Bowel cancer
What is cancer?
The body is constantly making new cells to replace or
repair those worn out or injured. Normally, cells die and are replaced
in equal measure. Cancer develops when abnormal cells begin to multiply
at an abnormal rate uncontrolled by the body's normal mechanisms. This
causes the growth lump called a tumour.
Tumours may be cancerous (malignant) or non-cancerous (benign).
Cancerous tumours may spread to other parts of the body. These are
called metastases.
How common is Bowel Cancer?
Bowel cancer is the most common internal cancer affecting both men and women. Australia has one of the highest rates of bowel cancer in the world. The most common sites of bowel cancer are in the large bowel and rectum.
Diagram showing the large bowel and rectum
What causes bowel cancer?
The cause of bowel cancer is largely unknown. We do however, know the incidence of this disease is more common in developed countries, which suggests that diet, age and lifestyle appear to be important factors in the development of the disease. Some people carry a faulty gene (inherited from their parents) that increases the risk of bowel cancer.
What are the signs and symptoms of bowel cancer?
The most common signs and symptoms of bowel cancer are:
-
Change in bowel habit - usually this involves a change over weeks to months for no apparent reason. You may become constipated or have diarrhoea or after years of using your bowels once daily, you start going twice daily or more. It is also common for the shape of your faeces to change i.e. it may look more of a "pencil" shape rather than a bulky formed stool.
-
Bleeding from the bowel - this may appear either mixed in with the faeces, in the toilet water or on the toilet paper after wiping the anus.
-
Anaemia - this is caused by loss of blood from the bowel. This bleeding may be very slow and therefore not noticeable or from higher up in the bowel so that you don't notice it during defecation. Anaemia can make you feel tired and lethargic and in more severe cases you may experience shortness of breath or even chest pain.
-
Abdominal pain/bloating - this is usually caused by the cancer blocking the passage of faeces through the bowel. This pain may be constant or intermittent and may be mild or severe. It may be crampy, colicky or sharp in nature.
-
Weight loss without obvious reason
-
Tiredness and malaise
-
Feeling your bowel does not empty properly
How is bowel cancer diagnosed?
Abdominal examination - Some cancers can be felt through the abdominal wall.
Rectal examination - the doctor may insert a gloved finger into the anus (back passage) to feel for abnormalities in the rectum
Barium Enema - This diagnostic test is an X-ray examination using barium to outline the bowel. A small tube is inserted into the anus and liquid barium and some air is introduced. The barium outlines the bowel and X-rays are taken to show up any irregularities of the bowel wall.
Colonoscopy - A Colonoscopy is an examination using a flexible telescope through the anus and rectum and then around the colon. Prior to this test a preparation to clean the bowel needs to be taken, so the doctor will be able to get a good view of the inside of the bowel.
Surgery - surgical treatment is performed with the intention of removing the cancer. The type of operation is dependent on the position of the cancer in your bowel and if the cancer has spread. There are 4 possible types of operation you may have. These are known as a colectomy (removal of the large bowel or part of).
-
Right hemicolectomy for cancer in the right side of your colon
-
Left hemicolectomy for cancer in your left colon
-
Transverse colectomy for cancer in the middle of your colon
-
Sigmoid colectomy for cancer in your sigmoid colon
For cancers in the rectum there are two types of operation you could have:
-
Anterior resection
-
Abdominoperineal resection
|
|
|
Colectomies or an anterior resection involve removing a section of bowel and then joining the two ends together (anastomosis). In some cases the doctor needs to create a colostomy (large bowel stoma) or ileostomy, (small bowel stoma) either as a temporary measure to allow the join (anastomsis) to heal or permanently if the rectum and anus have been removed as in the operation abdominoperineal resection.
Chemotherapy and Radiotherapy:
In some circumstances your doctor may suggest you have radiotherapy prior to your surgery to shrink the cancer, or your doctor may suggest this as a treatment option after your operation. This will be discussed with you following your surgery.
General information
All operations and general anaesthetics carry some risks. These can be quite different between individuals, and should be discussed with the surgeon and anaesthetist beforehand.
Useful Contacts and Further Information
Concord Hospital has an internationally recognised Colorectal Unit and can be contacted on 97678360
Contact your General Practitioner
Or visit the following web sites
www.nswcc.org.au
www.accv.org.au/cancer1/prevent/eatbeat/questions.htm
www.gesa.org.au
|
|
|
