Watch Out! Bowel Cancer Strikes At 60
Bowel cancer is a general term that is used to describe cancer that begins in the large bowel. Depending on where in the bowel the cancer starts, bowel cancer can sometimes be referred to as colon cancer, or rectal cancer. For various reasons, a significant increase in the incidence of colon cancer has been noted in the last decade.
Approximately 80 per cent of bowel cancer cases develop in people aged 60 years and above. Two thirds of bowel cancers develop in the colon, with the remaining third developing in the rectum. Many patients visit the doctor for the first time when their cancer is already at a very advanced stage and has spread to the liver and other organs. Unfortunately, such patients die within a year, despite the best possible treatment.
Risk Factors For Bowel Cancer
- Eating a high-fat diet
- Bowel conditions like Crohn’s disease and ulcerative colitis
- A family history of bowel cancer
- Alcohol misuse
- Excess smoking
- Blood in stools and/or bleeding from rectum.
- A change in normal bowel habits that persist for more than six weeks, such as diarrhoea, constipation, or passing stools more frequently than usual.
- Persistent abdominal pain.
- Unexplained weight loss.
- In some cases, it can also cause an obstruction in the bowel.
Origin And Spread
- Most cases of bowel cancer first develop as clumps of cells on the inner lining of the bowel. These clumps are known as polyps. (But development of polyps does not necessarily mean that you will get bowel cancer.)
- Bowel cancer can spread through the walls of the bowel into nearby lymph nodes.
A doctor will carry out a physical examination known as digital rectal examination. It involves the doctor gently placing his finger into the anus, and then up into the rectum, trying to feel any lump. In further examination, the tests that are used to confirm diagnosis of bowel cancer are:
- Colonoscopy – the examination of the entire large bowel.
- Barium enema – a type of X-ray to study the bowel in more detail.
Further testing will be done if the diagnosis of bowel cancer is confirmed. It is usually carried out for two reasons: To check if the cancer has spread from the bowel to other parts of the body and to help decide what will be the most effective treatment. The tests may include:
- CT scan and MRI scan – to provide a detailed image of the colon.
- Ultrasound scans – to look inside other organs, such as liver, to see if the cancer has spread there.
- Chest X-rays – to assess the state of the heart and lungs.
- Blood tests – the cancerous cells release a special protein, known as tumour marker, which can be detected through a blood test.
Staging And Grading After Diagnosis
At the completion of these examinations and tests, it should be possible to determine what stage and grade the cancer is. Staging refers to how far the cancer has advanced, and grading relates to how aggressive the cancer is and how likely is it to spread.
Screening For Bowel Cancer
- Screening is done by testing the stool sample for the presence of blood. All patients with positive stool samples for occult blood should undergo endoscopic examination of the colon.
- All healthy persons aged above 60 years and having any of the risk factors mentioned must undergo colonoscopic screening.
- Screening is important; the earlier the diagnosis, the greater is the chance of complete cure. Bowel cancer that is diagnosed in its earliest stages has a fair rate of patient survival and complete cure is usually possible.