What is Bowel Cancer?

What is Bowel Cancer?

HealthNutritionOnline Back-to-Directory A health article about Bowel Cancer fromYour Health Online the A to Z directory of dealing with Health Problems & nutritional Self Care Strategies

This from of cancer is like a silent and deadly killer. As a cause of death from cancer only lung cancer is clearly a greater risk.

Bowel cancer (also known as Colorectal cancer - a term which also covers both colon and rectal cancer) is a collective term to describe the development of cancer cells within various areas of the bowel (appendix, intestine, colon or rectum). If not treated it can spread from the affected area to other parts of the body.

The reason it is so deadly is that it does not show symptoms until it is well advanced. By the time the symptoms show it could well be too late to deal with it.

Signs & Symptoms

Any unexplained bleeding from the rectum should be investigated – often the cause is relatively harmless, but it still pays to visit your doctor.

Other symptoms include:
• a change in bowel habit, ie, more constipation or diarrhoea than is usual,
• and abdominal pain or bloating.
• Any unexplained weight loss.
• Anaemia – this can manifest itself as fatigue and being out of breath.

Types of Bowel Cancer

bowel

What Causes Bowel Cancer?

Causes of bowel cancer are a not clear cut but the body of evidence available is now giving fairly clear indications.

Genetics. Family history is a factor. If you have bowel cancer in your close family then you are at a higher risk and you should ensure that you are regularly testing for cancer when you reach 50 years of age if not before.

Diet. The incidence of bowel cancer is closely related to diet – cutting out junk food and stepping up dietary fiber is a very good start in prevention.

Eating five portions of fruit and vegetables a day is one way to do this – there's some evidence to suggest that cauliflower, broccoli and cabbage may play a particularly active role in preventing the disease.

Dietary supplementation to boost nutritional factors, especially if they include dietary fiber, can be useful.

(While there is not an absolute link established yet between healthy levels of fiber in the diet and reduced incidence of bowel cancer there is enough evidence in to make it very wise to get your diet right immediately to reduce the apparent risk of a low fiber diet.)

Try and avoid processed foods and those high in animal fats.

Drink plenty of water.

Lifestyle. Keep fairly fit. Lack of physical exercise has been established as a risk factor for bowel cancer.

Smoking has been established to increase the risk of bowel cancer.

Other medical conditions. People with inflammatory bowel conditions such as ulcerative colitis and Crohn's disease are at increased risk of bowel cancer.

Exposure to radiation or other cancer-causing agents is a risk factor.

Risk Factors:

There are a number of factors which increase your chances of getting bowel cancer. These are:

• being over 50 years of age.
• having bowel polyps or previous bowel cancer.
• having had ulcerative co;itis or Crohn's disease for more than eight years.
• having one or more close relatives who have had bowel cancer, especially if they were under 50 years of age.
• having a member of a family with familial adenomatous polyposis or another family cancer syndrome.
• have previously had special types of polyps yourself (adenomas) in the bowel.
• Having a long term diet that is low in fiber and fruit & vegetables.
• Being infected with human papillomavirus (HPV).
• Having many sexual partners.
• Having receptive anal intercourse (anal sex).
• Frequent anal redness, swelling, and soreness.
• Having anal fistulas (abnormal openings).
• Smoking cigarettes.
• Obesity appears to be a risk factor.

Prevention:

Can bowel cancer be prevented?

”While no cancer is completely preventable, it is believed that eating a healthy diet and exercising regularly could prevent 66 to 75% of bowel cancer cases. It is never too late to make changes to your diet and lifestyle. More information on a healthy diet can be obtained from your doctor.”
Source Bowel Cancer & Digestive Research Institute Australia

When to seek Medical Advice:

When you turn 50 it is time to test to ensure that you do not have a problem.

If you have a history of bowel cancer in your family then you may wish to begin the testing even earlier, some authorities recommend regular testing as early as 40 years of age.

If you find blood in your faeces then the alarm bells should be ringing.

The key to surviving bowel cancer is to find it sooner rather than later and it can be tested very simply and without embarrassment so if there is anything that gives any indication that there may be a problem (see “Signs and symptoms” and also “Risk factors” on this page) then just go and do the tests immediately.

Diagnosis & Treatment/Therapy:

Tests that examine the rectum and anus are used to detect (find) and diagnose anal cancer.

Here in Australia there is a huge push with government support and funding for a self test to be taken by everyone who turns 50 years old.

This involves occult blood test, which tests if there are small, often invisible, amounts of blood in the bowel motion.

