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Colon, rectum or bowel cancer





NHS Choices Syndication


Bowel cancer

'I never thought I'd have any problems'

Anne Messenger, 65, from London was diagnosed with bowel cancer in 2005. After keyhole surgery, she is now in the clear and focused on helping others.

“For years I’d suffered from indigestion and I thought I had irritable bowel syndrome, but when I noticed I had passed a little bit of blood, I went to the doctor. I was referred to St George’s Hospital for tests and, following a stool sample, I was told I had a peptic ulcer. However, when I had a routine colonoscopy, doctors discovered that it was bowel cancer.

“It turned out that the initial bleeding had nothing to do with the cancer, so I’m fortunate that whatever caused it put me in a position where the doctors could pick up on the cancer. 

“Not long after my diagnosis, I was given a date for an operation to remove the cancer. I had a full body scan and the consultant told me that everything looked straightforward. They would perform keyhole surgery and I wouldn’t need a colostomy.

“Leading up to the surgery, I had another colonoscopy, in which purple dye was used to pinpoint where doctors needed to operate. I never thought I’d have any problems, as I was naturally upbeat.

“The operation went well and they removed an 8cm (3 inch) growth. Doctors told me there was a 20% chance of recurrence, which would be halved if I had a course of chemotherapy. I began chemotherapy two weeks after my operation, but I had a bad reaction to it and had to stop. 

“For the two years after my operation, I had a check-up every three months. I now have one every six months. I had my last cigarette on the morning of my operation and I have become more aware of what I eat. My diet includes lots more fruit and veg.

“My advice is to try to take a bit of control and understand what is happening to you. Pay attention and always make a note of things to ask the consultant. You don’t want to fuss, but you also don’t want the consultant to say, ‘You should have come to see me about this two months ago.’ People can find doctors intimidating, but they’re nice to everyone, so if something is worrying you, just ask. I used to call up or write to my doctor if I had any worries, and I’d take my husband with me if I was going to an appointment where I needed to take in information or make decisions about my treatment.

“Also, try to carry on as if you’re going to be fine. I did, and because of that, my family coped well.

“I am now on the cancer committee at St George’s. I think it’s best to face cancer head on, and people who survive have a better view of life than most.”

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Published Date
2012-12-05 19:48:23Z
Last Review Date
2012-08-28 00:00:00Z
Next Review Date
2014-08-28 00:00:00Z
Classification
Bowel cancer,Colonoscopy






NHS Choices Syndication


Bowel cancer

'If it's caught early, you stand a good chance of recovery'

Lester and his wife Carolyn talk about his experience of bowel cancer, and offer their advice to others.

Published Date
2012-12-05 19:48:41Z
Last Review Date
2012-08-28 00:00:00Z
Next Review Date
2014-08-28 00:00:00Z
Classification






NHS Choices Syndication


Bowel cancer

'It was soft and smooth – I could feel it'

Linda recalls the day she first noticed her bowel cancer warning symptoms, and regrets not seeing her doctor straight away.

Published Date
2012-12-05 19:48:55Z
Last Review Date
2012-08-28 00:00:00Z
Next Review Date
2014-08-28 00:00:00Z
Classification






NHS Choices Syndication


Bowel cancer

Causes of bowel cancer

Cancer occurs when the cells in a certain area of your body divide and multiply too rapidly. This produces a lump of tissue known as a tumour.

Most cases of bowel cancer first develop inside clumps of cells on the inner lining of the bowel. These clumps are known as polyps. However, if you develop polyps, it does not necessarily mean you will get bowel cancer.

Exactly what causes cancer to develop inside the bowel is still unknown. However, research has shown several factors may make you more likely to develop it. These factors are outlined below.

Age

Your chances of developing bowel cancer increase as you get older. Almost nine out of 10 cases of bowel cancer in the UK are diagnosed in people over 60 years of age.

Family history

Having a family history of bowel cancer can increase your risk of developing the condition yourself, particularly if a close relative (mother, father, brother or sister) was diagnosed with bowel cancer below the age of 50.

If you are particularly concerned that your family’s medical history may mean you are at an increased risk of developing bowel cancer, it may help to speak to your GP.

If necessary, your GP can refer you to a genetics specialist who can offer more advice about your level of risk and recommend any necessary tests to periodically check for the condition.

Diet

A large body of evidence suggests a diet high in red and processed meat can increase your risk of developing bowel cancer. For this reason, the Department of Health advises people who eat more than 90 grams (cooked weight) of red and processed meat a day to cut down to 70 grams. Read more about red meat and bowel cancer risk.

There is also evidence suggesting that a diet high in fibre could help reduce your bowel cancer risk.

Read more about eating good food and a healthy diet.

Smoking

People who smoke cigarettes are more likely to develop bowel cancer, other types of cancer and other serious conditions such as heart disease than people who do not smoke.

Read more about stopping smoking

Alcohol

Drinking alcohol has been shown to be associated with an increased risk of bowel cancer, particularly if you regularly drink large amounts of it.

Read about drinking and alcohol for more information and tips on cutting down.

Obesity

Being overweight or obese is linked to an increased risk of bowel cancer, particularly in men.

If you are overweight or obese, losing weight may help lower your chances of developing the condition.

Inactivity

People who are physically inactive have a higher risk of developing bowel cancer.

You can help reduce your risk of bowel and other cancers by being physically active every day.

Read more about health and fitness.

Digestive disorders

Some conditions affecting the bowel may put you at a higher risk of developing bowel cancer. For example, bowel cancer is more common in people who have had severe Crohn’s disease or ulcerative colitis for many years.

If you have one of these conditions, you will usually have regular check-ups to look for signs of bowel cancer from about 10 years after your symptoms first develop.

Check-ups will involve examining your bowel with a colonoscope – a long, narrow flexible tube containing a small camera – that is inserted into your rectum. The frequency of the colonoscopy examinations will increase the longer you live with the condition, and will also depend on factors such as how severe your ulcerative colitis is and if you have a family history of bowel cancer.

Genetic conditions

There are two rare inherited conditions that can lead to bowel cancer. They are:

  • familial adenomatous polyposis (FAP) – a condition that triggers the growth of non-cancerous polyps inside the bowel
  • hereditary non-polyposis colorectal cancer (HNPCC), also known as Lynch syndrome – an inherited gene fault (mutation) that increases your bowel cancer risk

Although the polyps caused by FAP are non-cancerous, there is a high risk that, over time, at least one will turn cancerous. Most people with FAP will have bowel cancer by the time they are 50 years of age.

As people with FAP have such a high risk of getting bowel cancer, they are often advised by their doctor to have their large bowel removed by surgery before they reach the age of 25. Families affected can find support and advice from FAP registries such as the FAP registry provided by St Mark’s Hospital, London.

Removing the bowel as a precautionary measure is also usually recommended in people with HNPCC because the risk of developing bowel cancer is so high.

Want to know more?

Published Date
2014-10-07 13:15:43Z
Last Review Date
2014-09-01 00:00:00Z
Next Review Date
2016-09-01 00:00:00Z
Classification
Bowel cancer,Cancer and tumours,Colonic polyps,Intestinal and stomach conditions,Obesity






NHS Choices Syndication


Bowel cancer

Diagnosing bowel cancer

When you first see your GP they will ask about your symptoms and whether you have a family history of bowel cancer.

They will then usually carry out a simple examination of your abdomen (tummy) and your bottom – known as a digital rectal examination (DRE)

This is a useful way of checking whether there are any lumps in your tummy or back passage. The tests can be uncomfortable and most people find an examination of the back passage a little embarrassing but they take less than a minute.

If your symptoms suggest you may have bowel cancer, or the diagnosis is uncertain, you will be referred to your local hospital initially for a simple examination called a flexible sigmoidoscopy

Flexible sigmoidoscopy

A flexible sigmoidoscopy is an examination of your rectum and some of your large bowel using a device called a sigmoidoscope. A sigmoidoscope is a long, thin flexible tube attached to a very small camera and light that is inserted into your rectum and up into your bowel.

The camera relays images to a monitor and can also be used to take biopsies (where a small tissue sample is removed for further analysis).

It is better for your lower bowel to be as empty as possible when sigmoidoscopy is performed, so you may be asked to carry out an enema (a simple procedure to flush your bowels) at home beforehand. This should be used at least two hours before you leave home for your appointment.

A sigmoidoscopy can feel uncomfortable but only takes a few minutes and most people go home straight after the examination.

More detailed tests

Most people with bowel cancer can be diagnosed by flexible sigmoidoscopy. However, some cancers can only be diagnosed by a more extensive examination of the colon. The two tests used for this are colonoscopy and computerised tomography (CT) colonography.

These tests are described in more detail below.

Colonoscopy

A colonoscopy is an examination of your entire large bowel using a device called a colonoscope, which is like a sigmoidoscope but a bit longer.

Your bowel needs to be empty when a colonoscopy is performed, so you will be advised to eat a special diet for a few days beforehand and take a laxative (medication to help empty your bowel) on the morning of the examination.

You will be given a sedative to help you relax during the test, after which the doctor will insert the colonoscope into your rectum and move it along the length of your large bowel. This is not usually painful, but can feel uncomfortable.

The camera relays images to a monitor, which allows the doctor to check for any abnormal areas within the rectum or bowel that could be the result of cancer. As with a sigmoidoscopy, a biopsy may also be performed during the test.

A colonoscopy usually takes about one hour to complete, and most people can go home once they have recovered from the effects of the sedative.

After the procedure, you will probably feel drowsy for a while so you will need to arrange for someone to accompany you home and it is best for elderly people to have someone with them for 24 hours after the test. You will be advised not to drive for 24 hours.

In a small number of people it may not be possible to pass the colonoscope completely around the bowel and it is then necessary to have CT colonography.

For more information about what a colonoscopy involves, watch this video: what happens during a colonoscopy?

CT colonography

CT colonography, also known as a ‘virtual colonoscopy’, involves using a computerised tomography (CT) scanner to produce three-dimensional images of the large bowel and rectum.

During the procedure, gas is used to inflate the bowel using a thin, flexible tube placed in your rectum. CT scans are then taken from a number of different angles.

As with a colonoscopy, you may need to have a special diet for a few days and take a laxative before the test to ensure your bowels are empty when the test is carried out.

This test can help identify potentially cancerous areas in people who are not suitable for a colonoscopy due to other medical reasons. A CT colonography is a less invasive test than a colonoscopy, but you may still need to have colonoscopy or flexible sigmoidoscopy at a later stage so any abnormal areas can be removed or biopsied.

Want to know more?

Further tests

If a diagnosis of bowel cancer is confirmed, further testing is usually carried out to check if the cancer has spread from the bowel to other parts of the body and to help decide on the most effective treatment for you.

These tests can include:

  • a CT scan of your abdomen and chest to check if the rest of your bowel is healthy and whether the cancer has spread to the liver or lungs.
  • magnetic resonance imaging (MRI) scan is also done for people with a cancer in the rectum to provide a detailed image of the surrounding organs

Staging and grading

Once the above examinations and tests have been completed, it should be possible to determine the stage and grade of your cancer. Staging refers to how far your cancer has advanced. Grading relates to how aggressive and likely to spread your cancer is.

This is important as it helps your treatment team choose the best way of curing or controlling the cancer.

A number of different staging systems are used by doctors. A simplified version of one of the common systems used is outlined below.

  • Stage 1 – the cancer is still contained within the lining of the bowel or rectum
  • Stage 2 – the cancer has spread beyond the layer of muscle surrounding the bowel and may have penetrated the surface covering the bowel or nearby organs
  • Stage 3 – the cancer has spread into nearby lymph nodes
  • Stage 4 – the cancer has spread beyond the bowel into another part of the body, such as the liver

There are three grades of bowel cancer:

  • Grade 1 is a cancer that grows slowly and has a low chance of spreading beyond the bowel
  • Grade 2 is a cancer that grows moderately and has a medium chance of spreading beyond the bowel
  • Grade 3 is a cancer that grows rapidly and has a high chance of spreading beyond the bowel

If you are not sure what stage or grade of cancer you have, ask your doctor.

Want to know more?

Published Date
2014-10-07 13:16:02Z
Last Review Date
2014-09-01 00:00:00Z
Next Review Date
2016-09-01 00:00:00Z
Classification
Barium enema,Blood tests,Bowel cancer,Cancer and tumours,Chest,Colonoscopy,CT scan,Large intestine,MRI scan,Scans, imaging and barium studies,Ultrasound scan,X-rays






NHS Choices Syndication


Bowel cancer

Introduction

Bowel cancer is a general term for cancer that begins in the large bowel. Depending on where the cancer starts, bowel cancer is sometimes called colon or rectal cancer.

