Bowel cancer is a subject close to me both as a specialist in diagnosis and treatment of intestinal disease, but also because my family is affected by this disease. In the UK over 40,000 new cases of bowel cancer (also known as colon cancer) are diagnosed each year. It is the 4th most common cause of cancer in the UK yet is in many cases curable if diagnosed early.
Our individual bowel habits are often a closely guarded secret, rarely discussed even with our nearest and dearest. Concerns about ‘what is normal?’ or ‘should I worry?’ are difficult to express through fear of embarrassment, even to our GPs. Bowel Cancer Awareness Month is perhaps the time to have that discussion and seek specialist advice.
Symptoms such as a change in bowel habit, bleeding, abdominal pain or weight loss may be due to entirely harmless causes, but should not be ignored as they may indicate more serious bowel conditions. Timely expert assessment, diagnosis and treatment can often be vital in preventing long-term problems.
The best test for diagnosing many bowel conditions is a colonoscopy - this involves passing a flexible camera into the back passage to inspect closely the interior of the bowel. In expert hands, colonoscopy is a safe, effective and well tolerated procedure that allows diagnosis of intestinal disease and importantly, the removal of polyps.
Removing polyps during colonoscopy is important for bowel cancer prevention. Polyps are small growths in the bowel which can grow and develop into bowel cancer. The majority of bowel cancers start as polyps.
So, who is most at risk of polyps and bowel cancer? Many factors are associated with an increased risk: age, obesity, red meat consumption and smoking habits may all play a part. Polyps and colon cancer can also run in families, particularly if several relatives have been affected.
In the UK at the moment there are screening programmes in place to try to reduce the rate of bowel cancer by identifying people that have polyps. The National Bowel Cancer Screening Programme offers everyone between the ages of 60 and 74 a test to detect blood in the faeces; those that test positive are offered a colonoscopy. In the near future, everyone aged 55 will be offered a one-off ‘flexi sig’ (a shorter version of the full colonoscopy) to look for polyps in the lower part of the bowel.
During Bowel Cancer Awareness Month, please give a thought to your bowels. Bleeding, pain or a persistent change in bowel habit are not normal and require further expert assessment. If you or your family have been affected by bowel cancer or colonic polyps, now may be the time to discuss this - a consultation with your family doctor or a gastroenterologist may provide much-needed reassurance and prevent significant problems in the future.
Dr Alan Watson is a Consultant Gastroenterologist at Spire Roding Hospital, Redbridge. He is an expert in colonoscopy and one of the few local experts accredited to perform advanced colonoscopy as part of the National Bowel Cancer Screening Programme.