Don’t be embarrassed to go to your GP .
A consultant at West Middlesex University Hospital is urging people to go to their GP if they have symptoms linked to bowel cancer. Dr Kevin Monahan, Consultant Gastroenterologist, runs the Family History of Bowel Cancer Clinic at West Middlesex, and is speaking out to support bowel cancer awareness month during April. He says: “If for the last three weeks you’ve had blood in your poo or it’s been looser, go and see your GP. “We know that people are reluctant to visit their GP if they experience symptoms because they’re embarrassed and worried about wasting the doctor’s time. “But it could save your life. Over 90 per cent of bowel cancer patients diagnosed with the earliest stage of the disease survive five years from diagnosis compared with only 6.6 per cent of those diagnosed with advanced disease. “Bowel cancer is the third most common cancer in the UK for men and the second most common cancer for women. Every year more than 30,000 people will develop it. An estimated 13,000 people die annually from bowel cancer. “Many people worry about getting bowel cancer, sometimes because a relative has had it. At West Middlesex I run a Family History of Bowel Cancer Clinic specifically for those people who may be at higher risk of developing the disease. “The cause of most bowel cancers is not known, but we do know that some risk factors can increase your chances of developing cancer. This includes having one close relative aged under 50 or at least two close relatives on the same side of the family who developed bowel cancer at any age. “If these apply to your family and you’re worried about your risk of developing bowel cancer, you may want to talk to your GP. If your GP thinks there’s a chance you may have an increased risk of developing bowel cancer because of your family history, they can refer you to the Family History of Bowel Cancer Clinic here or elsewhere for advice and treatment.”
We have launched our ‘Never Too young’ campaign to raise awareness of bowel cancer in patients under the age of 50. Every year 2,100 younger people are diagnosed with bowel cancer in the UK, of which 21 are in their teens. Currently too many are being diagnosed late when treatment is harder and too many lives are needlessly being lost from this treatable disease.
Today from the Mirror Newspaper, By Claire Donnelly
When A Question of Sport captain Matt Dawson discovered he was at increased risk of developing bowel cancer he decided not to take any chances.
The 39-year-old former England rugby player, who lives with wife Carolin and six-month-old son Alex, explains here why he goes for regular health screenings.
Because of where it is in the body, bowel cancer is one of those things people can get embarrassed talking to their doctor about.
Let’s face it, we all feel a bit apprehensive when we know we’ve got to drop our trousers for someone.
But because of what’s happened in my family and the things we’ve all been through, I realised it was something I couldn’t ignore.
Sadly my grandfather on my mum’s side died of bowel cancer when I was a teenager. He was only 60, but by the time it was discovered it was advanced.
So it was even more terrifying when my mum, Lois, 64, was diagnosed in 2007. She was still fairly young – like many people who suffer from bowel cancer she was in her 50s – and it was a very frightening experience.
It was actually quite difficult for her to get a diagnosis, even with the family history. She’d gone to the doctor because she had symptoms, but still had to push for a diagnosis so she could finally begin her treatment.
It must have been very hard for her to do that, especially after seeing her own dad being so ill, but she knew that something wasn’t right.
And because she also knew that bowel cancer is one of the more treatable cancers, she kept going back to her doctor. Thankfully she had surgery and treatment and has been well for five years now.
But because of that strong history – having two ‘first degree’ relatives diagnosed – it does mean I could be at more risk than others. I’m of the opinion that it’s always better to know if there’s something wrong, so about three years ago I decided to undergo screening.
It was quite full-on, a complete MOT for the body really, but I needed that peace of mind.
When you know you could be at risk it’s hard not to be anxious or even paranoid about it, but bowel cancer is treatable a lot of the time if it’s caught early enough.
For me it’s not about, ‘am I going to find out I’m terminally ill?’ it’s more, ‘can I nip something potentially very bad in the bud?’
So I had the whole screening, including a full MRI scan and fitness checks.