Cancer can sometimes start in the small bowel (small intestine), but small bowel cancer is much rarer than large bowel cancer.

Bowel cancer is one of the most common types of cancer diagnosed in the UK, with around 40,000 new cases diagnosed every year.

About one in every 20 people in the UK will develop bowel cancer during their lifetime.

Signs and symptoms

The three main symptoms of bowel cancer are blood in the stools (faeces), changes in bowel habit (such as to more frequent, looser stools) and abdominal (tummy) pain. However, these symptoms are very common and most people with them do not have bowel cancer.

For example, blood in the stools is more often caused by haemorrhoids (piles), and a change in bowel habit or abdominal pain is usually due to something you have eaten.

As almost nine out of 10 people with bowel cancer are over 60 years old, these symptoms are more important as people get older. They are also more significant when they persist despite simple treatments.

Most people who are eventually diagnosed with bowel cancer have one of the following symptom combinations:

  • a persistent change in bowel habit causing them to go to the toilet more often and pass looser stools, usually together with blood on or in their stools
  • a persistent change in bowel habit without blood in their stools, but with abdominal pain
  • blood in the stools without other haemorrhoid symptoms such as soreness, discomfort, pain, itching or a lump hanging down outside the back passage
  • abdominal pain, discomfort or bloating always provoked by eating, sometimes resulting in a reduction in the amount of food eaten and weight loss

The symptoms of bowel cancer can be subtle and don’t necessarily make you feel ill.

Read more about the symptoms of bowel cancer.

When to seek medical advice

Try the bowel cancer symptom checker for advice on treatments you can try to see if your symptoms get better and when you should see your GP to discuss whether any tests are necessary.

Your doctor will probably carry out a simple examination of your tummy and bottom to make sure you have no lumps, and they may arrange a simple blood test to check for iron deficiency anaemia (as this can indicate whether there is any bleeding from your bowel that you haven’t been aware of).

In some cases, your doctor may decide it is best for you to have a simple test in hospital to make sure there is no serious cause for your symptoms.

Make sure you return to your doctor if your symptoms persist or keep coming back after stopping treatment, regardless of their severity or your age.

Read more about diagnosing bowel cancer.

Who’s at risk?

It’s not known exactly what causes bowel cancer, but there are a number of things that can increase your risk. These include:

  • age – almost nine in 10 cases of bowel cancer occur in people aged 60 or over
  • diet – a diet high in red or processed meats and low in fibre can increase your risk
  • weight – bowel cancer is more common in people who are overweight or obese
  • exercise – being inactive increases the risk of getting bowel cancer
  • alcohol and smoking – a high alcohol intake and smoking may increase your chances of getting bowel cancer
  • family history – having a close relative (mother or father, brother or sister) who developed bowel cancer below 50 years of age puts you at a greater lifetime risk of developing the condition

Some people are also at an increased risk of bowel cancer because they have another condition that affects their bowel, such as severe ulcerative colitis or Crohn’s disease over a long period of time.

Read more about the causes of bowel cancer and preventing bowel cancer.

Bowel cancer screening

Everyone between the ages of 60 and 69 in England is offered bowel cancer screening every two years, and the screening programme is currently being extended to those aged 70 to 74.

Screening is carried out by taking a small stool sample and testing it for the presence of blood that isn’t visible. This is known as the faecal occult blood test.

Screening plays an important part in the fight against bowel cancer because it can help detect bowel cancer before it causes obvious symptoms, which increases the chances of surviving the condition.

Read more about screening for bowel cancer.

Treatment and outlook

Bowel cancer can be treated using a combination of different treatments, depending on where the cancer is in your bowel and how far it has spread.

The main treatments are:

  • surgery to remove the cancerous section of bowel, this is the most effective way of curing bowel cancer and is all that many people need
  • chemotherapy – where medication is used to kill cancer cells 
  • radiotherapy – where radiation is used to kill cancer cells
  • biological treatments – a newer type of medication that increase the effectiveness of chemotherapy and prevent the cancer from spreading

As with most types of cancer, the chance of a complete cure depends on how far the cancer has advanced by the time it is diagnosed. If the cancer is confined to the bowel then surgery will usually be able to completely remove it.

Overall, between seven and eight in every 10 people with bowel cancer will live at least one year after diagnosis and more than half of those diagnosed will live at least another 10 years.

Every year, around 16,000 people die as a result of bowel cancer.

Read more about how bowel cancer is treated and living with bowel cancer.

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Published Date
2014-10-07 13:15:05Z
Last Review Date
2014-09-01 00:00:00Z
Next Review Date
2016-09-01 00:00:00Z
Classification
Blood in bowel motions,Bowel cancer,Bowel cancer screening,Cancer and tumours,Faeces,Gut,Large intestine,Rectum,Safe drinking,Small intestine,Weight loss






NHS Choices Syndication


Bowel cancer

Living with bowel cancer

Talk to others

Your GP or nurse may be able to reassure you if you have questions, or you may find it helpful to talk to a trained counsellor, psychologist or specialist telephone helpline operator. Your GP surgery will have information on these.

Some people find it helpful to talk to others with bowel cancer at a local support group or through an internet chat room.

Beating Bowel Cancer offers support services to people with bowel cancer. For example, they run a nurse advisory line on 08450 719 301 that is available from 9am to 5:30pm on Monday to Thursday, and from 9am to 4pm on Fridays. You can email a nurse at nurse@beatingbowelcancer.org.

The organisation also runs a national patient-to-patient network for people affected by bowel cancer – and their relatives – called Bowel Cancer Voices.

Want to know more?

Your emotions

Having cancer can cause a range of emotions. These may include shock, anxiety, relief, sadness and depression.

Different people deal with serious problems in different ways. It is hard to predict how knowing you have cancer will affect you. However, you and your loved ones may find it helpful to know about the feelings that people diagnosed with cancer have reported.

Want to know more?

Recovering from surgery

Surgeons and anaesthetists have found that using an enhanced recovery programme after bowel cancer surgery helps patients recover more quickly.

Most hospitals now use this programme. It involves giving you more information before the operation about what to expect, avoiding giving you strong laxatives to clean the bowel before surgery, and in some cases giving you a sugary drink two hours before the operation to give you energy. 

During and after the operation, the anaesthetist controls the amount of IV fluid you need very carefully, and after the operation you will be given painkillers that allow you to get up and out of bed by the next day.

Most people will be able to eat a light diet the day after their operation.

To reduce the risk of deep vein thrombosis (blood clots in the legs), you may be given special compression stockings that help prevent blood clots, or a regular injection with a blood thinning medication called heparin until you are fully mobile.

A nurse or physiotherapist will help you get out of bed and regain your strength so you can go home within a few days.

With the enhanced recovery programme, most people are well enough to go home within a week of their operation. The timing depends on when you and the doctors and nurses looking after you agree you are well enough to go home.

You will be asked to return to hospital a few weeks after your treatment has finished so tests can be carried out to check for any remaining signs of cancer. You may also need routine check-ups for the next few years to look out for signs of the cancer recurring.

Want to know more?

Diet after bowel surgery

If you have had part of your colon removed, it is likely that your stools (faeces) will be looser because one of the functions of the colon is to absorb water from the stools. This may mean that you need to go to the toilet more often to pass loose stools.

You should inform your care team if this becomes a problem, because medication is available to help control it.

You may find some foods upset your bowels, particularly during the first few months after your operation.

Different foods can upset different people, but food and drink that is commonly known to cause problems include fruit and vegetables that are high in fibre, such as beans, cabbages, apples and bananas, and fizzy drinks, such as cola and beer.

You may find it useful to keep a food diary to record the effects of different foods on your bowel.

If you find that you are having continual problems with your bowels as a result of your diet, and/or you are finding it difficult to maintain a healthy diet, you should contact your care team. You may need to be referred to a dietitian for further advice.

Want to know more?

Living with a stoma

If you need a temporary or permanent stoma with an external bag or pouch, you may feel worried about how you look and how others will react to you.

Information and advice about living with a stoma (including stoma care, stoma products and ‘stoma-friendly’ diets) is available on the ileostomy and colostomy topics.

For anyone wishing to obtain further information about living with a stoma, there are patient support groups who provide support for people who may have had, or are due to have, a stoma. You can obtain details through your stoma care nurse or visit them online for further information.

These include:

Want to know more?

Sex and bowel cancer

Having cancer and its treatment may affect how you feel about relationships and sex. Although most people are able to enjoy a normal sex life after bowel cancer treatment, if you have stoma you may feel self-conscious or uncomfortable.

Talking about how you feel with your partner may help you both to support each other. Or you may feel you’d like to talk to someone else about your feelings. Your doctor or nurse will be able to help.

Want to know more?

Financial concerns

A diagnosis of cancer can cause money problems because you are unable to work or someone you are close to has to stop working to look after you. There is financial support available for carers and for you if you have to stay off work for a while or have to stop work because of your sickness. 

Free prescriptions

People being treated for cancer are entitled to apply for an exemption certificate giving free prescriptions for all medication, including medication to treat unrelated conditions.

The certificate is valid for five years and you can apply for a certificate by speaking to your GP or cancer specialist.

Want to know more?

Dealing with dying

If you are told there is nothing more that can be done to treat your bowel cancer, your GP will still provide you with support and pain relief. This is called palliative care. Support is also available for your family and friends.

Want to know more?

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Published Date
2014-10-07 13:16:38Z
Last Review Date
2014-09-01 00:00:00Z
Next Review Date
2016-09-01 00:00:00Z
Classification
Beating Bowel Cancer,Bowel cancer,Bowel Cancer UK




Bowel cancer – Treatment – NHS Choices






























































Bowel cancer – Treatment 

Treating bowel cancer 

Surgery is usually the main treatment for bowel cancer, and may be combined with chemotherapy, radiotherapy or biological treatments, depending on your particular case.

The treatments recommended for you will depend on which part of your bowel is affected and how far the cancer has spread, but surgery is usually the main treatment.

If it’s detected early enough, treatment can cure bowel cancer and stop it coming back. Unfortunately, however, a complete cure is not always possible and there is sometimes a risk that the cancer could recur at a later stage.

In more advanced cases that cannot be removed completely by surgery, a cure is highly unlikely. However, symptoms can be controlled and the spread of the cancer can be slowed using a combination of surgery, chemotherapy, radiotherapy and biological treatments where appropriate.

Your treatment team

If you are diagnosed with bowel cancer, you will be cared for by a multidisciplinary team – including a specialist cancer surgeon, an oncologist (a radiotherapy and chemotherapy specialist), a radiologist and a specialist nurse.  

When deciding what treatment is best for you, your care team will consider the type and size of the cancer, your general health, whether the cancer has spread to other parts of your body and how aggressive the cancer is.

Want to know more?

Surgery for colon cancer hide

If colon cancer is at a very early stage, it may be possible to remove just a small piece of the lining of the colon wall. This is known as local excision.

If the cancer spreads into muscles surrounding the colon, it will usually be necessary to remove an entire section of your colon. Removing some of the colon is known as a colectomy.

There are two ways a colectomy can be performed:

  • an open colectomy – where the surgeon makes a large incision in your abdomen and removes a section of your colon
  • a laparoscopic (‘keyhole’) colectomy – where the surgeon makes a number of small incisions in your abdomen and uses special instruments guided by a camera to remove a section of colon

During surgery, nearby lymph nodes are also removed. It is usual to join the ends of the bowel together after bowel cancer surgery, but very occasionally this is not possible and a stoma (see below) is needed.

Both open and laparoscopic colectomies are thought to be equally effective in removing cancer and have similar risks of complications. Laparoscopic colectomies, however, have the advantage of a faster recovery time and less post-operative pain and this is becoming the routine way of doing most of these operations.

Laparoscopic colectomies should be available in all hospitals carrying out bowel cancer surgery, although not all surgeons perform this type of surgery. Discuss your options with your surgeon to see if the laparoscopic method can be done.

Want to know more?

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Surgery for rectal cancer show

There are a number of different types of operation that can be carried out to treat rectal cancer, depending on how far the cancer has spread.

Some of the main techniques used are described below.

Local resection

If you have a very small, early stage rectal cancer, your surgeon may be able to remove it in an operation called a local resection (trans anal resection).

The surgeon puts an endoscope (a flexible tube with a light) in through your back passage and removes the cancer from the wall of the rectum.

Total mesenteric excision

In many cases, however, a local resection is not possible. Instead, a larger area of the rectum will need to be removed, along with a border of rectal tissue around it that is free of cancer cells and fatty tissue from around the bowel (known as the mesentery). This type of operation is known as total mesenteric excision (TME).

Removing the mesentery can help ensure all the cancerous cells are removed, which can lower the risk of the cancer recurring at a later stage.

