June 28, 2007

Bowel Cancer

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Cancer is the uncontrolled growth and spread of abnormal cells. Bowel cancer is caused by the abnormal growth of cells in some part of the bowel to form a lump or tumour. Bowel cancer is most common in the large bowel which is made up of the colon and rectum.

Normally, the body's cells reproduce themselves in an orderly manner so that growth occurs and damaged or worn-out tissues are replaced. Sometimes, however, cells continue growing into a mass of tissue called a tumour which can be benign (noncancerous) or malignant (cancerous). In some cases, the malignant cells can spread to other parts of the body through the blood or lymph system. New cancers formed in this way are called secondaries or metastases.

Bowel cancer is more common in older people, and is the second most common cancer in NSW with about 3,500 new cases being diagnosed in NSW each year, and around 8,700 Australia wide. About 1 in 22 Australians will develop bowel cancer by the age of 75, and about 4,000 Australians will die from bowel cancer each year.

What are the signs or symptoms?
You should see your general practitioner if you notice any of the following symptoms:

Blood in the bowel motion or in the toilet bowl. If you are over 40 it is a good idea to check the toilet bowl and the toilet paper after each bowel motion.
Changes in your toilet habits lasting more than two weeks.


How can I prevent bowel cancer?
There are a number of factors which increase your chances of getting bowel cancer.

These are:

being over 40 years of age
having bowel polyps or previous bowel cancer
having had ulcerative cloitis or Crohn's disease for more than eight years
having one or more close relatives who have had bowel cancer, especially if they were under 50 years of age

having a member of a family with familial adenomatous polyposis or another family cancer syndrome.

You should ask your general practitioner whether you should have regular tests to check for early bowel cancer if you are in any of the above groups.

There are a number of tests that can be carried out to see whether you have bowel cancer. These include:

digital rectal examination,where the doctor inserts a gloved finger into the anus (back passage) to check the rectum

occult blood test, which tests if there are small amounts of blood in the bowel motion
sigmoidoscopy, where a tube-like instrument called a sigmoidoscope is used by a doctor to look inside the rectum and lower colon

colonoscopy, where a longer flexible tube-like instrument called a colonoscope is used by a doctor to look inside the rectum and whole colon

barium enema, where the bowel is filled with a mixture containing barium, and an X-ray is then taken which gives an enhanced picture of the bowel.

How can bowel cancer be treated?
If a test indicates that cancer is present, a number of treatments are available.

These include:

surgery to remove all the cancer in the hope of a cure. A permanent colostomy bag is rarely used today.

chemotherapy, which is a course of drugs given to kill or control the cancer cells
radiotherapy, which is a course of high energy X-rays given to kill or control the cancer cells. (Chemotherapy and radiotherapy do not cure cancer but may result in long-term control in some types of bowel cancer.)

The type of treatment recommended depends on the size of the cancer, whether it has spread, your general health and also what you want.

Adapted from: NSW Health