Spotting the signs of bowel cancer

Julia - Over the last couple of weeks, Dame Deborah James has raised over 6 million pounds for cancer charities. She launched the fundraiser after announcing publicly that she was receiving palliative care because her own bowel cancer was no longer responding to treatment.

She's undoubtedly also very much shone the spotlight on a disease that is unfortunately very common but discussed too little. Luckily we do have a screening programme across the UK that has been a big  success story. Chris Smith went to see consultant gastroenterologist Sibu Varghese, who is part of that initiative, to find out a bit more about bowel cancer, including the warning signs you should be aware of...

Sibu - The main symptoms to look out for are blood in the poo. The other thing is a change in your bowel habits you can't explain otherwise. If your stools or your bowels are more frequent, more loose, and also things like tummy pain, abdominal pain discomfort, and also unexplained weight loss. These are the key symptoms to look out for.

Chris - And who's at risk?

Sibu - We don't know the exact cause of bowel cancer, but there are certain risks to look out for. One is age; nine out of 10 people with bowel cancer are over the age of 60. There are other risk factors like your diet, being overweight, lack of exercise, smoking - and also if there's a strong family history of bowel cancer.

Chris - And, as cancers go, is this one becoming more common/becoming less common? Are there certain sectors of society among whom it's a particular problem?

Sibu - It is definitely one of the most common causes of cancer in the UK. I would think in the third or fourth place, and it can be a deadly cancer if diagnosed quite late. The incidence is increasing and that's the feel we are getting at the moment, yes.

Chris - Tell us about the screening program. Because that has been going for 15 years or so?

Sibu - Yes, we've had a screening program starting in 2006 in England. It is available for people over the age of 60. Between 60 and 74. We are looking at gradually lowering this age group to the fifties as well. You get sent a stool kit, which is quite simple kit to do. It's a plastic tube that you test your poo for any traces of blood. And if that's the case you're invited to discuss about having a colonoscopy to look for any polyps or sometimes cancer as well.

Chris - That's the next step is it? You'd call someone back and then physically take a look inside to see if you can pinpoint the cause of that bleeding?

Sibu - The first thing would be to have an appointment with one of our specialist screening practitioners where we discuss their health in general and discuss whether a colonoscopy would be appropriate.

Chris - And what's the intervention after that, if you do find someone's got bowel cancer, what happens next?

Sibu - It's the unfortunate part. What we tend to do is encourage them that this is something we're picking up early. We then refer them onto the specialist team which involves surgeons and cancer specialists with regards to treating this and taking care of this.

Chris - And because of earlier pickup, because of things like screening, is that translating into a drop in the mortality from bowel cancer? We're diagnosing people with it, but we're treating them and potentially curing them more. Is that actually happening? Is it bearing fruit?

Sibu  - It's very difficult to interpret this data. I think we're definitely making a difference because I do a lot of the colonoscopies and I can see that we're detecting things early, but also there's an increase in the incidence of cancers as well. It is difficult to sort of analyse this data more, but definitely we are making a plateau in terms of the incidence of cancer. And obviously people are surviving longer if they're treated early. IT is definitely making a big difference

Chris - The age at which this is kicking in, though, I know you've said the aim is to lower that a bit, nevertheless, Deborah James, who we've heard a lot about in the last couple of weeks, she would've been totally outside the scope of that screening window, wouldn't she?

Sibu - Yes. The number of people who get cancer very early, like her, you know, in her thirties, it's very small but, understandably, that's an important group. I think the only thing I can say with the younger age group is obviously to look out for symptoms as I mentioned and, number two, if you've got a family history of bowel cancer, a close relative, your father, mother, brother, or sister who has had bowel cancer under the age of 50, it would be important to talk to your GP about that because there would be a case of doing what's called surveillance or screening for bowel cancer with a colonoscopy much earlier on in this group of people.

Chris - And overall prognosis if someone is diagnosed with bowel cancer? What's the likely outcome?

Sibu - It all depends on how far advanced it is or what stage it is. If it is in an early stage, which is what we hope for, and it's limited to the bowel, essentially, an operational surgery to remove that bit of the bowel will cure the person of that condition. But, if it is quite advanced, we still have a lot of good treatment, but if it very advanced then, unfortunately, sometimes people don't survive. Obviously, the earlier you know about it, the better.