Depending on exactly where in your rectum the cancer is located, one of two main TME operations may be carried out. These are outlined below.

Low anterior resection

Low anterior resection is a procedure used to treat cases where the cancer is in the upper section of your rectum.

The surgeon will make an incision in your abdomen and remove the upper section of your rectum, as well as some surrounding tissue to make sure any lymph glands containing cancer cells are also removed.

They will then attach your colon to the lowest part of your rectum or upper part of the anal canal. Sometimes, they turn the end of the colon into an internal pouch to replace the rectum. You will probably require a temporary stoma (see below) to give the joined section of bowel time to heal.

Abdominoperineal resection

Abdominoperineal resection is used to treat cases where the cancer is in the lowest section of your rectum. In this case, it will be necessary to remove the whole of your rectum and surrounding muscles to reduce the risk of the cancer re-growing in the same area.

This involves removing and closing the anus and removing its sphincter muscles too, so there is no option except to have a permanent stoma after the operation. Bowel cancer surgeons always do their best to avoid giving people permanent stomas wherever possible.

Want to know more?

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Stoma surgery show

Where a section of the bowel is removed and the remaining bowel joined, the surgeon may sometimes decide to divert your stool away from the join to allow it to heal. The stool is temporarily diverted by bringing a loop of bowel out through the abdominal wall and attaching to the skin – this is called a stoma. A bag is worn over the stoma to collect the stool.

Where the stoma is made from small bowel (ileum) it is called an ileostomy and where it is made from large bowel (colon) it is called a colostomy

A specialist nurse, known as a stoma care nurse, is usually available to advise you, prior to surgery, on the best site for a stoma. The nurse will take into account factors such as your body shape and lifestyle, although this may not be possible where surgery is performed in an emergency. During the first few days post surgery the stoma care nurse will advise on the care necessary to look after the stoma and the type of bag suitable.

Once the join in the bowel has safely healed, which can take several weeks, the stoma can be closed during further surgery. In some people, for various reasons, re-joining the bowel may not be possible or may lead to problems controlling bowel function and therefore the stoma may become permanent.

Before having surgery, the care team will advise whether it may be necessary to form an ileostomy or colostomy and the likelihood of this being temporary or permanent.

For anyone wishing to obtain further information about living with a stoma, there are patient support groups which provide support for patients who may have just had or are due to have, a stoma. You can obtain details through your stoma care nurse or visit them online for further information.

These include:

Want to know more?

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Side effects of surgery show

Bowel cancer operations carry many of the same risks as other major operations, including the risks of bleeding, infection, developing blood clots or heart or breathing problems. 

The operations all carry a number of risks specific to the procedure.

One risk is that the joined up section of bowel may not heal properly and may leak inside your abdomen. This is usually only a risk in the first few days after the operation.

Another risk is for people having rectal cancer surgery. The nerves controlling passing urine and sexual function are very close to the rectum, and sometimes an operation to remove a rectal cancer can damage these nerves.

After rectal cancer surgery most people need to go to the toilet to open their bowels more often than before, although it usually settles down within a few months of the operation.

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Radiotherapy show

There are two main ways that radiotherapy can be used to treat bowel cancer. It can be given before surgery to shrink rectal cancers and increase the chances of complete removal, or used to control symptoms and slow the spread of cancer in advanced cases (called palliative radiotherapy).

Radiotherapy given before surgery for rectal cancer can be performed in two ways:

  • external radiotherapywhere a machine is used to beam high-energy waves at your rectum to kill cancerous cells
  • internal radiotherapy (also known as brachytherapy) – where a radioactive tube is inserted into your anus and placed next to the cancer to shrink it

External radiotherapy is usually given daily, five days a week, with a break at the weekend. Depending on the size of your tumour, you may need one to five weeks of treatment. Each session of radiotherapy is short and will only last for 10-15 minutes.

Internal radiotherapy can usually be performed in one session before surgery is carried out a few weeks later.

Palliative radiotherapy is usually given in short, daily sessions, with a course ranging from two to three days to 10 days.

Short-term side effects of radiotherapy can include:

  • feeling sick
  • fatigue
  • diarrhoea
  • burning and irritation of the skin around the rectum and pelvis (this looks and feels like sunburn)
  • a frequent need to urinate
  • a burning sensation when passing urine

These side effects should pass once the course of radiotherapy has finished. Tell your care team if the side effects of treatment become particularly troublesome. Additional treatments are often available to help you cope better with the side effects.

Long-term side effects of radiotherapy can include:

If you want to have children, it may be possible to store a sample of your sperm or eggs before treatment begins so they can be used in fertility treatments in the future.

Want to know more?

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Chemotherapy show

There are three ways chemotherapy can be used to treat bowel cancer. It can be given before surgery for rectal cancer in combination with radiotherapy to shrink a tumour, after surgery to reduce the risk of the cancer recurring, or to slow the spread of advanced bowel cancer and help control symptoms (palliative chemotherapy).

Chemotherapy for bowel cancer usually involves taking a combination of medications that kill cancer cells. They can be given as a tablet (oral chemotherapy), through a drip in your arm (intravenous chemotherapy), or as a combination of both. Treatment is given in courses (cycles) each two to three weeks long, depending on the stage or grade of your cancer.

A single session of intravenous chemotherapy can last from several hours to several days.

Most people having oral chemotherapy take tablets over the course of two weeks before having a break from treatment for another week.

A course of chemotherapy can last up to six months depending on how well you respond to the treatment. In some cases it can be given in smaller doses over longer periods of time (maintenance chemotherapy).

Side effects of chemotherapy can include:

  • fatigue
  • feeling sick
  • vomiting
  • diarrhoea
  • mouth ulcers
  • hair loss with certain treatment regimens, but this is generally uncommon in the treatment of bowel cancer       
  • a sensation of numbness, tingling or burning in your hands, feet and neck

These side effects should gradually pass once your treatment has finished.

It usually takes a few months for your hair to grow back if you experience hair loss.

Chemotherapy can also weaken your immune system, making you more vulnerable to infection. Inform your care team or GP as soon as possible if you experience possible signs of an infection, including a high temperature (fever) or a sudden feeling of being generally unwell.

Medications used in chemotherapy can cause temporary damage to men’s sperm and women’s eggs. This means that for women who become pregnant or for men who father a child, there is a risk to the unborn baby’s health. Therefore, it is recommended you use a reliable method of contraception while having chemotherapy treatment and for a period after your treatment has finished.

Want to know more?

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Biological treatments  show

Biological treatments, including cetuximab, bevacizumab and panitumumab, are a newer type of medication also known as monoclonal antibodies.

Monoclonal antibodies are antibodies that have been genetically engineered in a laboratory. They target special proteins found on the surface of cancer cells, known as epidermal growth factor receptors (EGFR). As EGFRs help the cancer to grow, targeting these proteins can help shrink tumours and improve the effect and outcome of chemotherapy.

Biological treatments are therefore usually used in combination with chemotherapy when the cancer has spread beyond the bowel (metastatic bowel cancer).

These treatments are not available to everyone with bowel cancer. The National Institute for Health and Care Excellence (NICE) has determined specific criteria which need to be met before they can be prescribed.

Cetuximab is only available on the NHS when:

  • surgery to remove the cancer in the colon or rectum has been carried out or is possible
  • bowel cancer has spread to the liver and cannot be removed surgically
  • a person is fit enough to undergo surgery to remove the cancer from the liver if this becomes possible after treatment with cetuximab

Cetuximab, bevacizumab and panitumumab are available on the NHS through a government scheme called Cancer Drugs Fund. All these medications are also available privately but are very expensive.

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Page last reviewed: 02/09/2014

Next review due: 02/09/2016

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The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

tollers said on 02 September 2013

On the 21st of august I was admitted to sheffields northern general teaching hospital for surgery on my colon for cancer , an extended right hemicolectomy,e I was put on the enhanced recovery procedure and I really thought I would be in hospital recovering for up to a week . The operation took three and half hours and I was back on a ward at five thirty pm , everyone I came into contact with including the surgeon who I saw three times over the next two days were wonderful ,so positive and confident it made me feel the same , two days later I was leaving hospital and it is now eleven days and I feel well on the way to full recovery , I am 58 years old so no spring chicken , and cant thank everyone involved enough

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Bowel cancer


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Find out who’s most at risk of bowel cancer, the questions to ask if you’re diagnosed and the treatment options available.

Media last reviewed: 21/02/2013

Next review due: 21/02/2015

Coping with a cancer diagnosis

Find out how to deal with a cancer diagnosis and where to find support, and watch a video about one man’s experience of cancer

Chemotherapy

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Bowel cancer – Treatment – NHS Choices






























































Bowel cancer – Treatment 

Treating bowel cancer 

Surgery is usually the main treatment for bowel cancer, and may be combined with chemotherapy, radiotherapy or biological treatments, depending on your particular case.

The treatments recommended for you will depend on which part of your bowel is affected and how far the cancer has spread, but surgery is usually the main treatment.

If it’s detected early enough, treatment can cure bowel cancer and stop it coming back. Unfortunately, however, a complete cure is not always possible and there is sometimes a risk that the cancer could recur at a later stage.

In more advanced cases that cannot be removed completely by surgery, a cure is highly unlikely. However, symptoms can be controlled and the spread of the cancer can be slowed using a combination of surgery, chemotherapy, radiotherapy and biological treatments where appropriate.

Your treatment team

If you are diagnosed with bowel cancer, you will be cared for by a multidisciplinary team – including a specialist cancer surgeon, an oncologist (a radiotherapy and chemotherapy specialist), a radiologist and a specialist nurse.  

When deciding what treatment is best for you, your care team will consider the type and size of the cancer, your general health, whether the cancer has spread to other parts of your body and how aggressive the cancer is.

Want to know more?

Surgery for colon cancer hide

If colon cancer is at a very early stage, it may be possible to remove just a small piece of the lining of the colon wall. This is known as local excision.

If the cancer spreads into muscles surrounding the colon, it will usually be necessary to remove an entire section of your colon. Removing some of the colon is known as a colectomy.

There are two ways a colectomy can be performed:

  • an open colectomy – where the surgeon makes a large incision in your abdomen and removes a section of your colon
  • a laparoscopic (‘keyhole’) colectomy – where the surgeon makes a number of small incisions in your abdomen and uses special instruments guided by a camera to remove a section of colon

During surgery, nearby lymph nodes are also removed. It is usual to join the ends of the bowel together after bowel cancer surgery, but very occasionally this is not possible and a stoma (see below) is needed.

Both open and laparoscopic colectomies are thought to be equally effective in removing cancer and have similar risks of complications. Laparoscopic colectomies, however, have the advantage of a faster recovery time and less post-operative pain and this is becoming the routine way of doing most of these operations.

Laparoscopic colectomies should be available in all hospitals carrying out bowel cancer surgery, although not all surgeons perform this type of surgery. Discuss your options with your surgeon to see if the laparoscopic method can be done.

Want to know more?

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Surgery for rectal cancer show

There are a number of different types of operation that can be carried out to treat rectal cancer, depending on how far the cancer has spread.

Some of the main techniques used are described below.

Local resection

If you have a very small, early stage rectal cancer, your surgeon may be able to remove it in an operation called a local resection (trans anal resection).

The surgeon puts an endoscope (a flexible tube with a light) in through your back passage and removes the cancer from the wall of the rectum.

Total mesenteric excision

In many cases, however, a local resection is not possible. Instead, a larger area of the rectum will need to be removed, along with a border of rectal tissue around it that is free of cancer cells and fatty tissue from around the bowel (known as the mesentery). This type of operation is known as total mesenteric excision (TME).

Removing the mesentery can help ensure all the cancerous cells are removed, which can lower the risk of the cancer recurring at a later stage.

Depending on exactly where in your rectum the cancer is located, one of two main TME operations may be carried out. These are outlined below.

Low anterior resection

Low anterior resection is a procedure used to treat cases where the cancer is in the upper section of your rectum.

The surgeon will make an incision in your abdomen and remove the upper section of your rectum, as well as some surrounding tissue to make sure any lymph glands containing cancer cells are also removed.

They will then attach your colon to the lowest part of your rectum or upper part of the anal canal. Sometimes, they turn the end of the colon into an internal pouch to replace the rectum. You will probably require a temporary stoma (see below) to give the joined section of bowel time to heal.

Abdominoperineal resection

Abdominoperineal resection is used to treat cases where the cancer is in the lowest section of your rectum. In this case, it will be necessary to remove the whole of your rectum and surrounding muscles to reduce the risk of the cancer re-growing in the same area.

This involves removing and closing the anus and removing its sphincter muscles too, so there is no option except to have a permanent stoma after the operation. Bowel cancer surgeons always do their best to avoid giving people permanent stomas wherever possible.

