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Bowel Cancer Awareness Month

Wednesday, 22 April 2009

It's Bowel Cancer awareness month. Bowel cancer is the second most common cancer in Ireland and it is also the second most common cause of cancer death in Ireland. It's very important that our viewers are kept informed as to the signs and symptoms of bowel cancer. With this in mind we're joined today by broadcaster Bill O Herlihy who will be telling us about his bowel cancer scare and also by Norma Cronin, Health Promotion Manager of the Irish Cancer Society who'll be telling us all about Bowel Cancer Awareness month.

Bowel Cancer
. Cancer of the bowel is when cells in the bowel change and affect how the bowel works normally.
. The main symptoms of bowel cancer are a change in your normal bowel motion, blood in your stools, pain or discomfort in your tummy, weight loss.
. Bowel cancer can be diagnosed by tests such as a rectal exam, colonoscopy, barium enema, CT colonography.
. The main treatment for bowel cancer is surgery. Chemotherapy, radiotherapy or biological therapy may be used as well.

Recent survey (2008)
. 36% of people cannot name one sign or symptom of bowel cancer.
. 25% of people do not know factors which might increase their risk of developing bowel cancer.
. Four in ten people believe that people under 50 years of age are most at risk of developing bowel cancer - in fact 90% of people diagnosed with bowel cancer in 2005 were over the age of 50.

What is the bowel?
The bowel is part of your digestive system. It is made up of two parts, the small bowel and the large bowel. The large bowel can be further divided into the ascending colon, transverse colon, descending colon, sigmoid colon, rectum and anus.

When you swallow food, it goes from the gullet (oesophagus) to the stomach and into the small bowel. Going through the small bowel, it is digested and nutrients are taken into the body. In the large bowel, water is absorbed from digested food.

The waste matter that is left is stored in the rectum (back passage) until ready to pass out of the body through the anus. This waste material is known as faeces or stools.

What is bowel cancer?
Bowel cancer happens when cells in the bowel change and start to grow quickly. They can form a tumour. A malignant tumour is also known as cancer. If a malignant tumour is not treated, it will affect how the bowel works. Most bowel cancers occur in the large bowel. Bowel cancer is also known as colorectal cancer or cancer of the colon and rectum.

How common is bowel cancer?
Bowel cancer can occur in men and in women. In Ireland it is the second most common cancer. In 2005, there were 2184 people diagnosed with it. It is also the second most common cause of cancer death in Ireland.

What causes bowel cancer?
The exact cause of bowel cancer is unknown. It occurs mostly in those over 60 years of age. Your chance or risk of getting bowel cancer is higher, if:

. You have had a previous bowel cancer.
. A member of your immediate family (mother, father, brother or sister) or relatives (uncle or aunt) has had bowel cancer.
. You or someone in your family has or had polyps or a bowel condition called familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (HNPCC).
. You have a history of bowel conditions like ulcerative colitis or Crohn's disease.
. You are obese (overweight).
. You eat a diet high in fats and low in fibre.

If you feel you may be at risk, first talk to your family doctor (GP) about your concerns. He or she may advise you to visit a specialist.

What are the symptoms of bowel cancer? The symptoms of bowel cancer can include:

. A change in your normal bowel motion, such as diarrhoea or constipation.
. Feeling you have not emptied your bowel fully after a motion.
. Pain or discomfort in your abdomen (tummy) or back passage.
. Trapped wind or fullness in your tummy.
. Weight loss.
. Tired and breathless (due to anaemia from blood loss).
. Rectal bleeding or blood in stools.

These symptoms can also be due to complaints other than bowel cancer. But do get them checked out by your doctor, especially if they go on for more than 4-6 weeks.

Can I be screened for bowel cancer?
Testing for bowel cancer when you have no symptoms is called screening. There is no national bowel cancer screening programme in Ireland at present. But there are efforts to start one in the near future. Screening involves a test that checks for hidden blood in your stools and a colonoscopy, if needed. Talk to your GP if you feel you or your family are at high risk.

If you are concerned about any of the above, please contact the Irish Cancer Societies helpline.

How is bowel cancer treated?
The main treatments for bowel cancer are:

. Surgery
. Chemotherapy
. Biological therapy
. Radiotherapy

. Surgery
Surgery is the most common treatment for bowel cancer. Surgery aims to remove the part of the bowel containing the tumour. There are different types of surgery like open surgery or keyhole surgery.

. Chemotherapy
Chemotherapy uses drugs to cure or control your cancer. It can be used alone to treat bowel cancer. It can also be given before surgery (neo-adjuvant therapy) or after surgery (adjuvant therapy) Some common chemotherapy drugs used in bowel cancer are:

. 5-FU
. Oxaliplatin
. Irinotecan (CPT-11)
. Capecitabine (Xeloda)
. Leucovorin (folinic acid)

. Biological therapy
This therapy uses the body's immune system to treat cancer. Some common drugs used are:

. Cetuximab
. Erbitux
. Avastin

. Radiotherapy
Radiotherapy uses high-energy X-rays to kill cancer cells in your bowel. Radiotherapy is mainly used in cancer of the rectum. It can be given before surgery (neo-adjuvant therapy) and also after surgery (adjuvant therapy).

How is advanced bowel cancer treated?
Advanced cancer is when the cancer has spread to other parts of the body. This can include the liver or the lungs. It may be possible to keep the cancer under control by surgery or chemotherapy. It is unlikely the cancer will be cured. Chemotherapy or radiotherapy can help to shrink the cancer to improve your symptoms. This is called palliative treatment.

What follow-up do I need?
Once your treatment is over, your doctor will want to see you for regular check-ups. This is known as follow-up. At first these check-ups will be quite often but gradually become less frequent. The follow-up will continue for at least 5 years. At the check-up, you may have tests like a physical exam, X-rays, scans, a colonoscopy or blood tests.

Is there a support group for bowel cancer?
The Irish Cancer Society offers support to people with bowel cancer. The support group is called the Bowel Cancer Support Group. This group helps you to discuss your feelings and anxieties to understand the shock of a cancer diagnosis. They will also help you to come to terms with the diagnosis. If you wish to speak to a volunteer, contact the Cancer Information Service on 1800 200 700 . Details of cancer support centres around the country are also available.

Bills Story

In November 2007 Bill wasn't feeling too well. He had lost his appetite, was pale and was also suffering from a lack of energy. However as he was very busy he was putting off going to see a doctor about this. Despite his reluctance to do so he eventually succumbed to his wife and two daughter's insistence and went for a check up.

At the check up he was told by his doctor that his blood count was very low and he had to get more tests done. After this he had a colonoscopy and a gastroscopy. After these it was confirmed to him that he had a tumour in his bowel.

Cancer had already hit Bills family in the two years previous to this. He has lost close members of his family to the illness and he was worried that it may affect him too. He was worried that he'd never get to see his grandchildren grow up however a positive outlook from his doctors meant that he faced up to the problem.

Luckily when he met with his oncologist he was told that they had caught the cancer in the early stages and that the chances of a full recovery were close to 100%. Bill was told that he had cancer of the colon and a growth as big as a lemon in his bowel and went into surgery in Novemebr 2007. During the surgery he had part of his intestine and the growth removed.

Since then he has had no problems. He credits this to a wonderful medical team who looked after him very well and also to the fact that his cancer was caught in its infancy.

Contact the Irish Cancer Society cancer helpline
Freefone 1800 200 700