I was a bit nervous and it was a lot more comprehensive than I was expecting – they had me on the treadmill and looked at my eyes, ears, everything.
Yes, it was uncomfortable at times, but it was well worth it to have the reassurance that I was cancer-free – it means you can forget about it for a while.
I’m due for another screening and it’s something I’ll continue to do for the rest of my life.
It isn’t just about me. Being a dad has made me even more aware of the need to look after myself for my family’s sake.
Being in shape and eating healthily all help lower the risk of bowel cancer, too. So although I don’t train any more, I do some exercise most days, preferably outside.
I’ll jump on my bike, play golf or do some work at home or if the weather’s really bad I might head to the gym.
It’s about relaxing and feeling good. Like most rugby players I’ve had my fair share of injuries and undergone surgery on my knees, shoulder and neck, so I’m careful about how I push my body.
I was filming with my Question of Sport co-star Phil Tufnell last week, hadn’t warmed up properly and felt my hamstring twinge – that’s when you realise you’re getting older and need to be careful.
Eating well is important too, so I try to get my five a day. Since I won Celebrity MasterChef in 2006, everyone knows that I like my food. It’s important to me to prepare the right kinds of meals – full of flavour rather than salt, sugar or fat.
I’m not over the top about it and I enjoy everything in moderation, but if I make a bacon sandwich I’ll cut the fat off.
I don’t even think about it any more, it’s just become the way I do things.
Cooking is a great way to relax too. I’m not often ill but if I do feel a tickle in the back of my throat I’ll reach for the supplements – my partner introduced me to them – and it seems to do the trick.
Put it this way, I’m going to turn 40 at the end of this month and I’m not worried about it.
My 30s have been amazing for so many reasons. If my 40s are half as good – and healthy – I’ll be very happy.
Research published in the journal Gastroenterology has found that fewer than 10% of bowel cancer patients who are at high risk of having Lynch Syndrome are appropriately screened for the condition in the United Kingdom.
Lynch Syndrome is an inherited genetic disorder which affects the genes responsible for detecting and repairing damage in the DNA, around half of whom develop cancer, mainly in the bowel and womb. Lynch Syndrome causes around 3% of bowel cancer cases in the UK.
When several members of the same family are diagnosed with bowel cancer it is recommended that they are screened for Lynch Syndrome.
Researchers investigated the clinical pathways of 554 bowel cancer patients in two UK hospitals. They found that fewer than 10% of bowel cancer patients who were at high risk of Lynch Syndrome were appropriately screened for the condition.
If there’s one thing most of us don’t like talking about, it’s our bowel movements. However, your stools (that’s poo to you and me) can be a clear indicator of how healthy your insides are, particularly problems with your digestive system. Many of us are too embarrassed to talk about discomfort of going to the toilet. But even short-term problems can indicate longer-term health risks that can go undiagnosed if you don’t do anything about them.
The Food Hospital Fibre Challenge aims to tackle the toilet taboo and encourage people to make simple changes in their diet that could have significant benefits to their bowel and overall health.
Find out more about our approach.
Take the Fibre Challenge
The Fibre Challenge has been devised by specialist dietitians and is a mass participation initiative to assess the effect of fibre on the nation’s bowel health. For 21 days, you’ll eat extra dietary fibre and send information about your bowel movements (anonymously) to our expert team for analysis. The results will help us to better understand whether a high fibre diet significantly improves short-term bowel health and general well-being. There are some people who shouldn’t take part for health reasons, but the rest of you can download the app, check out the assortment of fibre foods to add to your diet, print-out our stool chart and monitor the effects of eating extra fibre over the next few weeks. Find out more about the challenge.
PATIENTS who attend bowel screening are more likely to be diagnosed with bowel cancer at an early stage – when there is a better chance of survival – than those who wait until they have symptoms of the disease.
These are the findings of new data presented at the annual National Cancer Intelligence Network (NCIN) conference in Birmingham.
Researchers say the study shows that the NHS Bowel Cancer Screening Programme is working towards its aim to reduce deaths from bowel cancer.