Want to know more?

back to top

Stoma surgery show

Where a section of the bowel is removed and the remaining bowel joined, the surgeon may sometimes decide to divert your stool away from the join to allow it to heal. The stool is temporarily diverted by bringing a loop of bowel out through the abdominal wall and attaching to the skin – this is called a stoma. A bag is worn over the stoma to collect the stool.

Where the stoma is made from small bowel (ileum) it is called an ileostomy and where it is made from large bowel (colon) it is called a colostomy

A specialist nurse, known as a stoma care nurse, is usually available to advise you, prior to surgery, on the best site for a stoma. The nurse will take into account factors such as your body shape and lifestyle, although this may not be possible where surgery is performed in an emergency. During the first few days post surgery the stoma care nurse will advise on the care necessary to look after the stoma and the type of bag suitable.

Once the join in the bowel has safely healed, which can take several weeks, the stoma can be closed during further surgery. In some people, for various reasons, re-joining the bowel may not be possible or may lead to problems controlling bowel function and therefore the stoma may become permanent.

Before having surgery, the care team will advise whether it may be necessary to form an ileostomy or colostomy and the likelihood of this being temporary or permanent.

For anyone wishing to obtain further information about living with a stoma, there are patient support groups which provide support for patients who may have just had or are due to have, a stoma. You can obtain details through your stoma care nurse or visit them online for further information.

These include:

Want to know more?

back to top

Side effects of surgery show

Bowel cancer operations carry many of the same risks as other major operations, including the risks of bleeding, infection, developing blood clots or heart or breathing problems. 

The operations all carry a number of risks specific to the procedure.

One risk is that the joined up section of bowel may not heal properly and may leak inside your abdomen. This is usually only a risk in the first few days after the operation.

Another risk is for people having rectal cancer surgery. The nerves controlling passing urine and sexual function are very close to the rectum, and sometimes an operation to remove a rectal cancer can damage these nerves.

After rectal cancer surgery most people need to go to the toilet to open their bowels more often than before, although it usually settles down within a few months of the operation.

back to top

Radiotherapy show

There are two main ways that radiotherapy can be used to treat bowel cancer. It can be given before surgery to shrink rectal cancers and increase the chances of complete removal, or used to control symptoms and slow the spread of cancer in advanced cases (called palliative radiotherapy).

Radiotherapy given before surgery for rectal cancer can be performed in two ways:

  • external radiotherapywhere a machine is used to beam high-energy waves at your rectum to kill cancerous cells
  • internal radiotherapy (also known as brachytherapy) – where a radioactive tube is inserted into your anus and placed next to the cancer to shrink it

External radiotherapy is usually given daily, five days a week, with a break at the weekend. Depending on the size of your tumour, you may need one to five weeks of treatment. Each session of radiotherapy is short and will only last for 10-15 minutes.

Internal radiotherapy can usually be performed in one session before surgery is carried out a few weeks later.

Palliative radiotherapy is usually given in short, daily sessions, with a course ranging from two to three days to 10 days.

Short-term side effects of radiotherapy can include:

  • feeling sick
  • fatigue
  • diarrhoea
  • burning and irritation of the skin around the rectum and pelvis (this looks and feels like sunburn)
  • a frequent need to urinate
  • a burning sensation when passing urine

These side effects should pass once the course of radiotherapy has finished. Tell your care team if the side effects of treatment become particularly troublesome. Additional treatments are often available to help you cope better with the side effects.

Long-term side effects of radiotherapy can include:

If you want to have children, it may be possible to store a sample of your sperm or eggs before treatment begins so they can be used in fertility treatments in the future.

Want to know more?

back to top

Chemotherapy show

There are three ways chemotherapy can be used to treat bowel cancer. It can be given before surgery for rectal cancer in combination with radiotherapy to shrink a tumour, after surgery to reduce the risk of the cancer recurring, or to slow the spread of advanced bowel cancer and help control symptoms (palliative chemotherapy).

Chemotherapy for bowel cancer usually involves taking a combination of medications that kill cancer cells. They can be given as a tablet (oral chemotherapy), through a drip in your arm (intravenous chemotherapy), or as a combination of both. Treatment is given in courses (cycles) each two to three weeks long, depending on the stage or grade of your cancer.

A single session of intravenous chemotherapy can last from several hours to several days.

Most people having oral chemotherapy take tablets over the course of two weeks before having a break from treatment for another week.

A course of chemotherapy can last up to six months depending on how well you respond to the treatment. In some cases it can be given in smaller doses over longer periods of time (maintenance chemotherapy).

Side effects of chemotherapy can include:

  • fatigue
  • feeling sick
  • vomiting
  • diarrhoea
  • mouth ulcers
  • hair loss with certain treatment regimens, but this is generally uncommon in the treatment of bowel cancer       
  • a sensation of numbness, tingling or burning in your hands, feet and neck

These side effects should gradually pass once your treatment has finished.

It usually takes a few months for your hair to grow back if you experience hair loss.

Chemotherapy can also weaken your immune system, making you more vulnerable to infection. Inform your care team or GP as soon as possible if you experience possible signs of an infection, including a high temperature (fever) or a sudden feeling of being generally unwell.

Medications used in chemotherapy can cause temporary damage to men’s sperm and women’s eggs. This means that for women who become pregnant or for men who father a child, there is a risk to the unborn baby’s health. Therefore, it is recommended you use a reliable method of contraception while having chemotherapy treatment and for a period after your treatment has finished.

Want to know more?

back to top

Biological treatments  show

Biological treatments, including cetuximab, bevacizumab and panitumumab, are a newer type of medication also known as monoclonal antibodies.

Monoclonal antibodies are antibodies that have been genetically engineered in a laboratory. They target special proteins found on the surface of cancer cells, known as epidermal growth factor receptors (EGFR). As EGFRs help the cancer to grow, targeting these proteins can help shrink tumours and improve the effect and outcome of chemotherapy.

Biological treatments are therefore usually used in combination with chemotherapy when the cancer has spread beyond the bowel (metastatic bowel cancer).

These treatments are not available to everyone with bowel cancer. The National Institute for Health and Care Excellence (NICE) has determined specific criteria which need to be met before they can be prescribed.

Cetuximab is only available on the NHS when:

  • surgery to remove the cancer in the colon or rectum has been carried out or is possible
  • bowel cancer has spread to the liver and cannot be removed surgically
  • a person is fit enough to undergo surgery to remove the cancer from the liver if this becomes possible after treatment with cetuximab

Cetuximab, bevacizumab and panitumumab are available on the NHS through a government scheme called Cancer Drugs Fund. All these medications are also available privately but are very expensive.

Want to know more?

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Page last reviewed: 02/09/2014

Next review due: 02/09/2016

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How helpful is this page?



Average rating

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ratings

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Comments

The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

tollers said on 02 September 2013

On the 21st of august I was admitted to sheffields northern general teaching hospital for surgery on my colon for cancer , an extended right hemicolectomy,e I was put on the enhanced recovery procedure and I really thought I would be in hospital recovering for up to a week . The operation took three and half hours and I was back on a ward at five thirty pm , everyone I came into contact with including the surgeon who I saw three times over the next two days were wonderful ,so positive and confident it made me feel the same , two days later I was leaving hospital and it is now eleven days and I feel well on the way to full recovery , I am 58 years old so no spring chicken , and cant thank everyone involved enough

Report this content as offensive or unsuitable

Bowel cancer


Viewing video content in NHS Choices

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Find out who’s most at risk of bowel cancer, the questions to ask if you’re diagnosed and the treatment options available.

Media last reviewed: 21/02/2013

Next review due: 21/02/2015

Coping with a cancer diagnosis

Find out how to deal with a cancer diagnosis and where to find support, and watch a video about one man’s experience of cancer

Chemotherapy

Chemotherapy is a treatment for cancer where medication is used to kill cancerous cells. Find out more about its effects











NHS Choices Syndication


Bowel cancer

Preventing bowel cancer

There are some things that increase your risk of bowel cancer that you can’t change, such as your family history or your age.

However, there are several ways you can lower your chances of developing the condition.

Diet

Research suggests that making changes to your diet can help reduce your risk of bowel cancer.

It may help to prevent bowel cancer if you eat:

  • less cured and processed meat such as bacon, sausages and ham
  • less red meat (see below) and more fish
  • more fibre from cereals, beans, fruit and vegetables

The Department of Health advises people who eat more than 90 grams (cooked weight) of red and processed meat a day to cut down to 70 grams to help reduce their bowel cancer risk. 

Read more about red meat and bowel cancer risk and eating good food and a healthy diet.

Exercise

There is strong evidence to suggest regular exercise can lower the risk of developing bowel and other cancers.

It is recommended adults exercise for at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity (such as cycling or fast walking) every week.

Read more about health and fitness.

Healthy weight

Being overweight or obese increases your chances of developing bowel cancer, so you should try to maintain a healthy weight if you want to lower your risk

You can find out if you are a healthy weight by using the healthy weight calculator.

Changes to your diet and an increase in physical activities will help keep your weight under control.

Read more about losing weight.

Stop Smoking

If you smoke, stopping can reduce your risk of developing bowel and other cancers.

The free NHS Smoking Helpline can offer advice and encouragement to help you quit smoking. Call 0300 123 1044 or visit the NHS Smokefree website.

Your GP or pharmacist can also provide help, support and advice if you want to give up smoking.

Read more about stopping smoking.

Cut down on alcohol

Drinking alcohol has been linked to an increased risk of developing bowel cancer, so you may be able to reduce your risk by cutting down on the amount of alcohol you drink.

The current recommendations concerning alcohol are:

  • men should not regularly drink more than 3-4 units of alcohol a day
  • women should not regularly drink more than 2-3 units a day
  • if you’ve had a heavy drinking session, avoid alcohol for 48 hours

Read more about alcohol units and tips on cutting down.

Bowel cancer screening

Although screening cannot stop you getting bowel cancer, it can allow the condition to be detected at an earlier stage, when it is much easier to treat.

As well as making lifestyle changes to reduce your risk of bowel cancer and keeping an eye out for possible symptoms of bowel cancer, participating in bowel cancer screening when it is offered can help reduce your chances of dying from bowel cancer.

In England, NHS bowel cancer screening is currently offered to everyone aged 60 to 74 who is registered with a GP.

Read more about bowel cancer screening.

Published Date
2014-10-07 13:17:04Z
Last Review Date
2014-09-01 00:00:00Z
Next Review Date
2016-09-01 00:00:00Z
Classification
Bowel cancer,Getting active,Stopping smoking,Weight management




Bowel cancer – NHS Choices


































































Bowel cancer 

Introduction 

Bowel cancer


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Find out who’s most at risk of bowel cancer, the questions to ask if you’re diagnosed and the treatment options available.

Media last reviewed: 21/02/2013

Next review due: 21/02/2015

NHS cancer screening

There are some types of cancers you can get free routine screening for

Bowel cancer is a general term for cancer that begins in the large bowel. Depending on where the cancer starts, bowel cancer is sometimes called colon or rectal cancer.

Cancer can sometimes start in the small bowel (small intestine), but small bowel cancer is much rarer than large bowel cancer.

Bowel cancer is one of the most common types of cancer diagnosed in the UK, with around 40,000 new cases diagnosed every year.

About one in every 20 people in the UK will develop bowel cancer during their lifetime.

Signs and symptoms

The three main symptoms of bowel cancer are blood in the stools (faeces), changes in bowel habit (such as to more frequent, looser stools) and abdominal (tummy) pain. However, these symptoms are very common and most people with them do not have bowel cancer.

For example, blood in the stools is more often caused by haemorrhoids (piles), and a change in bowel habit or abdominal pain is usually due to something you have eaten.

As almost nine out of 10 people with bowel cancer are over 60 years old, these symptoms are more important as people get older. They are also more significant when they persist despite simple treatments.

Most people who are eventually diagnosed with bowel cancer have one of the following symptom combinations:

  • a persistent change in bowel habit causing them to go to the toilet more often and pass looser stools, usually together with blood on or in their stools
  • a persistent change in bowel habit without blood in their stools, but with abdominal pain
  • blood in the stools without other haemorrhoid symptoms such as soreness, discomfort, pain, itching or a lump hanging down outside the back passage
  • abdominal pain, discomfort or bloating always provoked by eating, sometimes resulting in a reduction in the amount of food eaten and weight loss

The symptoms of bowel cancer can be subtle and don’t necessarily make you feel ill.

Read more about the symptoms of bowel cancer.

When to seek medical advice

Try the bowel cancer symptom checker for advice on treatments you can try to see if your symptoms get better and when you should see your GP to discuss whether any tests are necessary.