I have turned 50 and recently took this test myself. It involves a restriction in diet over a couple of days and in Australia is a 3 day test period but it is really easy, simple and at the end you know that you are free from bowel cancer which is a great outcome. If you did get a negative test and needed further testing done then it is a good result anyway because at that stage of the disease cycle there is a very high chance that you will be able to recover from it.
Warren Tatersall

The following tests and procedures may also be used:

Physical exam and history - an exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

Digital rectal examination (DRE) - an exam of the anus and rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual.

Anoscopy - an exam of the anus and lower rectum using a short, lighted tube called an anoscope.

Proctoscopy - an exam of the rectum using a short, lighted tube called a proctoscope.

Endo-anal or endorectal ultrasound - a procedure in which an ultrasound transducer (probe) is inserted into the anus or rectum and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

Biopsy - the removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If an abnormal area is seen during the anoscopy, a biopsy may be done at that time.

Certain factors affect the prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) depends on the following:

• The size of the tumour.
• Where the tumour is in the anus.
• Whether the cancer has spread to the lymph nodes.

The treatment options depend on the following:

• The stage of the cancer.
• Where the tumour is in the anus.
• Whether the patient has human immunodeficiency virus (HIV).
• Whether cancer remains after initial treatment or has recurred.

Cancer

In some cases, if the cancer is small enough, it can be removed during the colonoscopy. But in practice most bowel cancers are too big by the time they are found to be removed this way.

So most are treated by surgery under general anaesthetic. The cancer and a bit of the healthy bowel either side of it are removed, and the ends of the bowel are joined up again. Usually about 20 to 25 centimetres of bowel are removed (this isn't much and doesn't affect the function of the bowel afterwards).

Sometimes, if the cancer is situated very low in the rectum, there may not be enough bowel on the side closest to the anus left to make a join. In this case, an opening may need to be made in the skin and the bowel joined to it so the faeces can empty out of the abdomen into a bag, which is attached the skin. This opening is called a stoma, or a colostomy, and it may need to be permanent. But this only happens in about five per cent of cases of bowel cancer. In 90 per cent of cases of colorectal cancer, no colostomy is necessary.

If the cancer is found to have spread beyond the bowel, then specialists will normally also recommend chemotherapy and/or radiation therapy.

The prognosis – an estimate of how well the person will remain in the future – depends on how advanced the cancer is when treated. Colorectal cancer is usually divided into four stages of advancement. The prognosis is expressed in what is called 'five year survival rates'; that is, the chance that a person will be alive five years after treatment.

Chances of Survival with bowel cancer

Stage of cancer - Five year survival figures

Localised within the bowel - 88 per cent

Penetrates the bowel wall - 70 per cent

Involvement of the lymph nodes in the region - 43 per cent

Distant metastases (spread to other organs) - 7 per cent

(Source: National Health and Medical Research Council)

CLEARLY IT IS BEST TO TEST EARLY AND FIND ANY PROBLEM BEFORE IT DEVELOPS ENOUGH TO GIVE OBVIOUS SYMPTOMS.

Self Care strategies for Living with Bowel Cancer

Diet change strategies:

Vitamin & Nutrient Associations

The main things that seem to lead to bowel cancer are poor diet and ongoing digestive problems. If you have Bowel Problems then clearing them up is critical. Overcoming the problem means the pain and lifestyle issues means that your life will be much more enjoyable and you can have more choices in what and how you eat.

Not dealing with the problem can lead to bowel cancer and maybe it will kill you.

This sounds overly dramatic but the reality is that real drama comes when you do a cancer test and it comes back positive. Anything you can do now to prevent that happening later needs to be seriously considered.

One of the risk factors is obesity so if you are over weight then this is another reason to look at trimming up.

The major thing that you can do in a normal lifestyle is to add some exercise, add some fiber and add the nutritional factors that 5 to 8 serves of fruit and vegetables can give you.

One of the issues involved in getting your diet right is that you need to be able to absorb the nutrition you are eating. If your villi (in the small intestine) are “energetically impaired” and you are not absorbing the nutrition from your food you eat then you will have problems. Check out our article on how your body absorbs nutrition and it will give a fairly clear picture of why this is all so important to your overall health. That article is here: nutrition for your cells

Further reading through our articles on health issues will give you a body of information that will help you decide what options you have to deal with the underlying causes of your Bowel Cancer problem through giving your body the nutrition products that will assist you body to heal from the inside out. We wish you well in your search for solutions to this problem and your movement towards better health in all areas.

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