This factsheet is for people who have bowel cancer, or who would like information about it including the symptoms, causes and treatments.
Bowel cancer is a lump created by an abnormal and uncontrolled growth of cells that start in the bowel.
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Bowel cancer is the third most common cancer in the UK. About five in 100 people will develop bowel cancer in the UK. You can get bowel cancer at any age but 80 out of 100 people who develop bowel cancer are over the age of 60.
Bowel cancer, also known as colorectal cancer, is the name for any cancer of your large bowel and back passage (rectum). Very rarely, cancers can occur in your small bowel.
Your large bowel (also called your colon) is the last section of your digestive system. Food passes through your small bowel (the longer, thinner part of your bowel) where nutrients are absorbed. Food waste then travels through your large bowel, where it becomes more solid faeces.
Your large bowel is divided into several sections including: the ascending; transverse; and descending colon. Your rectum, at the end of your large bowel, is where faeces collects before passing through your anus as a bowel movement.
Usually, large bowel cancers develop from small, non-cancerous (benign) growths of tissue called polyps that can extend from the lining of your bowel wall. Sometimes polyps can become cancerous (malignant) over time. If the cancer isn't treated, it can grow through the wall of your bowel and spread to other parts of your body.
Bowel cancer is often painless in the early stages, but there are symptoms, including:
These symptoms aren't always caused by bowel cancer. For example, problems such as piles may cause blood to appear in your faeces. However, if you have any of these symptoms, see your GP.
The causes of bowel cancer aren't fully understood at present.
Your risk of bowel cancer increases if you have:
You’re also more likely to get bowel cancer as you get older.
Your GP will ask about your symptoms and examine you. This may include a rectal examination to feel for any lumps or swellings in your back passage. He or she may also ask you about your medical history. Your GP may refer you to a doctor or surgeon who specialises in colorectal disease.
Tests for bowel cancer include the following.
If your doctor diagnoses bowel cancer, you may need further tests to find the size and position of the cancer.
These tests may include:
Screening is important for detecting bowel cancer in its early stages. The Department of Health has introduced a bowel cancer screening programme in England. Bowel cancer screening kits are sent to men and women aged between 60 and 69, although if you're older you can also request a kit. There are different programmes running in the rest of the UK. Ask your GP whether the screening programme has started in your area.
The screening kit contains a faecal occult blood (FOB) test that can detect small amounts of blood in your faeces. The FOB test doesn't diagnose bowel cancer, but the results show if you need to have your bowel examined.
Some people who are more likely to develop bowel cancer can also be screened. You may choose to have regular screening if you:
The type of treatment you have will depend on the size of the tumour, its position and whether it has spread.
Surgery is the most common treatment for bowel cancer.
If you have surgery, the part of your large bowel that contains the cancer will be removed and the two open ends are usually joined together. Lymph nodes (glands found throughout your body that are part of your immune system) near your bowel are often removed as well because they are the first place the cancer usually spreads to.
Sometimes, depending on the location and size of the cancer that is removed, the two ends of your bowel can't be rejoined. If this happens, the opening nearest the beginning of your bowel will be brought out to the skin surface of your abdomen. A colostomy is an opening of your large bowel onto the surface of your abdomen and an ileostomy is an opening of your small bowel onto the surface of the abdomen. The opening of the bowel is known as a stoma. See our common questions for more information.
A bag is worn over the stoma, which collects your bowel movements outside your body. Most people who have surgery don't need a colostomy, but if you do, it's usually temporary.
If you have cancer in your rectum, you may need surgery to remove the part of your rectum that contains the cancer, as well as the fatty tissue and lymph nodes around your rectum. You're more likely to need a colostomy if you have cancer of the rectum than if you have cancer of the colon.
Chemotherapy and radiotherapy
Sometimes it's not possible to remove all the cancer by surgery, so you may need to have additional treatment with chemotherapy and/or radiotherapy.
These treatments aim to destroy any remaining cancer cells and to prevent the cancer spreading further. Chemotherapy and radiotherapy are also sometimes used to shrink the tumour, before or after surgery, to kill any cancer cells that might be left after surgery or to help reduce your symptoms.
Chemotherapy aims to destroy cancer cells with medicines. These medicines may be given through a drip into your bloodstream (intravenous), as injections or as tablets or capsules that you swallow.
Radiotherapy uses X-rays to kill cancer cells. It’s often used to treat cancer that has started in the back rectum.
Chemotherapy and radiotherapy can both have side-effects.
Less commonly used are monoclonal antibodies that are medicines designed to recognise specific proteins on cancer cells. There are three main monoclonal antibodies used in the treatment for bowel cancer:
These medicines seek out cancer cells and stop them growing. They are sometimes used alongside chemotherapy. They can be used for various stages of cancer – ask your doctor for more advice.
There is evidence that taking the following steps can help to reduce your risk of getting bowel cancer.
There is increasing evidence that vitamin D may help to reduce your risk of bowel cancer, but more research needs to be done to be certain. Read more about how vitamin D may protect against cancer.
Produced by Stephanie Hughes, Bupa Health Information Team, January 2012.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
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This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.
Bupa can help you detect early signs of bowel cancer with our Colon Health Check.