Researchers compared the stage at diagnosis of bowel cancers picked up through screening and those diagnosed from symptoms.
The results showed that 18.5 per cent of bowel cancers detected through screening were at the earliest stages compared with 9.4 per cent of cancers diagnosed through symptomatic routes.**
In contrast, late stage tumours were more common in patients diagnosed through symptomatic routes compared with those diagnosed through screening.***
Sam Johnson, lead researcher based at the West Midlands Cancer Intelligence Unit, said: “When bowel cancer is diagnosed at an earlier stage, it’s easier to treat, has a lower chance of coming back and better survival rates.
“Our research shows that screening can play an important role in improving bowel cancer survival by picking up cancers at an earlier stage.”
Bowel cancer is the third most common cancer in the UK – around 40,000 people are diagnosed with the disease each year.
Researchers said that once the NHS Bowel Cancer Screening Programme has been established for several more years, and has been rolled out completely to people aged 60 – 74 years old, they would expect to see fewer late stage cancers.
Chris Carrigan, head of the NCIN, said: “When bowel cancer is found at the earliest stage, there is an excellent chance of survival, with more than 90 per cent of people surviving the disease at least five years.
“Compared with breast and cervical cancers, bowel cancer tends to have a lower five-year survival rate.
“This study highlights the potential improvements we can make through encouraging more people to take-up their screening invitation so the disease is diagnosed earlier.”
Risk factors other than family history can play a more important role in the development of bowel cancer. The main risk factor for bowel cancer is increasing age. Only 7% of bowel cancer occurs before the age of 50 years. However, even if you have a family history or other genetic risk of bowel cancer, this risk can be reduced by leading a healthy lifestyle. This kind of healthy lifestyle can also reduce your risk of heart disease, stroke and other cancers. It has been recently estimated that approximately 70% of colorectal cancer could be avoided by changes in lifestyle in Western countries.
A good further source of information about dietary and other lifestyle related risk factors is available from Cancer Research UK at http://www.cancerresearchuk.org/cancer-info/cancerstats/types/bowel/riskfactors/bowel-cancer-risk-factors
Summary: A diet high in red meat and animal fat and low in fruit and vegetables increases your risk of bowel cancer. So if you want to reduce your risk of bowel cancer, whether or not you have a genetic risk, eat 5 pieces of fruit or vegetables daily, plenty of fibre, and don’t eat too much processed or red meat.
Putative anti-carcinogenic mechanisms of dietary fibre within the bowel include: the formation of short-chain fatty acids from fermentation by colonic bacteria; the reduction of secondary bile acid production; the reduction in intestinal transit time and increase of faecal bulk; and a reduction in insulin resistance. In the European Prospective Investigation into Cancer and Nutrition (EPIC) study after an average 6.2 years of follow-up, and 1,721 colorectal cancer cases, a 21% reduced risk amongst participants in the highest intake quintile was observed when compared against the lowest intake group. These results support our previous conclusion, of the potential of reducing colorectal cancer incidence by increasing fibre intake from cereal, fruit, and vegetable food sources.
In the EPIC study high intake of red or processed meat may increase risk by 71%. The mechanisms underlying the association between colorectal cancer risk and high intake of red and processed meat are uncertain. Controlled human intervention studies have raised the possibility that the endogenous nitrosation that arises from ingestion of heme iron but not of inorganic iron or protein may account for the increased risk associated with red and processed meat consumption. Heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAH) in diet may pose a potential risk of cancer to humans, depending on the extent to which the compounds are activated in vivo by metabolic enzymes. HCAs are formed as a byproduct of reactions during the cooking of meat, poultry, and fish at high temperatures, such as pan-frying or grilling with charcoal or on a gas grill; PAHs are formed in grilled and barbecued meat and in cured, processed foods. It has been suggested that processed meat intake has a stronger association with colorectal cancer than red meat intake.
