Bowel cancer

Colorectal cancer, often referred to as bowel cancer, is a type of cancer that develops in the large bowel. It's the fourth most common cancer in the UK ^{Footnote [1]}. While bowel cancer can also occur in the small bowel, this is much rarer.

It’s cancer of the large bowel, which is part of your digestive system. It includes your rectum (back passage) and your colon (the longest part of your large intestine). It’s also sometimes called colorectal cancer.

 

Early symptoms are usually not very specific but you will need to watch specific warning signs that may be nothing to worry about but could be a sign of bowel cancer.

• Blood in your stools and/or bleeding from your bottom.
• Continuous pain or discomfort in your tummy, or bottom.
• Changes when you go for a poo, such as it’s harder to go (constipation), or looser (diarrhoea). Or you might also feel like you haven’t emptied out properly when you’ve been.
• A lump or bloating in your tummy.
• Tiredness, or weight loss when you haven’t been dieting.

Sometimes these can be symptoms of other less serious conditions, such as irritable bowel syndrome (IBS). But if something isn’t normal for you, it’s always worth going to see your doctor.

 

Lot of things have been linked to causing bowel cancer including your age, lifestyle and diet:

Your diet

Red and processed meat

Eating red and processed meat increases your risk of bowel cancer. The government advises people to eat no more than 70g of this a day – that’s about the weight of two cooked sausages ^{Footnote [2]}.

Processed meat is where the meat has been treated to preserve it or add flavour. These include bacon, salami, chicken nuggets and ham. Red meat includes beef, lamb, pork and goat.

Fibre

Too little fibre in your diet can cause bowel cancer. Eating fibre such as brown rice, wholegrain cereals and certain fruit and vegetables can reduce your chances of developing bowel cancer.

Exercise and weight

If you’re overweight you have a higher risk of developing bowel cancer. You can help this by being more physically active and eating a healthy, balanced diet.

Smoking and alcohol

If you’re a smoker or a drinker, you have an increased risk of bowel cancer. Both have been proven to cause cancer so cutting down will reduce your risk.

The NHS recommends to drink no more than 14 units of alcohol a week, spread across three days or more ^{Footnote [3]}. If you’re not sure what a unit is, check out our alcohol units calculator.

Inflammatory Bowel Disease

IBD (Inflammatory Bowel Disease), which includes conditions like Crohn's disease and ulcerative colitis, is linked to a higher bowel cancer risk. This is due to long-term inflammation in the bowel.

Family history

 When a close family member has had bowel cancer, your own risk of developing it increases. This is especially true if you have inherited conditions like FAP (Familial Adenomatous Polyposis) or Lynch syndrome.

FAP causes many polyps (small growths) to form in the bowel, raising the chance of cancer. Lynch syndrome increases cancer risk in the bowel and other areas due to genetic mutations.

Age

As you get older you’re more likely to develop cancer in general, and bowel cancer is more common in those over the age of 50.

 

The first step would be to visit your doctor and explain your symptoms. Your tummy and back passage may be examined for any signs of lumps or swelling.

You may also be asked to provide a stool sample to check for blood in your stools, and have a blood test to check for any underlying health conditions.

Further examinations

If your doctor thinks you need to see a specialist they’ll refer you on so that your symptoms can be further investigated.

You may be offered:

• A colonoscopy. This where a doctor will look at the lining of your large bowel using a long, thin flexible tube with a camera attached. You’ll usually be sedated before it’s passed into your back passage and through your large bowel.
• A sigmoidoscopy. This can be an alternative to colonoscopy as it just looks at the inside of your bottom and the lower part of your bowel.
• A virtual colonoscopy. This is a less invasive procedure where a radiologist examines your colon using a CT scan (computed tomography), to look for polyps. But you will still need a tube up your back passage that blows air to help visualise the colon.
• If cancer is found you’ll have further tests such as a CT or MRI scan to establish its size and position and to identify if it has spread

National screening for bowel cancer

The NHS offers a bowel screening service to anyone aged between 50 and 74 in England, Wales, Scotland and Northern Ireland.

Using a bowel screening test kit (sent in the post), you collect a small sample of stools in a sample bottle and send it for screening.

Your test result should be with you within two weeks, and you’ll be told if you need to have any further investigations. If your result says ‘further tests needed’ it means that blood was found in your stools, but it doesn’t necessarily mean its cancer.

You’ll be asked to make an appointment with your doctor to talk about which further test is right for you.

 

Your treatment will depend on the size and position of the cancer in your body. It may be in your rectum, or in your colon, and your specialist will decide what action needs to be taken.

It also depends on whether it has spread to any other parts of your body.

Your medical professionals will decide on your treatment plan, which could include surgery, chemotherapy, radiotherapy and/or medication.

Surgery

If you are referred for surgery the surgeon will need to remove the cancer from all, or part of, your bowel (colectomy) or bowel lining (local resection).

Depending on the size and location of the cancer, your medical team may be able to remove it using keyhole surgery (small cuts in your tummy). Alternatively, you may need to have surgery where the surgeon makes one large cut in your tummy.

Other treatments

You may have other treatments, either on their own, or alongside surgery.

• Chemotherapy is a treatment with powerful anti-cancer drugs. It can be used to destroy cancer cells or slow the progression of the growth of tumours. This can be effective if the cancer has spread to other parts of your body.
• Radiotherapy is usually used to treat cancer in the rectum. There’s internal and external radiotherapy which involve high energy waves being beamed at the area to destroy cancer cells.
• Targeted or immunotherapy medicines can be used to shrink the cancer. They can be used alongside other treatments.