Your doctor will probably carry out a simple examination of your tummy and bottom to make sure you have no lumps, and they may arrange a simple blood test to check for iron deficiency anaemia (as this can indicate whether there is any bleeding from your bowel that you haven’t been aware of).

In some cases, your doctor may decide it is best for you to have a simple test in hospital to make sure there is no serious cause for your symptoms.

Make sure you return to your doctor if your symptoms persist or keep coming back after stopping treatment, regardless of their severity or your age.

Read more about diagnosing bowel cancer.

Who’s at risk?

It’s not known exactly what causes bowel cancer, but there are a number of things that can increase your risk. These include:

  • age – almost nine in 10 cases of bowel cancer occur in people aged 60 or over
  • diet – a diet high in red or processed meats and low in fibre can increase your risk
  • weight – bowel cancer is more common in people who are overweight or obese
  • exercise – being inactive increases the risk of getting bowel cancer
  • alcohol and smoking – a high alcohol intake and smoking may increase your chances of getting bowel cancer
  • family history – having a close relative (mother or father, brother or sister) who developed bowel cancer below 50 years of age puts you at a greater lifetime risk of developing the condition

Some people are also at an increased risk of bowel cancer because they have another condition that affects their bowel, such as severe ulcerative colitis or Crohn’s disease over a long period of time.

Read more about the causes of bowel cancer and preventing bowel cancer.

Bowel cancer screening

Everyone between the ages of 60 and 69 in England is offered bowel cancer screening every two years, and the screening programme is currently being extended to those aged 70 to 74.

Screening is carried out by taking a small stool sample and testing it for the presence of blood that isn’t visible. This is known as the faecal occult blood test.

Screening plays an important part in the fight against bowel cancer because it can help detect bowel cancer before it causes obvious symptoms, which increases the chances of surviving the condition.

Read more about screening for bowel cancer.

Treatment and outlook

Bowel cancer can be treated using a combination of different treatments, depending on where the cancer is in your bowel and how far it has spread.

The main treatments are:

  • surgery to remove the cancerous section of bowel, this is the most effective way of curing bowel cancer and is all that many people need
  • chemotherapy – where medication is used to kill cancer cells 
  • radiotherapy – where radiation is used to kill cancer cells
  • biological treatments – a newer type of medication that increase the effectiveness of chemotherapy and prevent the cancer from spreading

As with most types of cancer, the chance of a complete cure depends on how far the cancer has advanced by the time it is diagnosed. If the cancer is confined to the bowel then surgery will usually be able to completely remove it.

Overall, between seven and eight in every 10 people with bowel cancer will live at least one year after diagnosis and more than half of those diagnosed will live at least another 10 years.

Every year, around 16,000 people die as a result of bowel cancer.

Read more about how bowel cancer is treated and living with bowel cancer.

Page last reviewed: 02/09/2014

Next review due: 02/09/2016

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The 20 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Makemjohn said on 26 June 2014

PS forgot to say does anyone from the NHS read these comments or is it just a sham page for disgruntled people, as nobody from the NHS has responded to my first comments but again they have the tick in the right boxes

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Makemjohn said on 26 June 2014

Further to my post 18th June saw my own doctor who treat the need for an urgent appoinment with the seriousness it deserved and has arranged a Colonscopy before my appointment with the screening practitioner. Told the bowel screening programme to cancel my appointment have recieved letter from them thanking me for cancelling and saying I have now been taken out of the screening programme. Might as well talk to a brick wall for all the sense you get from this screening team in Rugby, usual dogs bodys with idiot boards for the answers, divert from that and they are lost. Try talking to the programme Hub Director is like looking for hens teeth immpossable, still as I said before the ticks are in the right boxes who cares about the patient

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Makemjohn said on 18 June 2014

Tested Positive on first and second screening was offered an appointment to see a screening practitioner at 9.00am at a hospital over one and a half hour car journey away (thats if you have a car) immpossible for me to attend,rang and was given an alternative appointment at my local hospital on 2nd July (2 weeks wait) having suffered from prostrate cancer and a rare cancer called Mucdepidermoid carinoma within Hyperplasia oncocytic (salivery gland cancer) I am naturally worried sick with this two week wait just to see someone, god knows how long I will then have to wait for a colonoscopy. Still the NHS has got the right ticks in the right boxes, What about the Paitent, who!!! oh them who cares as long as the ticks are in the right boxes.

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Piano legs said on 15 June 2014

Recently had a colonoscopy due to me having more bowel movements than normal. I was a once a week girl! However, a few months back I started going more often, good I thought as I usually felt bloated . However, I was starting to have permanent cramps which peaked and ebbed. My GP referred me and the day came 4 days ago! I was informed there and then that there was a tumour in my sigmoid colon. Was taking up 2 thirds of the circumference, this is what has been causing my constipation! They believe it’s took 5 to 10yrs to get to this and are convinced its malignant. Awaiting pathology results and to have a ct scan to see if it’s contained within the bowel. Also to see a colorectal surgeon to have this removed. 41 yrs old. Heathy diet, not overweight . I’m shocked at the diagnosis, but I’m changing nothing! I feel great and the only difference form today and last week is a word…..cancer! I’m doing race for life today also. Not sure what the prognosis will be but I will face it head on and deal with whatever faces me.

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jen35 said on 18 October 2013

I had a colonoscopy on mon and they removed a 3cm polyp. The doctor said he was concerned about one side of the polyp and has sent it for biopsy. He has also arranged for a ct scan on tue which he said on the report was due to variable.crypt pattern? I have no idea what this means. Im scared to death i have cancer. Im a 35 year old female x

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Ashley1919 said on 07 June 2013

I am 21 years old and am having a colonoscopy on Wednesday. I have had problems with me bowels all my life and only have bowel movements every 3 weeks sometimes longer. My stomach is very swollen and hard it feels tight all the time. I get extreme pain in my stomach that comes like contractions. Doctors suspected I had ovarian cancer but scans showed I haven’t. I’m very worried and would like to know what the symptoms were like for others? Please help I know my own body and I know something’s wrong…

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Vaileria said on 12 December 2012

I was having difficulty in passing complete colon.I felt pain in the middle of stomach.I had several different assessments but only the colonoscopy test recognized my tumor. My age made physicians look for other factors than colon cancer, but as long as you got utilizing, a process of test eliminations will find it.
http://coloncaretips.wordpress.com/2012/10/22/colonoscopy-process/

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martin111 said on 05 December 2012

The people have spoken: http://www.hscreformseries.co.uk/primary-care/14066-britons-want-bowel-cancer-screening-recommendation

Being told to you need a bowel cancer screening means less embarrassment and more pressure to have it done. If it saves lives, which it will, perhaps there should be screening for many types of cancer in the same appointment?

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johnnya said on 19 January 2012

I had a Colonoscopy in Sept 2011 4 days after my son got married and a 6cm long polyp was found. Biopsies were taken but I was told there and then that I had Cancer. The results from biopsies came back benign.
I had a second colonoscopy in Sept when I was told that it still looked suspicious and could be cancer in its early stages. Then I had an operation to remove the polyp in October. After 4 weeks of waiting the results were benign!!
What a terrible couple of months me, my wife and family went through all because “someone jumped the gun” with my diagnosis.

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muppetmagic said on 24 July 2011

well guys! its now a year since i got my diagnosis of terminal im still on chemo but im still here! i was given some great words of comfort from my friends about this horrible disease and it was that although it is a parasitic disease you should live with it rather than let it take over your life! good luck.

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Marinamagic said on 20 July 2011

Went for the results of my colonoscopy today(,as it was 6 weeks ago I felt very up beat as I was sure that if they had found anything my appointment would have been much sooner.) Good news I do not have bowel cancer,but where do we go from here as the symptoms are still the same??So we talk about medication ,which the consultant was not very happy about ,and on to diet.So it was suggested that after a chat with my doctor,that I consider leaving out,for a 2 week period ,each,various foods.i.e.carbs,if no change then protein etc etc. So intend to give all this a try and will come back with any positive ideas at a later date.I hope this helps anyone looking for the same answers as me and wish all good luck for the future.

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Marinamagic said on 07 June 2011

I had the colonoscopy yesterday with some sedation,so I was aware and looking at the screen but felt nothing.Looking back I’m not sure I was awake all the time.
The worse part was the day before when you have to drink 4 litres of a preparation (to totally clear the bowels. )at set times.8am/10am/6pm/8pm.Nothing happened ’til 9.30am .I did as suggested put some fruit squash in the liquid but NOT blackcurrant.I suppose it is a good way to detox.!!
4 specimens were taken for biopsy and a wait of 2/3/weeks for results.I was told that it looked pretty good,so I’m thinking positive.

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Marinamagic said on 07 May 2011

I had a sigmoidoscopy yesterday,not painful,and am to be referred for a colonoscopy.Consultant said he did not think it was cancer but there were significant changes to warrant further investigation.
I am an optimist so am concerned but not too worried.Symptoms are the same,still have constant discomfort in my stomach and abdomen,but not what I would call pain.I do not eat large meals and don’t snack……have not lost any weight!!

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Marinamagic said on 13 March 2011

I have had stomach pains and constant discomfort in my bowels since July 2010,after having a seafood meal.4 days of chronic pain,no food just sips of water and no bowel movement.Took senacot,which worked.Since then I have had bowels open 3–4 times a day.I eat a high fibre diet,don’t drink or smoke,am fairly active and fit otherwise.I did the NHS bowel cancer check(which incidentaly was very easy to do at home once I had the "bits" set up)The reply came back within 14 days as clear,but if symptoms persisted to see the doctor.I did and she recommended a colonoscopy,so I’m waiting for appointment.I have left it this long as my husband had been diagnosed with prostate cancer in March’10 an thought he did not need the extra stress.Will be in touch.

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Nellwyn Stellens said on 21 February 2011

My main symptom was constant nausea that got worse when eating and worse still when opening bowels. I didn’t start to lose weight or pass blood or anything until it was almost too late.

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muppetmagic said on 08 February 2011

i was admitted to hospital on 13 june 2010 wih constipation the doctors could feel that i had a massive blockage in my bowels so they did ct scan. by fluke they found 2 massive tumors in my liver on doing another ct scan they found speckles all over my lungs i was told these were not primary and the doctors thought that it was in my bowels. on 2nd july i was rushed in for emergency surgery before my bowels burst and killed me. they gave me a colostomy. if that was my only problem i would be over the moon. since then i have had 8 cycles of chemotherapy my prognosis is still terminal.i have also since found that i have a massive tumour wich comes out into my pelvic cavitiy.
it really annoys me that i have been dealt this hand in life because i am now only 37years old i have five children ranging from 20 down to 6years old.and a grandaughter. i worked am a nonsmoker, dont drink or smoke or eat processed food to have found out all this by accident. generally i had a really happy healthy life. i was told last week that the cancer is no longer shrinking and that i should live the life that ihave left. this is heart breaking to my husband and babies.

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homsey said on 25 November 2010

I had early stage bowel cancer, one tumour in lower left hand side, was told i would be in hospital for upto 10 days, infact was in 33 days with a spell in intensive care, was also told at the time that it was a straight forward op and would be reversed in 6 months however have been told now that it cannot be reversed and i am stuck with a stoma on my right side and one on my left side, to say i am dissapointed is an understatement…..regards h

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Hamcatsmammy said on 03 November 2010

I had no idea i had bowel cancer, i was 51 worked full time, fit & active, my family health history came up in conversation during a consultation for my daughter! lucky for me the consultant insisted i should have screening has my father & grandfather both had bowel cancer. I reluctantly had a colonoscope only to discover i had polyps that had turned cancerous. 2 weeks later after scans, blood test etc, i had surgery. I was so relieved to find it was caught early so no chemo, or rad, treatment was needed but best of all no stoma. So if you have any close family history of bowel cancer please get checked. I later found out that my cancer is genetic so all my family are now aware and are being tested to see if they carry the gene.

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sujabi said on 13 July 2010

I had been experiencing irregular bowel movements (I am 82) and had been to two doctors (I live in Jersey and UK). I said that the discharges had been frequent and mucus. No pain at all presented. Stools were taken in both case. I doubted the findings and browsed nhsdierct symptoms for bowel cancer. They were so relevant I requested colonoscpy. The results found a cancer (Dukes B) in the lower bowel which was excised – a reversal of my ileostomy is due shortly. On enquiring how long I must have had this tumour I was told – about 7 years! I feel somewhat aggrieved that we are told so much about prostate, strokes, smoking, drinking etc but nothing, until recently, about bowel cancer – the third most dangerous form. Had I had an examination ten years ago I might only have had some polyps to excise.

