Publication date Sep 10, 2007
Bowel cancer is a serious disease, but it can often be cured if it's caught early enough.
If some of the cells in your body start to grow out of control, they can form a lump called a tumour. Not all tumours are dangerous. But if a tumour is cancer, parts of it can break off and spread to other parts of your body. Even if a tumour isn't cancer, you may need treatment to remove it. That's because there may be a danger it could turn into cancer in the future.
Bowel cancer happens in the parts of your body that break down the food you eat. Food travels to your bowels after it's been in your stomach. Two of the main parts of your bowel are called your colon and your rectum. Because of this, you may hear bowel cancer called colon cancer, rectal cancer or colorectal cancer.
You might not get any symptoms in the early stages of bowel cancer. Some people only find out they have it when they go for a routine screening test.
But some people do get symptoms. These include changes in your bowel habits that last for several weeks. For example, you may get diarrhoea or become constipated. You may get blood in your stools, feel as if you're not finished when you pass a stool, or get painful cramps, bloating or wind. If you have bleeding in your bowel, this can make you feel tired and look pale (this is called being anaemic). Your stools may be narrower than usual. This can happen if the cancer has partly blocked your bowel.
If your doctor thinks you may have bowel cancer, you'll need several tests. These tests can tell you for certain whether you have cancer or not. If you do have cancer, they can tell your doctor what stage it's at. You may hear your doctor describe the stage of your cancer using letters, numbers or a combination of the two. They describe how far your cancer has spread inside your body. Knowing the stage of your cancer helps your doctor decide what treatments you need.
Cancers that grow in your bowel can be treated. You have a good chance of being cured if the cancer hasn't spread very far.
Surgery is the main treatment for most people. You may also need radiotherapy or chemotherapy.
Most people with bowel cancer are treated with surgery. If your cancer was caught fairly early, your surgeon will try to remove all the cancer cells. This gives you a chance of getting rid of your cancer completely. If your cancer has spread, surgery won't be able to cure you. But your surgeon may recommend an operation to slow down your cancer or to clear a blockage in your bowel.
The type of surgery you will need depends on how big the tumour is and how far it has spread. If you have a small tumour (a polyp), you may only need a minor operation. A flexible tube is put into your back passage. Thin surgical implements are passed through this tube. Your surgeon won't need to make any cuts on your body.
If the tumour is bigger, you may need an operation to remove part of your bowel. A section is cut away and the ends from either side are joined together. Your surgeon may also need to remove some extra tissue from around your bowel.
Surgery for bowel cancer can be done through a cut in your abdomen (open surgery). It can also be done as keyhole surgery. That's when the instruments are put through small cuts in your body. Keyhole surgery seems to work just as well as open surgery. And you're likely to recover more quickly afterwards.
The part of your bowel called your colon is quite long. So, an operation to remove part of it may not have much impact on your life. Your rectum (the last part of your bowel before the anus) is much shorter. This makes surgery more difficult. There's a chance you could need a colostomy. If you have a colostomy, the surgeon makes a hole in your abdomen. Part of your bowel is then attached to this hole. Instead of passing through your rectum, waste from your bowel travels through the hole in your abdomen. It's collected in a bag.
Not everyone who has rectal cancer will need a colostomy. And for some people it's just temporary, while their bowel heals. Lots of people worry about having a colostomy. But even if you do need one, you'll get plenty of help learning to cope. Modern technology means that a colostomy is much less inconvenient than it used to be. The bags are small, and don't show through your clothes. They usually have a filter, so they don't smell. And a colostomy shouldn't stop you doing things you did before, such as playing sport.
After surgery, you'll need to stay in hospital for a few days. If you get pain, make sure you talk to a doctor or nurse. They'll be able to give you strong painkillers if you need them.
Chemotherapy uses drugs to kill cancer cells. These drugs affect your whole body, so they're good for killing any cancer cells that might have been missed by surgery or radiotherapy. There are several drugs that can be used. Some newer drugs aim to treat cancer that has spread, or can be tried if another drug hasn’t worked. Chemotherapy drugs are usually given as injections.
There's good research to show that chemotherapy after surgery helps people with bowel cancer live longer. In studies, 7 in 10 people who had chemotherapy were still alive after five years. This compared with 6 in 10 people who just had surgery. But chemotherapy had side effects. About 3 in 10 people get a side effect that needs medical help. Some common side effects include diarrhoea, swelling in your mouth and throat, or feeling very tired. Some people feel sick. You may be given other drugs to stop you feeling sick. Some people get problems with their blood that mean they bleed more easily and pick up more infections.
Radiotherapy uses high-energy X-rays to kill cancer cells. It's not used very often for cancer in the colon. But it can be used to treat cancer in your rectum (the last part of your bowel before your anus).
Radiotherapy can be used to shrink your tumour before surgery. This makes it easier for your surgeon to cut away all the cancer cells. There's some research to show that radiotherapy before surgery may help you live longer after your operation. But the benefits will depend on the stage of your cancer. Your doctor will help you decide whether the benefits are worth the side effects.
Radiotherapy can also be used after surgery. The aim is to kill any cancer cells left behind after your operation.
You'll need to go to hospital to have radiotherapy. A machine fires a beam of radiation into the spot where your cancer is. You'll be given small doses of treatment each day for several days or weeks. There's also a newer kind of radiotherapy where a radioactive pellet is implanted into your tumour.
Radiotherapy doesn't usually hurt, although you'll have to stay still for a minute or so during treatment. This can be uncomfortable. Side effects during radiotherapy include feeling very tired, feeling sick or getting diarrhoea. Other problems can happen a while after treatment. About 1 in 7 people get a blocked bowel. This may need emergency surgery. If radiotherapy damages the nerves in your abdomen, you could have problems during sex. Men might find it hard to get an erection, and women can get a dry vagina.
Bowel cancer is a serious illness. But many people are completely cured with treatment. It's natural to worry about whether your cancer could come back. Your doctor will be able to tell you about how many people recover, on average, from the stage and type of cancer you have. In general, the earlier you were diagnosed and the earlier the stage of your cancer, the better. But remember, you are not a statistic. No one can say exactly what will happen to you.
You'll have regular check-ups after being treated for bowel cancer. There's good research to show that being checked on regularly can help you live longer. If your cancer does come back, regular check-ups mean that it will get picked up and treated sooner. However, if you get any symptoms that worry you, see your doctor straight away. Don't wait for your next check-up.
People who have colon or rectal cancer often say that being diagnosed comes as a big shock. But once they have got over the shock, many people say that their illness helps them focus on the things that mean a lot to them, such as their family and relationships.
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice.
If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.