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Bowel Cancer Awareness Month April 2016


    A blog to raise awareness of bowel cancer- reported to be the fourth most common cancer in the UK, with over 41,000 people being diagnosed every year in the UK, and the importance of early diagnosis and treatment.

    By Richard Coleman

Bowel cancer UK, a leading bowel cancer charity, are raising awareness of bowel cancer, the importance of screening and the need for an improvement to ensure individuals who have advanced bowel cancer have access to better treatment and care.

It is reported that nearly 4,000 people are diagnosed with advanced bowel cancer each year in the UK, and typically they have a poor outlook, but access to surgery and drugs can help extend life and at times be curative. Some of the changes they recommend include:

1) Reducing inequalities in access to potential life-saving liver surgery;
2) Improving access to cancer drugs based on clinical need and not postcode;
3) Provide better communications and support for people with palliative and end of life care needs.

What is bowel cancer?

Bowel cancer (also known as colorectal cancer or colon cancer) is a cancer that affects the colon and rectum.

The factors that can increase the risk of bowel cancer are:

  • Aged over 50;
  • A family history of bowel cancer;
  • A history of non-cancerous growths (polyps) in your bowel;
  • Longstanding inflammatory bowel disease such as Crohn’s disease;
  • Type 2 diabetes;
  • An unhealthy lifestyle.

What are the symptoms and how is bowel cancer diagnosed?

Symptoms for any type of illness differ for each individual, but the key symptoms of bowel cancer are:

  • Bleeding from your bottom and/or blood found in stools;
  • A change in bowel habit lasting for 3 weeks, such as diarrhoea, constipation, or a higher frequency of passing stool;
  • Unexplained weight loss;
  • Extreme tiredness for no obvious reason;
  • A pain or lump in your tummy.

These symptoms can be associated with other health issues and therefore may not always be bowel cancer, but if you have one or more of these, or if you do not feel quite right, the message is that you should go and see your GP immediately.

If bowel cancer is suspected by your GP, they will likely refer you to the hospital where a specialist will perform the relevant tests and examinations. A colonoscopy is the usual procedure which is an examination that looks into the lining of the whole bowel to see if there are any polyps or a cancerous tumour within any part of it.

Further tests include a sigmoidoscopy, an examination to look into the rectum or a barium enema- a detailed x-ray of the bowel.

Why is early diagnosis important?

As with most cases of cancer, chances of recovery depend on how far along the cancer has developed when diagnosed. If diagnosed early enough, when the cancer is at stage 1, the chances of surviving a further five years is reported to be as high as 90%, and a complete cure is usually very likely. However, if bowel cancer is diagnosed at an advanced stage, the five year survival rate is by contrast 6%, with a complete cure very unlikely.

Although bower cancer can affect individuals of all ages, it is far likely to occur in people over the age of 50. Statistics show that 9 out of 10 bowel cancer diagnoses (94%) are for people over the age of 50.

The National Institute for Health and Care Excellence (NICE) guidelines have taken this point into account and recommend that GPs are expected to arrange for an “urgent” referral to a specialist within two weeks.

Screening for bowel cancer

There is also an active bowel cancer screening programme in operation in England for those aged 60 and above, and raising awareness of this is the focus of Bowel Cancer UKs specific awareness campaign this month.  Screening in the UK is undertaken by patients taking a stool sample which is then checked for traces of blood.

Any patient over the age of 60 in England who is registered with a GP should automatically receive an invitation to be screened.  Having said that, Cancer Research UK recently published data showing that less than half of all patients took up the option of screening, despite clear results that the screening programme had identified more than 7,000 cancers in the first 4 years of operation.  Patients are therefore urged to take up the option of screening which could lead to an earlier diagnosis.

I have also been interested to read about different screening programmes in other countries, such as in Germany where patients are invited for a colonoscopy to screen for bowel cancer.  Initial results reported suggest that within ten years of the start of the screening program, the number of new cases of bowel cancer has significantly dropped in the age groups 55 years and over.

Hope going forward and what can be done?

Bowel cancer is entirely treatable if caught early enough. It is imperative that all individuals are aware of the signs and symptoms of the disease and the availability of the bowel-cancer screening program which is aimed at regularly screening everyone aged 60 and over for bowel cancer.

My colleagues and I in the Clinical Negligence Team are fully supportive of the Bowel Cancer Awareness campaign this month, and hope that increased awareness will seek an increase in the uptake of screening available to the most at risk age group.

Unfortunately, we have represented individuals who have suffered a delay in diagnosis due to the failures of a GP/medical team in referring the patient to a specialist or a failure to act promptly to the patients test results. These patients are often then diagnosed at a later stage, requiring more extensive treatment and a worse long term outcome and therefore demonstrate clearly why early diagnosis is so important.

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