Bowel cancer is one of the most common types of cancer in the UK, and unless it is properly treated, it can also be one of the most serious. This form of cancer affects the large bowel, and can affect your daily life in various ways if you are diagnosed with the disease.

As with all forms of cancer, the seriousness and treatability of bowel cancer will often depend on how early it is diagnosed. If it is caught before the cancer spreads, it will be possible to provide effective treatment and ensure that the patient achieves a positive outcome. As such, it is vital for anyone at risk of this disease to be aware of the most common bowel cancer symptoms, in order to make sure the signs can be spotted early.

At JMW Solicitors, we have seen the long-term health impact that a failure to diagnose early-stage bowel cancer, also known as colorectal cancer, can cause. As such, we have created a guide to the signs, symptoms and therapy options available for people with bowel cancer, in order to make it easier for those affected to get the treatment they need.

What is bowel cancer?

Bowel cancer targets the body's large bowel, which is made up of the colon and rectum. Depending on the exact part of the bowel that is affected, this condition is also called colorectal cancer, rectal cancer or colon cancer.

As with all forms of cancer, it develops as a result of cells in this part of the body forming abnormal mutations, resulting in collections of cells that grow in an uncontrolled way. Initially, these growths are not necessarily cancerous, and may simply result in a benign polyp on the colon wall. However, these precancerous polyps can develop into cancerous cells over time, which is why doctors will often act to remove these growths before they become harmful.

According to statistics provided by Bowel Cancer UK, nearly 43,000 people are diagnosed with bowel cancer every year in the UK, making it the fourth most common form of cancer in the UK. It is also the second biggest cause of cancer deaths.

The same stats also show that around 268,000 people are living in the UK today who have been diagnosed with bowel cancer, and more than 16,500 people die from the disease in the UK every year. Despite the widespread and potentially deadly nature of the disease, the number of people dying from bowel cancer has been dropping in recent years, thanks to earlier diagnosis and the availability of better colon cancer treatment options.

Overall, the stats show that although bowel cancer is a relatively common condition, it is very survivable if it is caught in its early stages. This is why knowing the symptoms of bowel cancer is so important.

What are the most common signs and symptoms of bowel cancer?

There are a number of common bowel cancer symptoms that may act as early warning signs. More than 90% of people with bowel cancer have one or more of the following symptoms:

• A persistent change in bowel habits, including: needing the toilet more often; experiencing looser and runnier stool; feeling abdominal pain
• Observing blood in their stool - sometimes rectal bleeding can be a result of piles/haemorrhoids, but if you do not have any other haemorrhoid symptoms, the bleeding may be due to some form of rectal cancer
• Abdominal pain, discomfort or bloating regularly associated with eating
• Unexplained weight loss or a reduction in appetite

In some cases of colorectal cancer, cancer cells may result in a blockage in the digestive tract, and will stop digestive waste passing through your intestines. This is known as a bowel obstruction, and is associated with other symptoms, including:

• Intermittent and sometimes severe abdominal pain that occurs whenever you eat
• Unintentional weight loss, with persistent abdominal discomfort
• A constant swelling of the stomach area, again accompanied by abdominal pain
• Nausea and vomiting paired with constant abdominal swelling

Conversely, constipation is not a condition generally associated with serious bowel conditions, and is unlikely to be a symptom of bowel cancer.

What else could your symptoms be?

Although all of the above signs are potential symptoms of bowel cancer, it is important to note that none of them are guaranteed signs of cancer. In fact, the vast majority of people with these symptoms do not go on to develop colon cancer, as there are a number of other common conditions that might explain your symptoms instead.

Examples include:

• Anal fissures
• Crohn's disease
• Diverticular disease
• Irritable bowel syndrome (IBS) or inflammatory bowel disease
• Piles/haemorrhoids
• Ulcerative colitis

What are the common risk factors for bowel cancer?

Although bowel cancer is one of the more common cancer types, your risk of developing the disease will vary significantly depending on a number of factors:

• Older people are at an increased risk of colorectal cancer - more than 90% of cases of bowel cancer develop in adults over the age of 50, and nearly 6 out of 10 cases develop in those aged 70 or older
• Men have a higher colon cancer risk than women - it is estimated that one in 15 men will develop colon cancer at some point in their lives, compared to one in 18 women
• Having a family history of bowel cancer is known to increase colon cancer risk, especially when pertaining to a first-degree relative - such as a parent or sibling - under the age of 50
• People with existing digestive disorders are more likely to develop rectal cancer - for example, those who have been affected by Crohn's disease or ulcerative colitis for more than 10 years
• Certain genetic conditions may act as risk factors for colon cancer. Examples include familial adenomatous polyposis (FAP), a condition associated with the growth of non-cancerous polyps inside the bowel, and hereditary non-polyposis colorectal cancer (HNPCC), a genetic defect that is also known as Lynch syndrome. People with these conditions are at a very high risk of going on to develop colon cancer

Additionally, there are a number of controllable lifestyle-related risk factors that may affect how often colon cancer develops. These include:

• An unhealthy diet that is heavy in red or processed meat
• Smoking, which also increases your risk of various other cancers, as well as conditions such as heart disease
• Drinking alcohol in excess quantities
• Being overweight or obese, which is linked to a particularly heightened risk of bowel cancer in men
• Physical inactivity and sedentary lifestyles

When should I see a doctor about possible symptoms of bowel cancer?

