Royal Prince Alfred Hospital
Royal Prince Alfred Hospital
Department of Colorectal Surgery

Colorectal Surgery

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Colon and rectal cancer

Colorectal cancer (bowel cancer) is a very common cancer in Australia – affecting about 1 in 20 Australians.

Who gets colorectal cancer?

Colorectal cancer becomes more common with age. Most patients with colorectal cancer develop the condition between 55 and 75 years of age. Men and women are equally affected although cancers of the rectum occur more frequently in men.

Patients with a family history of cancer or polyps have a higher risk of developing colorectal cancer. The risk of colorectal cancer increases with the number of risk factors such as: the number of family members with colorectal cancer (especially if on the same side of the family), younger age at diagnosis of colorectal cancer, multiple cancers in the same individual.

Some conditions of the bowel also predispose to colorectal cancer including ulcerative colitis and Crohn's disease. Maintaining a healthy lifestyle with regular exercise and maintaining a balanced diet low in saturated fats may also help reduce the risk of bowel cancer.

What symptoms do patients with colorectal cancer have?

The type of symptoms experienced varies depending on the location of the cancer and how early or advanced the cancer is. Common symptoms include change in bowel habits, rectal bleeding, abdominal pain, weight loss and anaemia.

Patients may have cancers detected at the asymptomatic stage with a stool test which forms the bowel cancer screening program.

Tests for colorectal cancer

Most patients with a colorectal cancer will require several tests to confirm the diagnosis of cancer and to allow the doctor to determine has spread. These tests include:

  • Colonoscopy: allows the surgeon to determine the location of the tumour and to take a sample at the time to confirm the diagnosis

  • CT scan: to check the lungs and liver to determine if the tumour has spread

  • CEA test: a tumour marker that can be helpful in confirming diagnosis and may allow for early detection of cancer recurrence after treatment

  • Patients with rectal cancer may also be required to undergo an MRI of the pelvis, PET scan and/ or a trans-rectal ultrasound.

Treatment for colorectal cancer

The mainstay treatment of colorectal cancer is surgery. This involves removal of the part of the bowel where the tumour is located as well as the lymph glands surrounding this part of bowel. Most patients will be able to have the ends of the bowel rejoined together although some patients may require a temporary or permanent stoma bag.

After surgery, the cancer will be sent for further analysis which will determine if chemotherapy is necessary. Patients with rectal cancer may also require radiotherapy. More information can be found at www.bowelcanceraustralia.org.

Reviewed 2017