into cancer.

Who is most at risk of bowel cancer?

The biggest single risk factor is age. More than 8 out of 10 bowel cancers are diagnosed in people aged 60 or over. So the risk increases as you get older. Other factors thought to increase the risk include smoking, obesity and eating excessive red meat, alcohol, animal fat and sugar. A reduced risk has been noted in those who exercise and eat more fibre and pulsesThere are some other medical conditions that increase the risk of bowel cancer and these include; Ulcerative colitis, Crohns Disease and having lots of polyps (which are more common as you get older).

If there is a family history of bowel cancer, should extra precaution be taken?

Bowel cancer is very common so having a relative with bowel cancer is not unusual. The chance of getting bowel cancer goes up only if the family history is very strong. A strong family history means having several relatives with bowel cancer, especially if they are particularly young.

Examples of a strong family history might be; having a first degree relative diagnosed before the age of 45 or having two first degree relatives diagnosed at any age. To have a strong family history, the affected relatives must all come from the same side of the family.

If you have a strong family history of bowel cancer you may need to be referred to a genetics service. You will need to see a bowel specialist for regular colonoscopies to pick up any signs of cancer as early as possible.

How is bowel cancer detected?

Usually patients develop symptoms and go to see their GP. The GP will do a rectal examination and some blood tests and then send the patient to see a specialist in the hospital. The two most common investigations to diagnose bowel cancer is a colonoscopy (a camera examination of the large bowel) and a CT colonogram (instead of having the camera put inside your bowel, the doctor looks at x ray pictures of the bowel).

Some patients without symptoms are diagnosed through the NHS. The Bowel Cancer Screening Programme is offered to everyone aged 60 to 69 years old (75 years in some areas). Every 2 years patients are asked to send a poo sample to the laboratory. If blood is detected in the poo a colonoscopy is offered to see if there are early signs of cancer.

What treatments are available?

The treatment depends on how advanced the cancer is when it is diagnosed. The mainstay of treatment for confirmed bowel cancer is an operation to remove the cancer and its surrounding lymph glands. The bowel ends are usually joined back together but sometimes a colostomy bag is required. Nowadays, these operations are performed by keyhole surgery and patients typically spend less than a week in hospital.

Often, surgery is all the treatment that is needed but If the cancer is advanced chemotherapy is offered and this can last for 6 months. Surgery can also be used to remove certain cancers that have spread to the liver or lungs but this is not always possible.

For cancer in the rectum, radiotherapy is often used to shrink down the tumour before surgery.

BMI Healthcare’s research assessed 1,039 men and women in the UK, to gain consumer insights into the symptoms and risk factors of bowel cancer. The campaign is in line with the global health awareness event, Bowel Cancer Awareness Month which takes place over the course of April.

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