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Helen M W said on 02 April 2010

My husband & I have both undergone the NHS screening for bowel cancer and were found to be "clear".
Two weeks ago my husband (aged underwent emergency surgery for a "blockage" when 2 tumours were discovered, one where the small intestine joins the colon and one in the colon. Faecal screening does not detect everything it seems.
Be very aware of any stomach pain, bloating, burping & difficulty in eating. His tumours were found in the nick of time after he vomited bile violently after having the sympoms above.
Take unexplained stomach ache which comes & goes very seriously.

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Bowel cancer – Living with 

Living with bowel cancer 

Bowel cancer can affect your daily life in different ways, depending on what stage it is at and what treatment you are having.

How people cope with their diagnosis and treatment varies from person to person. There are several forms of support available if you need it. Not all of them work for everybody, but one or more of them should help:

  • talk to your friends and family – they can be a powerful support system
  • communicate with other people in the same situation – for example, through bowel cancer support groups (see links below)
  • find out as much as possible about your condition
  • do not try to do too much or overexert yourself
  • make time for yourself

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Talk to others  hide

Your GP or nurse may be able to reassure you if you have questions, or you may find it helpful to talk to a trained counsellor, psychologist or specialist telephone helpline operator. Your GP surgery will have information on these.

Some people find it helpful to talk to others with bowel cancer at a local support group or through an internet chat room.

Beating Bowel Cancer offers support services to people with bowel cancer. For example, they run a nurse advisory line on 08450 719 301 that is available from 9am to 5:30pm on Monday to Thursday, and from 9am to 4pm on Fridays. You can email a nurse at nurse@beatingbowelcancer.org.

The organisation also runs a national patient-to-patient network for people affected by bowel cancer – and their relatives – called Bowel Cancer Voices.

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Your emotions show

Having cancer can cause a range of emotions. These may include shock, anxiety, relief, sadness and depression.

Different people deal with serious problems in different ways. It is hard to predict how knowing you have cancer will affect you. However, you and your loved ones may find it helpful to know about the feelings that people diagnosed with cancer have reported.

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Recovering from surgery show

Surgeons and anaesthetists have found that using an enhanced recovery programme after bowel cancer surgery helps patients recover more quickly.

Most hospitals now use this programme. It involves giving you more information before the operation about what to expect, avoiding giving you strong laxatives to clean the bowel before surgery, and in some cases giving you a sugary drink two hours before the operation to give you energy. 

During and after the operation, the anaesthetist controls the amount of IV fluid you need very carefully, and after the operation you will be given painkillers that allow you to get up and out of bed by the next day.

Most people will be able to eat a light diet the day after their operation.

To reduce the risk of deep vein thrombosis (blood clots in the legs), you may be given special compression stockings that help prevent blood clots, or a regular injection with a blood thinning medication called heparin until you are fully mobile.

A nurse or physiotherapist will help you get out of bed and regain your strength so you can go home within a few days.

With the enhanced recovery programme, most people are well enough to go home within a week of their operation. The timing depends on when you and the doctors and nurses looking after you agree you are well enough to go home.

You will be asked to return to hospital a few weeks after your treatment has finished so tests can be carried out to check for any remaining signs of cancer. You may also need routine check-ups for the next few years to look out for signs of the cancer recurring.

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Diet after bowel surgery show

If you have had part of your colon removed, it is likely that your stools (faeces) will be looser because one of the functions of the colon is to absorb water from the stools. This may mean that you need to go to the toilet more often to pass loose stools.

You should inform your care team if this becomes a problem, because medication is available to help control it.

You may find some foods upset your bowels, particularly during the first few months after your operation.

Different foods can upset different people, but food and drink that is commonly known to cause problems include fruit and vegetables that are high in fibre, such as beans, cabbages, apples and bananas, and fizzy drinks, such as cola and beer.

You may find it useful to keep a food diary to record the effects of different foods on your bowel.

If you find that you are having continual problems with your bowels as a result of your diet, and/or you are finding it difficult to maintain a healthy diet, you should contact your care team. You may need to be referred to a dietitian for further advice.

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Living with a stoma show

If you need a temporary or permanent stoma with an external bag or pouch, you may feel worried about how you look and how others will react to you.

Information and advice about living with a stoma (including stoma care, stoma products and ‘stoma-friendly’ diets) is available on the ileostomy and colostomy topics.

For anyone wishing to obtain further information about living with a stoma, there are patient support groups who provide support for people who may have had, or are due to have, a stoma. You can obtain details through your stoma care nurse or visit them online for further information.

These include:

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Sex and bowel cancer  show

Having cancer and its treatment may affect how you feel about relationships and sex. Although most people are able to enjoy a normal sex life after bowel cancer treatment, if you have stoma you may feel self-conscious or uncomfortable.

Talking about how you feel with your partner may help you both to support each other. Or you may feel you’d like to talk to someone else about your feelings. Your doctor or nurse will be able to help.

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Financial concerns show

A diagnosis of cancer can cause money problems because you are unable to work or someone you are close to has to stop working to look after you. There is financial support available for carers and for you if you have to stay off work for a while or have to stop work because of your sickness. 

Free prescriptions

People being treated for cancer are entitled to apply for an exemption certificate giving free prescriptions for all medication, including medication to treat unrelated conditions.

The certificate is valid for five years and you can apply for a certificate by speaking to your GP or cancer specialist.

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Dealing with dying  show

If you are told there is nothing more that can be done to treat your bowel cancer, your GP will still provide you with support and pain relief. This is called palliative care. Support is also available for your family and friends.

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Bowel cancer: Anne’s story


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Watch how Anne describes being diagnosed with bowel cancer, what treatment choices she had, and what it’s like to live with bowel cancer

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Cancer and social care

If you have cancer, your first priority is medical care. But there are people who can help with other aspects of your life

Talking with your children about cancer

If you have cancer, talking to your kids about your condition can help reassure them

Cancer: end of life care

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Bowel cancer – Causes 

Causes of bowel cancer 

Cancer occurs when the cells in a certain area of your body divide and multiply too rapidly. This produces a lump of tissue known as a tumour.

Most cases of bowel cancer first develop inside clumps of cells on the inner lining of the bowel. These clumps are known as polyps. However, if you develop polyps, it does not necessarily mean you will get bowel cancer.

Exactly what causes cancer to develop inside the bowel is still unknown. However, research has shown several factors may make you more likely to develop it. These factors are outlined below.

Age

Your chances of developing bowel cancer increase as you get older. Almost nine out of 10 cases of bowel cancer in the UK are diagnosed in people over 60 years of age.

Family history

Having a family history of bowel cancer can increase your risk of developing the condition yourself, particularly if a close relative (mother, father, brother or sister) was diagnosed with bowel cancer below the age of 50.

If you are particularly concerned that your family’s medical history may mean you are at an increased risk of developing bowel cancer, it may help to speak to your GP.

If necessary, your GP can refer you to a genetics specialist who can offer more advice about your level of risk and recommend any necessary tests to periodically check for the condition.

Diet

A large body of evidence suggests a diet high in red and processed meat can increase your risk of developing bowel cancer. For this reason, the Department of Health advises people who eat more than 90 grams (cooked weight) of red and processed meat a day to cut down to 70 grams. Read more about red meat and bowel cancer risk.

There is also evidence suggesting that a diet high in fibre could help reduce your bowel cancer risk.

Read more about eating good food and a healthy diet.

Smoking

People who smoke cigarettes are more likely to develop bowel cancer, other types of cancer and other serious conditions such as heart disease than people who do not smoke.

Read more about stopping smoking

Alcohol

Drinking alcohol has been shown to be associated with an increased risk of bowel cancer, particularly if you regularly drink large amounts of it.

Read about drinking and alcohol for more information and tips on cutting down.

Obesity

Being overweight or obese is linked to an increased risk of bowel cancer, particularly in men.

If you are overweight or obese, losing weight may help lower your chances of developing the condition.

Inactivity

People who are physically inactive have a higher risk of developing bowel cancer.

You can help reduce your risk of bowel and other cancers by being physically active every day.

Read more about health and fitness.

Digestive disorders

Some conditions affecting the bowel may put you at a higher risk of developing bowel cancer. For example, bowel cancer is more common in people who have had severe Crohn’s disease or ulcerative colitis for many years.

If you have one of these conditions, you will usually have regular check-ups to look for signs of bowel cancer from about 10 years after your symptoms first develop.

Check-ups will involve examining your bowel with a colonoscope – a long, narrow flexible tube containing a small camera – that is inserted into your rectum. The frequency of the colonoscopy examinations will increase the longer you live with the condition, and will also depend on factors such as how severe your ulcerative colitis is and if you have a family history of bowel cancer.

Genetic conditions

There are two rare inherited conditions that can lead to bowel cancer. They are:

  • familial adenomatous polyposis (FAP) – a condition that triggers the growth of non-cancerous polyps inside the bowel
  • hereditary non-polyposis colorectal cancer (HNPCC), also known as Lynch syndrome – an inherited gene fault (mutation) that increases your bowel cancer risk

Although the polyps caused by FAP are non-cancerous, there is a high risk that, over time, at least one will turn cancerous. Most people with FAP will have bowel cancer by the time they are 50 years of age.

As people with FAP have such a high risk of getting bowel cancer, they are often advised by their doctor to have their large bowel removed by surgery before they reach the age of 25. Families affected can find support and advice from FAP registries such as the FAP registry provided by St Mark’s Hospital, London.

Removing the bowel as a precautionary measure is also usually recommended in people with HNPCC because the risk of developing bowel cancer is so high.

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NHS Choices Syndication


Bowel cancer

Screening for bowel cancer

Bowel cancer can be present for a long time before any symptoms appear. If it’s detected before symptoms appear, it’s easier to treat and there’s a better chance of surviving the disease.

To detect cases of bowel cancer sooner, the NHS Bowel Cancer Screening Programme was introduced in England in 2006. Men and women aged 60-69 registered with a GP will automatically be sent an invitation for screening through the post every two years.

The screening programme is also being extended in England to those aged 70 to 74. Screening centres in England are rolling out the extension once their two-year screening invites have completed.

Bowel cancer screening is also being carried out in the rest of the UK, but in Scotland people aged 50-74 are invited for screening.

People over 70 can also request a screening kit by calling the freephone helpline 0800 707 6060 (you’ll need your NHS number to hand).

Routine screening isn’t offered to people less than 60 years of age, so if you think you may be at an increased risk of bowel cancer and you are not yet eligible for screening, it may help to speak to your GP about your options and what you should be looking out for.

Screening consists of a home testing kit, called an FOBt (faecal occult blood test) kit. The kit arrives through the post when screening is due. The kit is used to collect tiny stool samples on a special card.

The card is then sealed in a special hygienic freepost envelope and sent to a laboratory where it will be checked for traces of blood that may not be visible to the naked eye, but may indicate a problem.

Results

Results are received in writing within two weeks of sending in the test kit. There are three types of result:

  • Normal – when no blood was found in the samples. Screening will be offered again in two years’ time.
  • Unclear – when there were possible traces of blood that could be caused by factors other than cancer, such as haemorrhoids (piles) or stomach ulcers. If you have an unclear result, you will be asked to repeat the test kit up to two more times.
  • Abnormal – when blood was definitely found in the samples. Again, this could be due to something such as piles or bowel polyps. If you have an abnormal result, you will be offered an appointment with a specialist nurse to discuss having an examination of the bowel, called a colonoscopy (see below).

Only half of all bowel cancers are picked up by the screening test. The ones missed by the screening test cause symptoms at a later date. If you develop symptoms after a negative test, try the bowel cancer symptom checker to see whether you need to see your GP.

Colonoscopy

A colonoscopy is an investigation of the lining of the large bowel (colon). A thin, flexible tube with a camera on the end (colonoscope) is passed into your rectum and guided around the bowel.

Only around two in every 100 people completing the FOBt kit will have an abnormal result and will be offered a colonoscopy. Of those who have a colonoscopy, only about one in 10 will have cancer.

New screening test

As well as the FOBt described above, an additional screening test is being rolled out by 2016. This involves inviting people at age 55 to have a one-off flexible sigmoidoscopy test to examine the lower bowel with a camera.

A flexible sigmoidoscopy is a similar test to a colonoscopy, although it cannot be used to see quite as far into the bowel. If the test shows polyps in your bowel, the person will then be offered a full colonoscopy (see above) to investigate further.

Both FOBt and flexible sigmoidoscopy screening tests have been shown to reduce the risk of dying of bowel cancer.

See diagnosing bowel cancer for more information about colonoscopies and sigmoidoscopies.

