by CATHERINE NGUYEN
Bowel cancer is also called colon or rectal cancer depending on where the cancer begins. It is the third most common cancer in Australia and is more widespread in people over the age of 50, but occurrences in young people are on the rise. Bowel cancer is the second deadliest cancer, claiming 101 Australian lives each week. Amazingly, 99% of cases can be treated successfully if found early, making it critical to be aware of symptoms and see your doctor early.
Warning Signs
The most common symptoms for bowel cancer are:
- An obvious change in bowel habit such as diarrhoea, constipation, or going to the toilet more often
- A change in shape or appearance of your stools
- Blood in your stools or rectal bleeding – this should never be ignored!
- Frequent gas pain, cramps, or feeling full or bloated in the bowel or rectum
- Unexplained anaemia causing tiredness, weakness or weight loss
- A feeling that the bowel has not emptied completely itself after going to the toilet
- Pain or a lump in the anus or rectum
- Abdominal pain or swelling
While these symptoms may be suggestive of bowel cancer, they may also be caused by other medical conditions, some foods or medicines, and are not cause for panic. If you experience any of these symptoms for two weeks or more, please see your doctor.
The more information you can provide, the easier it will be for your doctor to make an accurate diagnosis. Bowel Cancer Australia recommends tracking your symptoms in a symptom diary to assist with this process.
Investigations
Early diagnosis is critical and so it is of utmost importance that your symptoms are investigated thoroughly.
In addition to asking questions about your symptoms at the initial appointment, your GP may feel your stomach for any lumps or tenderness, and may also perform a rectal examination to check for any suspicious lumps or swelling in the bottom or rectum.
Your GP may also ask you to have a blood test to see if there are signs that you are losing blood in your stools. The blood test can also check your red blood cell count as low red blood cells are common in people with bowel cancer.
You may be asked to have an immunochemical faecal occult blood test (iFOBT) depending on your symptoms. This involves taking samples of your stools at home using a test kit which are then analysed at a pathology laboratory to detect any blood in your bowel motions. Test kits are currently sent out to Australians from the age of 50 as part of the National Bowel Cancer Screening Program.
Some key points to keep in mind include:
- If your GP does not examine you, you should ask why not. You should also seek a second opinion if you are not satisfied with your doctor’s diagnosis or you are still concerned.
- If there is no clear cause for your symptoms, your GP may ask you to watch and wait for a week or so to see if things improve. It is very important to go back to your GP again if the problem(s) you are having do not get better. You should then be referred for further investigations by a specialist.
- The iFOBT is not the most accurate diagnostic test for bowel cancer. A negative test result means that no blood has been detected in the samples provided, and does not mean that you do not have bowel cancer. If your symptoms persist even after a negative result, you need to seek further testing.
- If your symptoms include any unexplained signs such as blood in your stools, changed bowel habit, anaemia or a lump in your abdomen, you should be referred by your GP for further investigation via colonoscopy within 30 days.
A personal note
I wish I had known all of these when my husband started having symptoms in January 2015. He saw his GP multiple times but was diagnosed as potentially developing food allergy or lactose intolerance. It was not until July when we sought a second opinion that the doctor suspected bowel cancer. He was asked to have an iFOBT immediately, but unfortunately the result came back negative. We breathed a sigh of relief and waited for a specialist to come back from holiday to perform a colonoscopy in November. By then, the cancer had blocked his colon completely and he was diagnosed with stage 4 colon cancer on 1 December 2015. He passed away in May 2017.
I have now known many people including my cousin, my neighbour and friends who have had bowel cancer and survived, and so have developed a deep appreciation for the importance of early diagnosis. It is most likely that my husband would still be here with me now if we had not lost those precious months in 2015.
Early diagnosis is everything when it comes to bowel cancer. Please be vigilant and don’t let time slip away from you.
Catherine has been volunteering with Peter MacCallum Cancer Centre since 2017, and joined Solaris Cancer Care as a blog writer in early August 2020. She cared for her father and her husband with cancer, and the experiences changed her life. Catherine developed a passion for researching all matters relating to cancer during her husband’s fight, and is keen to continue building on her knowledge and using it to help others.