You are advised to seek medical attention if you have been experiencing symptoms of bowel cancer for three weeks or more - for example, if you have noticed a persistent change in your normal bowel habit, or are showing signs and symptoms of a potential bowel obstruction.

In most cases, the symptoms will not turn out to be caused by cancer, but whatever the outcome, it is always best to be assessed by your GP as early as possible.

If you have already been examined for symptoms of bowel cancer and you find that the signs have persisted or keep coming back after stopping treatment, you should return to your GP and get examined again. This will allow them to refer you to the hospital for further tests.

How is bowel cancer diagnosed?

For those who are already experiencing symptoms of bowel cancer, the diagnostic process will start when you visit your GP. You will be asked to tell your doctor about the symptoms you have been experiencing, their frequency and severity, as well as provide information about your family history and general health.

Your doctor will then conduct a physical examination of your abdomen and back passage, via a digital rectal examination (DRE), to look for any lumps or external signs of illness. After this, you may be subject to the following tests:

• Flexible sigmoidoscopy - an examination of parts of your large intestine using a long, thin and flexible camera tube inserted through the back passage and into the bowel
• Colonoscopy - a more thorough examination of the large bowel using a colonoscope, which is similar to a sigmoidoscope but longer
• CT colonography - an alternative scanning method that uses a CT scanner to produce a three-dimensional image of the large bowel and rectum
• Laboratory tests of your stool samples to identify whether they contain any traces of blood
• A blood test to look for signs of iron-deficiency anaemia, marked by a low number of red blood cells. This may be a sign that blood is being lost as a result of the cancer

Based on the result of these tests, your doctors will be able to diagnose whether or not you have bowel cancer, and if so, to what stage the disease has progressed.

Additionally, bowel cancer can also be diagnosed through routine NHS colon cancer screening. These regular screening tests are available to everyone aged 60 to 74 years, and the programme is expanding over time, with the aim of eventually making it available to everyone over 50.

These home test kits are called faecal immunochemical tests (FITs), and are sent out to everyone within the eligible age bracket every two years. By sending a small stool sample, it becomes possible to detect signs of hidden blood in the stool and detect bowel cancer in its early stages.

For those with a known family history or other risk factors for bowel cancer, it is recommended that you speak to your GP to discuss your concerns, and you also may be able to undergo regular screening tests to identify signs of the disease.

How is bowel cancer treated?

If you are diagnosed with bowel cancer, there are a number of potential treatment options available to you, depending on how advanced the cancer is, and how far it has spread. These include:

• Chemotherapy and radiotherapy to attack the cancer cells directly
• Targeted therapies and medicines designed to interrupt the biological processes that cancerous cells use to spread inside the body
• Surgery to remove the cancer cells, or sections of the lining of the colon wall to prevent the cancer from spreading
• Stoma surgery to divert the flow of faeces away from the area affected by the bowel cancer, and into a colostomy bag until the effects of the surgery have healed

The treatment chosen will depend on numerous factors, including the type of bowel cancer, the affected area and the potential impact of the treatment's side effects on the person in question. This will need to be discussed with your doctor when the time comes, and they will be able to advise you on a course of treatment that is most likely to deliver the best outcome.

What are the long-term prospects of living with bowel cancer?

Bowel cancer can be a serious condition, but thanks to advances in diagnostic methods and treatment techniques, the long-term prognosis is relatively positive.

According to data from Cancer Research UK:

• Nearly 80% of people with bowel cancer survive with the disease for one year or more
• Nearly 60% live with bowel cancer for five years or more, and just under 55% do so for at least 10 years
• Bowel cancer survival in the UK has more than doubled in the last 40 years

Surviving bowel cancer may pose certain ongoing health challenges beyond the initial recovery from surgery. For example, you may need to live with a stoma for an extended period of time, or you may experience issues with sexual confidence. If you have had part of your colon removed, you may also experience more frequent diarrhoea and changes to your normal bowel habit, which may require you to change your diet in the long term.

If you are living with bowel cancer in the long term, it is important to look after yourself, and to call upon all of the available resources and support available to you. This may include:

• Speaking to your GP or specialist clinician for advice on how to manage your condition
• Reaching out to other people with the same condition through bowel cancer support groups
• Learning as much as possible about your condition and the lifestyle changes that can help you live a happier and healthier life
• Relying on family and friends for practical and emotional support

How can I reduce my risk of developing bowel cancer?

Although there are no guaranteed ways to prevent colon cancer, there are numerous lifestyle changes that people can make to reduce their risk of developing this type of cancer. These include:

• Eating a healthy diet, keeping red and processed meat to a minimum while eating plenty of fibre
• Maintaining a healthy weight, or taking steps to lose weight if you are obese
• Engaging in regular physical activity and avoiding an overly sedentary lifestyle
• Avoiding drinking and smoking
• Paying attention to the regularity of bowel movements, and seeking medical attention if these change for unexplained reasons

By taking these steps, people who have not previously had colon cancer can minimise their risk of developing the disease, while those who have been affected by bowel cancer symptoms in the past can reduce the chances of a recurrence.

Download our bowel cancer infographic

JMW Solicitors has compiled an infographic that highlights the most common signs and symptoms of bowel cancer, in order to make it easier for people to understand the condition and its treatments.

Click on the image below to find out more.