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Published Date
2014-10-07 13:17:20Z
Last Review Date
2014-09-01 00:00:00Z
Next Review Date
2016-09-01 00:00:00Z
Classification
Blood in bowel motions,Bowel cancer,Colonoscopy






NHS Choices Syndication


Bowel cancer

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The Map of Medicine is used by doctors throughout the NHS to determine the best treatment options for their patients. NHS Choices offers everyone in England exclusive and free access to this cutting-edge internet resource, which lets you see exactly what your doctor sees.

The information in the Map has been approved by the UK’s leading clinical experts, is based on the best available clinical evidence, and is continually updated. To take advantage of this unique resource go to:

Map of Medicine: colorectal cancer

Published Date
2012-12-05 19:50:04Z
Last Review Date
2009-11-06 00:00:00Z
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Classification
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NHS Choices Syndication


Bowel cancer

Signs and symptoms of bowel cancer

The three main symptoms of bowel cancer are blood in the stools (faeces), a change in bowel habit (such as to more frequent, looser stools) and abdominal (tummy) pain.

However, these symptoms are very common. Blood in the stools is usually caused by haemorrhoids (piles) and a change in bowel habit or abdominal pain is often due to something you have eaten.

In the UK, an estimated 7 million people have blood in the stools each year and even more people have temporary changes in bowel habit and abdominal pain.

Most people with these symptoms do not have bowel cancer.

As the vast majority of people with bowel cancer are over 60 years old, these symptoms are more important as people get older. They are also more significant when they persist in spite of simple treatments.

Most patients with bowel cancer present with one of the following symptom combinations:

  • a persistent change in bowel habit, causing them to go to the toilet more often and pass looser stools, usually together with blood on or in their stools
  • a persistent change in bowel habit without blood in their stools, but with abdominal pain
  • blood in the stools without other haemorrhoid symptoms such as soreness, discomfort, pain, itching or a lump hanging down outside the back passage
  • abdominal pain, discomfort or bloating always provoked by eating, sometimes resulting in a reduction in the amount of food eaten and weight loss

The symptoms of bowel cancer can be subtle and don’t necessarily make you feel ill.

When to seek medical advice

Try the bowel cancer symptom checker for advice on what treatments you can try to see if your symptoms get better and when you should see your GP to discuss whether any tests are necessary.

Your doctor you will probably perform a simple examination of your tummy and bottom to make sure you have no lumps and a simple blood test to check for iron deficiency anaemia (as this can indicate whether there is any bleeding from your bowel you haven’t been aware of).

In some cases, your doctor may decide it is best to have a simple test in hospital to make sure there is no serious cause for your symptoms.

Make sure you return to your doctor if your symptoms persist or keep coming back after stopping treatment, regardless of their severity or your age.

Read more about diagnosing bowel cancer.

Bowel obstruction

In some cases, bowel cancer can stop digestive waste passing through the bowel. This is known as a bowel obstruction.

Symptoms of a bowel obstruction can include:

  • severe abdominal pain, which may initially come and go
  • not being able to pass stools when you go to the toilet
  • noticeable swelling or bloating of the tummy
  • vomiting

A bowel obstruction is a medical emergency. If you suspect your bowel is obstructed, you should see your GP quickly and if this isn’t possible go to the accident and emergency (A&E) department of your nearest hospital.

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Published Date
2014-10-07 13:15:23Z
Last Review Date
2014-09-01 00:00:00Z
Next Review Date
2016-09-01 00:00:00Z
Classification
Beating Bowel Cancer,Blood in bowel motions,Bowel cancer,Bowel Cancer UK




Bowel cancer – Living with – NHS Choices






























































Bowel cancer – Living with 

Living with bowel cancer 

Bowel cancer can affect your daily life in different ways, depending on what stage it is at and what treatment you are having.

How people cope with their diagnosis and treatment varies from person to person. There are several forms of support available if you need it. Not all of them work for everybody, but one or more of them should help:

  • talk to your friends and family – they can be a powerful support system
  • communicate with other people in the same situation – for example, through bowel cancer support groups (see links below)
  • find out as much as possible about your condition
  • do not try to do too much or overexert yourself
  • make time for yourself

Want to know more?

Talk to others  hide

Your GP or nurse may be able to reassure you if you have questions, or you may find it helpful to talk to a trained counsellor, psychologist or specialist telephone helpline operator. Your GP surgery will have information on these.

Some people find it helpful to talk to others with bowel cancer at a local support group or through an internet chat room.

Beating Bowel Cancer offers support services to people with bowel cancer. For example, they run a nurse advisory line on 08450 719 301 that is available from 9am to 5:30pm on Monday to Thursday, and from 9am to 4pm on Fridays. You can email a nurse at nurse@beatingbowelcancer.org.

The organisation also runs a national patient-to-patient network for people affected by bowel cancer – and their relatives – called Bowel Cancer Voices.

Want to know more?

back to top

Your emotions show

Having cancer can cause a range of emotions. These may include shock, anxiety, relief, sadness and depression.

Different people deal with serious problems in different ways. It is hard to predict how knowing you have cancer will affect you. However, you and your loved ones may find it helpful to know about the feelings that people diagnosed with cancer have reported.

Want to know more?

back to top

Recovering from surgery show

Surgeons and anaesthetists have found that using an enhanced recovery programme after bowel cancer surgery helps patients recover more quickly.

Most hospitals now use this programme. It involves giving you more information before the operation about what to expect, avoiding giving you strong laxatives to clean the bowel before surgery, and in some cases giving you a sugary drink two hours before the operation to give you energy. 

During and after the operation, the anaesthetist controls the amount of IV fluid you need very carefully, and after the operation you will be given painkillers that allow you to get up and out of bed by the next day.

Most people will be able to eat a light diet the day after their operation.

To reduce the risk of deep vein thrombosis (blood clots in the legs), you may be given special compression stockings that help prevent blood clots, or a regular injection with a blood thinning medication called heparin until you are fully mobile.

A nurse or physiotherapist will help you get out of bed and regain your strength so you can go home within a few days.

With the enhanced recovery programme, most people are well enough to go home within a week of their operation. The timing depends on when you and the doctors and nurses looking after you agree you are well enough to go home.

You will be asked to return to hospital a few weeks after your treatment has finished so tests can be carried out to check for any remaining signs of cancer. You may also need routine check-ups for the next few years to look out for signs of the cancer recurring.

Want to know more?

back to top

Diet after bowel surgery show

If you have had part of your colon removed, it is likely that your stools (faeces) will be looser because one of the functions of the colon is to absorb water from the stools. This may mean that you need to go to the toilet more often to pass loose stools.

You should inform your care team if this becomes a problem, because medication is available to help control it.

You may find some foods upset your bowels, particularly during the first few months after your operation.

Different foods can upset different people, but food and drink that is commonly known to cause problems include fruit and vegetables that are high in fibre, such as beans, cabbages, apples and bananas, and fizzy drinks, such as cola and beer.

You may find it useful to keep a food diary to record the effects of different foods on your bowel.

If you find that you are having continual problems with your bowels as a result of your diet, and/or you are finding it difficult to maintain a healthy diet, you should contact your care team. You may need to be referred to a dietitian for further advice.

Want to know more?

back to top

Living with a stoma show

If you need a temporary or permanent stoma with an external bag or pouch, you may feel worried about how you look and how others will react to you.

Information and advice about living with a stoma (including stoma care, stoma products and ‘stoma-friendly’ diets) is available on the ileostomy and colostomy topics.

For anyone wishing to obtain further information about living with a stoma, there are patient support groups who provide support for people who may have had, or are due to have, a stoma. You can obtain details through your stoma care nurse or visit them online for further information.

These include:

Want to know more?

back to top

Sex and bowel cancer  show

Having cancer and its treatment may affect how you feel about relationships and sex. Although most people are able to enjoy a normal sex life after bowel cancer treatment, if you have stoma you may feel self-conscious or uncomfortable.

Talking about how you feel with your partner may help you both to support each other. Or you may feel you’d like to talk to someone else about your feelings. Your doctor or nurse will be able to help.

Want to know more?

back to top

Financial concerns show

A diagnosis of cancer can cause money problems because you are unable to work or someone you are close to has to stop working to look after you. There is financial support available for carers and for you if you have to stay off work for a while or have to stop work because of your sickness. 

Free prescriptions

People being treated for cancer are entitled to apply for an exemption certificate giving free prescriptions for all medication, including medication to treat unrelated conditions.

The certificate is valid for five years and you can apply for a certificate by speaking to your GP or cancer specialist.

Want to know more?

back to top

Dealing with dying  show

If you are told there is nothing more that can be done to treat your bowel cancer, your GP will still provide you with support and pain relief. This is called palliative care. Support is also available for your family and friends.

Want to know more?

back to top

Page last reviewed: 02/09/2014

Next review due: 02/09/2016

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Bowel cancer: Anne’s story


Viewing video content in NHS Choices

If you do not have a version of the Flash Player you can download the free Adobe Flash Player from Adobe Systems Incorporated.


Watch how Anne describes being diagnosed with bowel cancer, what treatment choices she had, and what it’s like to live with bowel cancer

Media last reviewed: 02/10/2013

Next review due: 02/10/2015

Cancer and social care

If you have cancer, your first priority is medical care. But there are people who can help with other aspects of your life

Talking with your children about cancer

If you have cancer, talking to your kids about your condition can help reassure them

Cancer: end of life care

Information on coping with a terminal cancer diagnosis, including advice on counselling, practical issues and financial help









Bowel cancer – Living with – NHS Choices






























































Bowel cancer – Living with 

Living with bowel cancer 

Bowel cancer can affect your daily life in different ways, depending on what stage it is at and what treatment you are having.

How people cope with their diagnosis and treatment varies from person to person. There are several forms of support available if you need it. Not all of them work for everybody, but one or more of them should help:

  • talk to your friends and family – they can be a powerful support system
  • communicate with other people in the same situation – for example, through bowel cancer support groups (see links below)
  • find out as much as possible about your condition
  • do not try to do too much or overexert yourself
  • make time for yourself

Want to know more?

Talk to others  hide

Your GP or nurse may be able to reassure you if you have questions, or you may find it helpful to talk to a trained counsellor, psychologist or specialist telephone helpline operator. Your GP surgery will have information on these.

Some people find it helpful to talk to others with bowel cancer at a local support group or through an internet chat room.

Beating Bowel Cancer offers support services to people with bowel cancer. For example, they run a nurse advisory line on 08450 719 301 that is available from 9am to 5:30pm on Monday to Thursday, and from 9am to 4pm on Fridays. You can email a nurse at nurse@beatingbowelcancer.org.

The organisation also runs a national patient-to-patient network for people affected by bowel cancer – and their relatives – called Bowel Cancer Voices.

Want to know more?

back to top

Your emotions show

Having cancer can cause a range of emotions. These may include shock, anxiety, relief, sadness and depression.

Different people deal with serious problems in different ways. It is hard to predict how knowing you have cancer will affect you. However, you and your loved ones may find it helpful to know about the feelings that people diagnosed with cancer have reported.

Want to know more?

back to top

Recovering from surgery show

Surgeons and anaesthetists have found that using an enhanced recovery programme after bowel cancer surgery helps patients recover more quickly.

Most hospitals now use this programme. It involves giving you more information before the operation about what to expect, avoiding giving you strong laxatives to clean the bowel before surgery, and in some cases giving you a sugary drink two hours before the operation to give you energy. 

During and after the operation, the anaesthetist controls the amount of IV fluid you need very carefully, and after the operation you will be given painkillers that allow you to get up and out of bed by the next day.

Most people will be able to eat a light diet the day after their operation.

To reduce the risk of deep vein thrombosis (blood clots in the legs), you may be given special compression stockings that help prevent blood clots, or a regular injection with a blood thinning medication called heparin until you are fully mobile.

A nurse or physiotherapist will help you get out of bed and regain your strength so you can go home within a few days.

With the enhanced recovery programme, most people are well enough to go home within a week of their operation. The timing depends on when you and the doctors and nurses looking after you agree you are well enough to go home.

You will be asked to return to hospital a few weeks after your treatment has finished so tests can be carried out to check for any remaining signs of cancer. You may also need routine check-ups for the next few years to look out for signs of the cancer recurring.

Want to know more?

back to top

Diet after bowel surgery show

If you have had part of your colon removed, it is likely that your stools (faeces) will be looser because one of the functions of the colon is to absorb water from the stools. This may mean that you need to go to the toilet more often to pass loose stools.

You should inform your care team if this becomes a problem, because medication is available to help control it.

You may find some foods upset your bowels, particularly during the first few months after your operation.

Different foods can upset different people, but food and drink that is commonly known to cause problems include fruit and vegetables that are high in fibre, such as beans, cabbages, apples and bananas, and fizzy drinks, such as cola and beer.

You may find it useful to keep a food diary to record the effects of different foods on your bowel.

