Gene ral Hea lth Colorectal Cancer Sadly, Australia has one of the highest incidences of bowel cancer in the world. One in 12 Australians will get bowel cancer. While we’re not sure why – maybe there is something in the food we eat, or we’re simply just living longer – the consensus is that a complex interaction between environmental and genetic factors is at play and more research is needed in order to better understand Australia's second biggest cancer killer. So what do we know about bowel cancer? We know that bowel cancer is a malignant growth that develops most commonly in the lining of the large bowel. Most bowel cancers develop, over time, from tiny growths called 'polyps'. Not all polyps become cancerous but all polyps should be removed to reduce the risk of developing into the disease. Almost all polyps can be removed during a colonoscopy. Once removed from the bowel, the polyp can no longer develop into cancer. Even if a polyp develops into cancer, in its early stages it can be cured by surgery. However, in more advanced cases, the cancer can spread beyond the bowel to other organs. Bowel cancer is the second most common type of newly diagnosed cancer in Australia, with lung cancer being the most common. 15,151 Australians are told they have bowel cancer every year. Bowel cancer is claiming the lives of 3,980 people every year. We also know that age is one of the biggest risk factors when it comes to bowel cancer and risk rises sharply and progressively from age 50. A person is also at a greater risk if they have: • Previous history of polyps in the bowel • Previous history of bowel cancer • Chronic inflammatory bowel disease (i.e. Crohn’s disease) • A strong family history of bowel cancer • Familial adenomatous polyposis or hereditary non-polyposis colorectal cancer (Lynch syndrome) • Increased insulin levels or diabetes. Given we know that if polyps in the bowel are left undetected they can lead to bowel cancer, and given we know that the risk of bowel cancer increases dramatically from the age of 50, it stands to reason that if you are aged 50 years and over, you are now in an age group at higher risk of developing bowel cancer and you need to act to try to detect polyps early. In fact, doing nothing is not an option for the 50 and overs when it comes to bowel cancer. You need to talk to your GP about your risk factors and the best and most appropriate bowel cancer screening method given your medical history. Screening for bowel cancer can be done by way of a Faecal Occult Blood Test (FOBT), or by colonoscopy, if you are thought to be at an above average risk of developing the disease. Symptoms of bowel cancer: • A change in bowel habits with diarrhoea, constipation or the feeling of incomplete emptying or “thin” bowel movements • Blood in the motion • Abdominal bloating or cramping • Unexplained tiredness • Unusual weight loss • Unexplained anaemia. From age 50, if you have no symptoms and the risk factors listed above do not relate to you, you should be screened for bowel cancer every one to two years. If you are aged 50 years or over and have symptoms, it is very important to talk to your doctor ASAP. Similarly, if you are aged 50 years or over and have a family/personal history of bowel cancer/polyps, it is important to discuss your bowel cancer risk with your doctor - you might require a colonoscopy. Gold Coast Colorectal Surgeon Dr Mark Doudle cites family history as a risk factor for bowel cancer is complex. “Family history, on its own, is not necessarily a major risk factor but family history at a young age is very important,” Dr Doudle said. “Even young people can get bowel cancer.” “If you are aged 50 or over and have a family member diagnosed at say 70, you are in the risk factor group that needs to have some sort of screening (FOBT) at regular intervals.” “If however, you have a first degree relative, who was diagnosed with bowel cancer before they reached the age of 50, you (even if you are under 50) should think about having a colonoscopy, when you are aged 10 years younger than your relative was when they were diagnosed with bowel cancer. For example, if the relative was diagnosed with bowel cancer at 48 years you should have colonoscopy when you are 38 years of age.” If someone has an abnormality, symptoms or a strong family history, they should look at having colonoscopy; otherwise, from the age of 50, they should have some sort of screening on a regular basis. “Screening can be done by way of a Faecal Occult Blood Test (FOBT) and the objective (of screening) is to detect a cancer early, before symptoms of disease exist,” Dr Doudle said. “The ideal person for FOBT screening is someone who has no symptoms. If they are experiencing symptoms, such as unusual abdominal pain or discomfort, unusual loss of weight, change of bowel habits, fatigue, bleeding then they might require a colonoscopy for further investigation.” Dr Doudle said survival rates for bowel cancer are much better than they were 20 years ago. “Our laparoscopic surgical methods have improved significantly and chemotherapy treatments have also improved, but we want to detect bowel cancer early so that we don’t need to intervene surgically.” “Early detection is the key,” he said, “so if you are aged 50 or over, and you receive a FOBT kit in the post – complete the test – it might save your life!” pindaramagazine.com.au Pindara Magazine 27
Pindara Private Hospital Magazine - Issue Five
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