Recognising critical symptoms of 'silent killer' that appear in advanced stages

Early detection of bowel cancer can significantly enhance the chances of successful treatment, yet symptoms often only appear once the disease is advanced. Bowel Cancer UK emphasises that survival rates are high when the disease is detected early, but these rates decrease as the cancer progresses.

There are approximately 44,100 new bowel cancer cases in the UK every year, equating to around 120 every day (2017-2019). Bowel cancer is the fourth most common cancer in the UK, accounting for 11% of all new cancer cases.

Dr Deborah Lee, from Dr Fox Online Pharmacy, has explained that in stage one, "the cancer has grown through the cells lining the bowel wall and into the muscular wall of the intestines but has not spread any further," and importantly, "Stage one bowel cancer usually has no symptoms". Bowel cancer claims the lives of around 16,800 people in Britain each year, making it the second deadliest cancer in the country, which highlights the importance of symptom awareness.

Each year almost 6 in 10 of all bowel cancer deaths (58%) in the UK are in people aged 75 and over. Projections suggest there could be around 19,100 deaths from bowel cancer every year in the UK by 2038-2040.

Dr Lee highlighted the insidious nature of bowel cancer, stating: "Bowel cancer is thought to have a long premalignant phase. It may take 10 years for bowel cancer to grow from a small bowel polyp."

In its second stage, though cancer has penetrated through the bowel wall and may affect nearby tissues, it often hasn't spread to lymph nodes or other parts of the body, with some patients experiencing no symptoms yet. Symptoms usually present in stages three and four, with visible signs including blood in the stool and lower abdominal pain.

Further symptoms Dr Lee identified for these advanced stages are blood in the stools, rectal bleeding, changes in bowel habits like diarrhoea or constipation, lower abdominal discomfort, alterations in stool shape such as long and narrow stools, and excessive gas discharge.

Changes in bowel habits leading to conditions like diarrhoea or constipation, a persistent lower abdominal ache, transformation in stool contour suggesting long, narrow stools, and significant excess gas are all early warning signals of bowel cancer. The NHS underscores that any unexplained weight loss, extreme tiredness, bloating, or a continual urge to pass stools even after going to the bathroom could be tell-tale signs.

They firmly advise anyone encountering possible symptoms of bowel cancer persisting for more than three weeks to urgently consult their GP.

Dr Lee has made it clear: "In stage three bowel cancer, the cancer has spread to the lymph nodes but not elsewhere in the body,", elaborating that, "In stage four, it has spread for example to the lungs or the liver."

Symptoms of advanced bowel cancer may include fatigue, weakness, abdominal pain, and weight loss, along with vomiting, "It can also cause jaundice (yellowing of the skin) and shortness of breath."

The doctor emphasised the importance of not ignoring potential symptoms, saying, "If you have any worries, see your GP. Don't be embarrassed. Even your GP sits on the toilet! " He stressed that early consultation with a medical professional is vital, "They will be pleased you have come to see them and be more than happy to do all they can to help you. Don't leave it to chance."

For those seeking to lower their risk of developing bowel cancer, the Office for Health Improvement and Disparities recommends making positive lifestyle changes—reducing the intake of processed and red meat, increasing dietary fibre, and other adjustments, especially pertinent for individuals over 50. Alcohol consumption, smoking, obesity, and having a family history of bowel cancer are among the factors that raise the likelihood of the disease, according to health experts.

Conditions such as inflammatory bowel disease, polyps in the bowel, and genetic syndromes like Lynch syndrome or familial adenomatous polyposis also play a role in the increased risk.

The Office for Health Improvement and Disparities has highlighted that lifestyle changes could prevent around half of all bowel cancer cases. Key dietary shifts such as cutting down on processed and red meat, along with upping fibre intake, have been identified as crucial.

Additional risk factors include being over 50, alcohol consumption, smoking, obesity, a family history of bowel cancer, inflammatory bowel disease, polyps in the bowel, Lynch syndrome, and familial adenomatous polyposis. Staying active and maintaining a healthy weight are also recommended to reduce cancer risks.

Dr Lee noted the unusual but significant ability of dogs to detect bowel cancer, saying: "Interestingly, dogs can smell bowel cancer. In one study, dogs were as successful as colonoscopy (telescope in the bowel) at detecting bowel cancer. Dogs are very sensitive at detecting chemicals produced by the tumour, in the exhaled breath and the poo."

People with any health concerns are urged to seek medical advice immediately since early diagnosis and intervention are key for better outcomes. Those seeking further information can visit Cancer Research UK.