If you find that you are having continual problems with your bowels as a result of your diet, and/or you are finding it difficult to maintain a healthy diet, you should contact your care team. You may need to be referred to a dietitian for further advice.

Want to know more?

back to top

Living with a stoma show

If you need a temporary or permanent stoma with an external bag or pouch, you may feel worried about how you look and how others will react to you.

Information and advice about living with a stoma (including stoma care, stoma products and ‘stoma-friendly’ diets) is available on the ileostomy and colostomy topics.

For anyone wishing to obtain further information about living with a stoma, there are patient support groups who provide support for people who may have had, or are due to have, a stoma. You can obtain details through your stoma care nurse or visit them online for further information.

These include:

Want to know more?

back to top

Sex and bowel cancer  show

Having cancer and its treatment may affect how you feel about relationships and sex. Although most people are able to enjoy a normal sex life after bowel cancer treatment, if you have stoma you may feel self-conscious or uncomfortable.

Talking about how you feel with your partner may help you both to support each other. Or you may feel you’d like to talk to someone else about your feelings. Your doctor or nurse will be able to help.

Want to know more?

back to top

Financial concerns show

A diagnosis of cancer can cause money problems because you are unable to work or someone you are close to has to stop working to look after you. There is financial support available for carers and for you if you have to stay off work for a while or have to stop work because of your sickness. 

Free prescriptions

People being treated for cancer are entitled to apply for an exemption certificate giving free prescriptions for all medication, including medication to treat unrelated conditions.

The certificate is valid for five years and you can apply for a certificate by speaking to your GP or cancer specialist.

Want to know more?

back to top

Dealing with dying  show

If you are told there is nothing more that can be done to treat your bowel cancer, your GP will still provide you with support and pain relief. This is called palliative care. Support is also available for your family and friends.

Want to know more?

back to top

Page last reviewed: 02/09/2014

Next review due: 02/09/2016

Ratings

How helpful is this page?



Average rating

Based on
13
ratings

All ratings











Add your rating

Comments

Bowel cancer: Anne’s story


Viewing video content in NHS Choices

If you do not have a version of the Flash Player you can download the free Adobe Flash Player from Adobe Systems Incorporated.


Watch how Anne describes being diagnosed with bowel cancer, what treatment choices she had, and what it’s like to live with bowel cancer

Media last reviewed: 02/10/2013

Next review due: 02/10/2015

Cancer and social care

If you have cancer, your first priority is medical care. But there are people who can help with other aspects of your life

Talking with your children about cancer

If you have cancer, talking to your kids about your condition can help reassure them

Cancer: end of life care

Information on coping with a terminal cancer diagnosis, including advice on counselling, practical issues and financial help











NHS Choices Syndication


Bowel cancer

Treating bowel cancer

Surgery for colon cancer

If colon cancer is at a very early stage, it may be possible to remove just a small piece of the lining of the colon wall. This is known as local excision.

If the cancer spreads into muscles surrounding the colon, it will usually be necessary to remove an entire section of your colon. Removing some of the colon is known as a colectomy.

There are two ways a colectomy can be performed:

  • an open colectomy – where the surgeon makes a large incision in your abdomen and removes a section of your colon
  • a laparoscopic (‘keyhole’) colectomy – where the surgeon makes a number of small incisions in your abdomen and uses special instruments guided by a camera to remove a section of colon

During surgery, nearby lymph nodes are also removed. It is usual to join the ends of the bowel together after bowel cancer surgery, but very occasionally this is not possible and a stoma (see below) is needed.

Both open and laparoscopic colectomies are thought to be equally effective in removing cancer and have similar risks of complications. Laparoscopic colectomies, however, have the advantage of a faster recovery time and less post-operative pain and this is becoming the routine way of doing most of these operations.

Laparoscopic colectomies should be available in all hospitals carrying out bowel cancer surgery, although not all surgeons perform this type of surgery. Discuss your options with your surgeon to see if the laparoscopic method can be done.

Want to know more?

Surgery for rectal cancer

There are a number of different types of operation that can be carried out to treat rectal cancer, depending on how far the cancer has spread.

Some of the main techniques used are described below.

Local resection

If you have a very small, early stage rectal cancer, your surgeon may be able to remove it in an operation called a local resection (trans anal resection).

The surgeon puts an endoscope (a flexible tube with a light) in through your back passage and removes the cancer from the wall of the rectum.

Total mesenteric excision

In many cases, however, a local resection is not possible. Instead, a larger area of the rectum will need to be removed, along with a border of rectal tissue around it that is free of cancer cells and fatty tissue from around the bowel (known as the mesentery). This type of operation is known as total mesenteric excision (TME).

Removing the mesentery can help ensure all the cancerous cells are removed, which can lower the risk of the cancer recurring at a later stage.

Depending on exactly where in your rectum the cancer is located, one of two main TME operations may be carried out. These are outlined below.

Low anterior resection

Low anterior resection is a procedure used to treat cases where the cancer is in the upper section of your rectum.

The surgeon will make an incision in your abdomen and remove the upper section of your rectum, as well as some surrounding tissue to make sure any lymph glands containing cancer cells are also removed.

They will then attach your colon to the lowest part of your rectum or upper part of the anal canal. Sometimes, they turn the end of the colon into an internal pouch to replace the rectum. You will probably require a temporary stoma (see below) to give the joined section of bowel time to heal.

Abdominoperineal resection

Abdominoperineal resection is used to treat cases where the cancer is in the lowest section of your rectum. In this case, it will be necessary to remove the whole of your rectum and surrounding muscles to reduce the risk of the cancer re-growing in the same area.

This involves removing and closing the anus and removing its sphincter muscles too, so there is no option except to have a permanent stoma after the operation. Bowel cancer surgeons always do their best to avoid giving people permanent stomas wherever possible.

Want to know more?

Stoma surgery

Where a section of the bowel is removed and the remaining bowel joined, the surgeon may sometimes decide to divert your stool away from the join to allow it to heal. The stool is temporarily diverted by bringing a loop of bowel out through the abdominal wall and attaching to the skin – this is called a stoma. A bag is worn over the stoma to collect the stool.

Where the stoma is made from small bowel (ileum) it is called an ileostomy and where it is made from large bowel (colon) it is called a colostomy

A specialist nurse, known as a stoma care nurse, is usually available to advise you, prior to surgery, on the best site for a stoma. The nurse will take into account factors such as your body shape and lifestyle, although this may not be possible where surgery is performed in an emergency. During the first few days post surgery the stoma care nurse will advise on the care necessary to look after the stoma and the type of bag suitable.

Once the join in the bowel has safely healed, which can take several weeks, the stoma can be closed during further surgery. In some people, for various reasons, re-joining the bowel may not be possible or may lead to problems controlling bowel function and therefore the stoma may become permanent.

Before having surgery, the care team will advise whether it may be necessary to form an ileostomy or colostomy and the likelihood of this being temporary or permanent.

For anyone wishing to obtain further information about living with a stoma, there are patient support groups which provide support for patients who may have just had or are due to have, a stoma. You can obtain details through your stoma care nurse or visit them online for further information.

These include:

Want to know more?

Side effects of surgery

Bowel cancer operations carry many of the same risks as other major operations, including the risks of bleeding, infection, developing blood clots or heart or breathing problems. 

The operations all carry a number of risks specific to the procedure.

One risk is that the joined up section of bowel may not heal properly and may leak inside your abdomen. This is usually only a risk in the first few days after the operation.

Another risk is for people having rectal cancer surgery. The nerves controlling passing urine and sexual function are very close to the rectum, and sometimes an operation to remove a rectal cancer can damage these nerves.

After rectal cancer surgery most people need to go to the toilet to open their bowels more often than before, although it usually settles down within a few months of the operation.

Radiotherapy

There are two main ways that radiotherapy can be used to treat bowel cancer. It can be given before surgery to shrink rectal cancers and increase the chances of complete removal, or used to control symptoms and slow the spread of cancer in advanced cases (called palliative radiotherapy).

Radiotherapy given before surgery for rectal cancer can be performed in two ways:

  • external radiotherapywhere a machine is used to beam high-energy waves at your rectum to kill cancerous cells
  • internal radiotherapy (also known as brachytherapy) – where a radioactive tube is inserted into your anus and placed next to the cancer to shrink it

External radiotherapy is usually given daily, five days a week, with a break at the weekend. Depending on the size of your tumour, you may need one to five weeks of treatment. Each session of radiotherapy is short and will only last for 10-15 minutes.

Internal radiotherapy can usually be performed in one session before surgery is carried out a few weeks later.

Palliative radiotherapy is usually given in short, daily sessions, with a course ranging from two to three days to 10 days.

Short-term side effects of radiotherapy can include:

  • feeling sick
  • fatigue
  • diarrhoea
  • burning and irritation of the skin around the rectum and pelvis (this looks and feels like sunburn)
  • a frequent need to urinate
  • a burning sensation when passing urine

These side effects should pass once the course of radiotherapy has finished. Tell your care team if the side effects of treatment become particularly troublesome. Additional treatments are often available to help you cope better with the side effects.

Long-term side effects of radiotherapy can include:

If you want to have children, it may be possible to store a sample of your sperm or eggs before treatment begins so they can be used in fertility treatments in the future.

Want to know more?

Chemotherapy

There are three ways chemotherapy can be used to treat bowel cancer. It can be given before surgery for rectal cancer in combination with radiotherapy to shrink a tumour, after surgery to reduce the risk of the cancer recurring, or to slow the spread of advanced bowel cancer and help control symptoms (palliative chemotherapy).

Chemotherapy for bowel cancer usually involves taking a combination of medications that kill cancer cells. They can be given as a tablet (oral chemotherapy), through a drip in your arm (intravenous chemotherapy), or as a combination of both. Treatment is given in courses (cycles) each two to three weeks long, depending on the stage or grade of your cancer.

A single session of intravenous chemotherapy can last from several hours to several days.

Most people having oral chemotherapy take tablets over the course of two weeks before having a break from treatment for another week.

A course of chemotherapy can last up to six months depending on how well you respond to the treatment. In some cases it can be given in smaller doses over longer periods of time (maintenance chemotherapy).

Side effects of chemotherapy can include:

  • fatigue
  • feeling sick
  • vomiting
  • diarrhoea
  • mouth ulcers
  • hair loss with certain treatment regimens, but this is generally uncommon in the treatment of bowel cancer       
  • a sensation of numbness, tingling or burning in your hands, feet and neck

These side effects should gradually pass once your treatment has finished.

It usually takes a few months for your hair to grow back if you experience hair loss.

Chemotherapy can also weaken your immune system, making you more vulnerable to infection. Inform your care team or GP as soon as possible if you experience possible signs of an infection, including a high temperature (fever) or a sudden feeling of being generally unwell.

Medications used in chemotherapy can cause temporary damage to men’s sperm and women’s eggs. This means that for women who become pregnant or for men who father a child, there is a risk to the unborn baby’s health. Therefore, it is recommended you use a reliable method of contraception while having chemotherapy treatment and for a period after your treatment has finished.

Want to know more?

Biological treatments

Biological treatments, including cetuximab, bevacizumab and panitumumab, are a newer type of medication also known as monoclonal antibodies.

Monoclonal antibodies are antibodies that have been genetically engineered in a laboratory. They target special proteins found on the surface of cancer cells, known as epidermal growth factor receptors (EGFR). As EGFRs help the cancer to grow, targeting these proteins can help shrink tumours and improve the effect and outcome of chemotherapy.

Biological treatments are therefore usually used in combination with chemotherapy when the cancer has spread beyond the bowel (metastatic bowel cancer).

These treatments are not available to everyone with bowel cancer. The National Institute for Health and Care Excellence (NICE) has determined specific criteria which need to be met before they can be prescribed.

Cetuximab is only available on the NHS when:

  • surgery to remove the cancer in the colon or rectum has been carried out or is possible
  • bowel cancer has spread to the liver and cannot be removed surgically
  • a person is fit enough to undergo surgery to remove the cancer from the liver if this becomes possible after treatment with cetuximab

Cetuximab, bevacizumab and panitumumab are available on the NHS through a government scheme called Cancer Drugs Fund. All these medications are also available privately but are very expensive.

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Published Date
2014-10-07 13:16:19Z
Last Review Date
2014-09-01 00:00:00Z
Next Review Date
2016-09-01 00:00:00Z
Classification
Beating Bowel Cancer,Bowel cancer,Bowel Cancer UK,Bowel surgery,Brachytherapy,Cancer and tumours,Cancer specialists,Chemotherapy,Colostomy,Crohn's disease,Gut,Ileostomy,Large intestine,National Institute for Health and Clinical Excellence,Radiotherapists,Radiotherapy,Rectum,Small intestine,Ulcerative colitis


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