Bowel Cancer
What is bowel cancer?
Bowel cancer develops from abnormal growths in the inner lining of your bowel or from certain polyps. The cancer can spread to the nearby region to involve the lymph nodes or metastasize to other organs. Bowel cancer is the third most commonly diagnosed cancer in Australia and the second deadliest cancer following lung cancer. Approximately 15,610 new cases are diagnosed per year with 10% consisted of younger age patients.
What are the causes of bowel cancer?
The underlying cause of bowel cancer is unknown. Dietary, environmental and genetic factors are all thought to be important causative factors that expose the lining of bowel to cancer producing carcinogen.
Risk factors for bowel cancer
Inherited conditions
Lifestyle choice related:
Smoking
Excessive alcohol use
Obesity, sedentary life style
Diet consisting lots of red meat or processed meat
Medical condition related
Inflammatory bowel disease
Inherited conditions e.g. Lynch syndrome, FAP - Family history of colon cancer or polyps
Symptoms of bowel cancer
Blood in poo
Changes in bowel habit
Unexplained abdominal pain
Unexplained weight and appetite loss
Lethargy, Iron deficiency anaemia
Investigation for bowel cancer
Blood tests: Full blood count, Liver function test, comprehensive metabolic panel, Tumour marker (CEA)
Imaging:
CT chest / abdomen and pelvis to diagnose or stage the disease
MRI liver to further evaluate the spread of cancer to the liver
PET scan in stage IV disease that may be amenable to resection or in recurrences
MRI pelvis is performed to evaluate and stage the rectal cancer.
Management for bowel cancer
The most effective treatment with the aim of cure is to surgically remove the involved segment of the bowel with or without the need of a stoma. Chemotherapy and/or radiotherapy may be given before or after surgery in patients with advanced disease. When the cancer has already spread and cannot be surgically removed, the aim of treatment would then be to relieve / palliate symptoms in order to improve patient’s quality of life.
It is very important that the surgeon is familiar with all aspects of bowel cancer and is skilled in the full range of available surgical techniques. Members of CSSANZ have these skills, and they are trained in the long term support and follow-up of patients who have surgery for bowel cancer.
What is the recovery and follow up after treatment?
Tiredness, abdominal discomfort and bowel frequencies are common complaints. These problems may last for a few months, at times up to 6 to 12 months. However, most people would return to work or their daily activities within four weeks. Finally, your surgeon will arrange for subsequent follow up which may include a combination of clinical assessment, blood test, surveillance scan and colonoscopy.