Cancers of the colon and rectum are amongst the most common cancers. They tend to progress relatively slowly, and usually follow the same pattern of spread from the inside of the bowel, through its wall and via veins and lymph nodes to the liver and/or lungs.
There has been much debate about the contribution of diet to the development of bowel cancers, and it is thought that too much saturated fat and too little fibre do increase the risk of bowel cancer. Your bowel habit can play a role: chronic constipation can be a contributory factor to bowel cancer. Family history is a very important factor in some cases.
Cancer of the bowel can be difficult to detect in its early stages, as the warning signs can be easily overlooked. The symptoms you may notice include blood in your stools, a change in your bowel habit to diarrhoea or constipation and abdominal pain and swelling. Blood in your stool can, of course, be caused by other conditions such as haemorrhoids – but you should still consult your doctor to check.
The diagnosis of bowel cancer involves physical examination, testing of the stool to check whether blood is present, a barium enema X-ray to look at the bowel in more detail and usually further scans to check whether any spread has occurred.
Surgery forms a major part of treatment for cancer of the bowel. Since the aim is to remove the tumour completely this may involve removing a significant portion of the bowel itself, depending on the size and position of the tumour. This may lead to a need for a temporary or permanent colostomy or ileostomy (these are discussed in Chapter 3), so it is very important to discuss the extent and nature of surgery in detail with your doctor to ensure that you fully understand the likely results and implications. If the cancer is still in its early stages, then surgery may bring a complete cure – although it will be some years before this can be confirmed. Radiotherapy may also be considered, usually in addition to surgery as a follow-up treatment, as may chemotherapy.
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