#BowelCancerAwarenessMonth A Guide to Bowel Cancer

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Clinical Negligence Article

07 April, 2021

What is Bowel Cancer?

Bowel Cancer, also known as Colorectal cancer includes large-bowel cancer (colon cancer) and rectal cancer. The large bowel has five sections (ascending colon, transverse colon, descending colon, sigmoid colon and the rectum). Cancer develops as a result of cells changing and growing in an uncontrolled way.

Facts about Bowel Cancer

  • Bowel cancer is the fourth most common malignancy in both men and women in the UK, and the second most common cause of cancer death*.
  • 85% percent of cases are diagnosed in people aged 60 or higher
  • More than 40% of diagnoses are in those over 75 years of age
  • One in 15 men and one in 18 women in the UK will be diagnosed with colorectal cancer in their lifetime*.
  • Adenocarcinoma arises from the inside of the bowel and accounts for 95% of colorectal cancer.
  • 54% of bowel cancer cases in the UK are preventable*.

How can the risks of contracting Bowel Cancer be reduced?

  • increase fibre in your diet
  • reduce consumption of processed meat
  • Avoid being overweight
  • Stop smoking
  • Reduce alcohol consumption
  • Increase exercise

Hereditary factors can also mean a higher-than-average risk. Other conditions associated with an increased risk factors include inflammatory bowel disease.

Symptoms of Bowel Cancer

Symptoms of Bowel Cancer can include:

  • bleeding from the rectum or blood in the stool
  • a change in bowel habits
  • development of a lump
  • the sensation of needing to strain to pass a bowel movement
  • pain in the stomach or rectum
  • anaemia (lower than normal levels of red blood cells)
  • weight loss.

Diagnosis of Bowel Cancer

Referral should be to a team specialising in the management of colorectal cancer. The recommendations for the investigation and diagnosis of colorectal cancer are outlined in the NICE Guidelines 2014. Initial investigations should be with either a colonoscopy or a sigmoidoscopy, depending on the patient's medical history and any other existing problems, staging is by way of a CT scan or MRI scan.

Staging of Bowel Cancer

Staging is essential to effective treatment and dictates condition and prognosis. The international standard for colorectal cancer staging is the TNM system, which takes into account the size and position of the primary tumour (T), whether there is any lymph node spread (N) and whether there is any metastatic disease (M).

Management of Rectal Carcinoma

Rectal cancer is managed according to the NICE Guidelines published in 2011 and updated in 2014 (CG131). The basis of treatment is as follows:

  • Pre-operative radiotherapy and operation.
  • chemoradiotherapy
  • Adjuvant chemotherapy is considered in patients with high-risk stage Il and all stage I ll rectal cancers.
  • Metastatic disease is managed with systemic treatment, with possible resection

Survival rate of Bowel Cancer

The NHS bowel screening programme has increased survival. The stage of disease at diagnosis generally dictates diagnosis. Stage I l colorectal cancer has a five-year survival rate of about 84%. Stage Ill colorectal cancer has a five year survival rate of about 65%. Stage IV colorectal cancer has a five-year survival rate of about 10%.*

The guidance for follow-up was introduced in 2011 with the NICE Guidelines. At least two CT scans of the chest, abdomen and pelvis should be performed in the first three years, as well as regular serum CEA tests.

*Bowel Cancer | Bowel Cancer UK

For more information contact Leonie Millard in our Clinical Negligence department via email or phone on 01254 770517. Alternatively send any question through to Forbes Solicitors via our online Contact Form.

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