Folate (a water-soluble B vitamin) appears to protect against bowel cancer, but it remains unclear whether the same level of benefit is derived from dietary folate (from food, particularly fruit and vegetables) and synthetic folate (folic acid supplements). Selenium can be obtained in food (particularly brazil nuts) and supplements; evidence for its effect on bowel cancer risk is mixed. The WCRF/AICR 2010 Report concluded that “Evidence for foods containing folate… and selenium… is less consistent and no conclusion could be drawn”.
Some experts have proposed that folate plays a dual role in bowel cancer in which moderate dietary intake before development of pre-cancerous adenomas reduces risk of adenoma development, but increased folate intake once adenomas have developed increases risk of cancer. Data from interventional studies indicate that folate supplementation decreases colonic mucosal cell proliferation . A large prospective study showing a 31% reduction in bowel cancer risk for people with the highest overall folate intake 12-16 years before diagnosis, but no effect of intakes in the more recent past.
The US Government was sufficiently convinced of the health benefits (and absence of risk) from folic acid that it introduced mandatory folic acid fortification of grain products in 1997, and a recent large cohort study found that 8.5 years on, higher total folate intake (including intake specifically from supplements) was associated with a decreased bowel cancer risk. There is some evidence that it is better to take folic acid in its natural form rather than as supplements i.e. tablets.
A 2011 meta analysis found men with the highest concentrations of selenium in the blood had 32% lower bowel cancer risk compared with men with the lowest concentrations, but found no association between selenium level and bowel cancer risk in women.3A 2004 pooled analysis found a similar level of risk reduction for both sexes combined.
Obesity is associated with an increased risk of colon cancer, particularly for men. Meta analyses show the risk of colon cancer increases by an estimated 24-30% per 5kg/m2 increase in body mass index (BMI) for men. In comparison to healthy-weight men (BMI less than 25 kg/m2), overweight men (BMI 25-29.9kg/m2) have a 23% higher risk of colon cancer, and obese men (BMI 30kg/m2 or more) have a 53% higher risk. The association is weaker in women, with colon cancer risk increasing by 9-12% per 5kg/m2 BMI increase, and the association proving non-significant in one meta analysis.
Larger waist size has been associated with increases in colon cancer risk in men (33% risk increase per 10cm waist circumference increase) and women (16% risk increase per 10cm waist circumference increase), as has increasing waist-to-hip ratio in both men (43% risk increase per 0.1-unit increase in ratio) and women (20% risk increase per 0.1 unit increase in ratio).
Higher BMI is linked less strongly to higher rectal cancer risk: a 5kg/m2 BMI increase is associated with a 9-12% higher rectal cancer risk for men (obese men have a 27% higher rectal cancer risk than healthy-weight men), but with no effect on rectal cancer risk in women
Regular physical activity can reduce your risk of bowel cancer, this is clearly shown in many studies. We would recommend 2-3 30 minute sessions per week of dedicated exercise (rather than more ‘passive’ exercise such as being busy at work!).
The relationship between physical activity and a reduced risk is one of the most consistent findings in epidemiologic literature.
Not smoking and drinking less than the upper recommended limit of normal (less than 21 units for men and less than 14 units for women) may also be helpful in reducing risk.
Core is the only charity in the UK that funds research into the entire range of gut, liver, intestinal and bowel illnesses. We are called Core because the digestive system is at the core of our body and a good digestive system is the core of good health.
The charity was established in 1971 with the help and support of the British Society of Gastroenterologists and today it supports Clinical Research Fellows and Research Scientists at hospitals and universities throughout the UK, investigating conditions such as pancreatitis, hepatitis, ulcerative colitis, irritable bowel syndrome, Crohn’s disease and digestive cancers. All research that we fund is rigorously peer-reviewed. Core is a member of the Association of Medical Research Charities.
We have a major interest in providing patients with good, accurate information about their illness. We publish 25 patient information leaflets and 15 fact-sheets explaining the nature of various gut illnesses and their treatment. Some 200,000 are distributed annually.