Bowel cancer symptoms explained by Doctor Richard Roope

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The decreased ability to exercise, through fatigue and pain could be a sign that you have bowel cancer. Whilst it could also be unrelated, it is important to see your GP if you find that you have a sudden struggle to exercise.

Throughout our lives, the lining of the bowel constantly renews itself. This lining contains many millions of tiny cells, which grow, serve their purpose and then new cells take their place.

Each one of these millions of cells contains genes that give instructions to the cell on how to behave. When genes behave in a faulty manner, this can cause the cells to grow too quickly, which eventually leads to the formation of a growth that is known as a polyp. This can be the first step on the road towards cancer.

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:

• Intermittent, and occasionally severe, abdominal pain – this is always bought on by eating
• Unintentional weight loss – with persistent abdominal pain
• Constant swelling of the tummy – with abdominal pain
• Being sick – with constant abdominal swelling.

The development of a bowel cancer from a polyp may take between five and 10 years, and early on there may be no symptoms at all.

The most common symptoms are bleeding from the bowel, a change in bowel habit, such as unusual episodes of diarrhoea or constipation and an increase in the amount of mucus in the stool.

A bowel cancer can enlarge causing partial or complete blockage of the bowel leading to abdominal pain, constipation and bloating.

The decreased ability to work and exercise can be caused by small amounts of bleeding, which could go unnoticed and result in the development of anaemia.

Unexplained weight loss is also a symptom.

Some of these symptoms are similar to those of Irritable Bowel Syndrome (IBS).

However, a prolonged change in bowel habit lasting more than two or three months should always be investigated. If you have a family history of bowel cancer you should visit your doctor within a few weeks of any changes.

Achieving a complete cure of bowel cancer usually depends on detecting it early on and if people wait too long before reporting symptoms, the opportunity to remove the cancer completely may be lost.

An early diagnosis can also be made in the absence of symptoms by the use of screening.

If a person is young when bowel cancer is diagnosed or if cancer is very common in the family, it may be that there is an inherited genetic abnormality, such as Lynch Syndrome, a condition that increases the risk of bowel cancer.

In such circumstances, brothers, sisters and children may be referred to a specialist for advice.

If the risk of inherited disease is high enough some relatives may be advised to undergo a regular colonoscopy.

There are uncommon and inherited conditions including familial adenomatous polyposis (FAP) in which numerous polyps develop throughout the bowel and the cancer risk is greatly increased.

Unless the tumours are very small and can be removed by a local operation, most cancers of the rectum need to be carefully assessed (usually at the MDM as above) before any surgery takes place.

Chemotherapy or radiotherapy can decide whether or not the cancer can be shrunk down by radiotherapy or chemotherapy before surgery as this can often improve the outcome of the cancer.

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