What is bowel cancer?
Bowel cancer is the fourth most common type of cancer in the UK, with around 42,900 new diagnoses of bowel cancer in the UK each year, according to Cancer Research UK. Early diagnosis and rapid access to the best possible treatment means that long term survival is becoming more and more common, even for some cases of secondary bowel cancer.
The bowel, also called the intestine, is part of your digestive system. It’s split into two sections, which are the small and large bowel. When we talk about bowel cancer, we’re usually referring to the large bowel, but cancer can occasionally form in the small bowel. Depending on the location of the cancer, it can be called large bowel or colon cancer, colorectal cancer, or rectal cancer.
There are several options for treating bowel cancer, and the outcomes are improving owing to better treatment options and early diagnosis. Bowel cancer treatment may include surgery (resection or a colectomy), chemotherapy, radiotherapy, targeted therapies, immunotherapy and a specialist diet. Very often a treatment plan can include a combination of treatments, with chemotherapy and radiotherapy often being used together before or after surgery.
At GenesisCare, we combine these with consultant-led integrative cancer care, such as personalised exercise medicine, wellbeing therapies and psychological support, to help you achieve the best possible outcome. Our qualified physiotherapists and wellbeing consultants will carefully plan these therapies tailored to your needs by working with you and your consultant.
Types of bowel cancer
Your bowels are split into two main sections, the small bowel and the large bowel. This page is about large bowel cancers. You can find out more about small bowel cancers here.
Large and small bowel cancer are also types of gastrointestinal cancer, as your bowels form part of the gastrointestinal (GI) system, also known as your digestive system.
The type of bowel cancer depends on where the cancer started.
Colon cancer
Cancer that starts in the large bowel (the colon) is called colon cancer. It can start from tiny bumps called colon polyps that grow inside the lining of your colon. They’re normally harmless but sometimes they can develop into cancerous tumours. If undetected, tumours can spread to other parts of your body.
Rectal cancer
Cancer that starts in your rectum is called rectal cancer. Rectal cancer also begins as polyps that grow in your rectal lining. These can sometimes develop into cancerous tumours.
Although it starts similarly to colon cancer, the treatment for rectal cancer is different. Treatment can also depend on the stage of your cancer.
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Contact us today to find out more about our bowel cancer services and how we can help you
Bowel cancer signs and symptoms
Having symptoms of bowel cancer doesn’t always mean bowel cancer. Often, the signs and symptoms are caused by other conditions. It’s important to get checked out as soon as possible, because finding cancer early can improve outcomes.
- Changes in bowel habit
- Diarrhoea or constipation
- Feeling like you need to go again after a bowel movement
- Pain when passing bowel movements
- Blood in the stool or on the tissue, which can be red or black
- Mucus in the stool
- Nausea and vomiting
- Abdominal (stomach) pain or cramping
- Unexplained weight loss or loss of appetite
- Tiredness
- Low red blood cell count (anaemia)
You can read more about the signs and symptoms of bowel cancer and what happens next here.
Sometimes, bowel cancer can cause a complete or partial blockage of the large bowel. This can cause:
- Abdominal (stomach) pain
- Vomiting
- Constipation
- Bloating
If you think you have blocked bowels, go to your nearest accident and emergency department (A&E) immediately.
If you experience any signs and symptoms of bowel cancer, it’s important to speak to your GP. You can also book directly with us and be seen by a leading cancer expert.
Causes of bowel cancer
Bowel cancer starts with a mutation that causes bowel cells to grow too quickly, forming tumours. These often start in polyps, which are small growths in the intestines that look like skin tags.
Up to 1 in 10 cases of bowel cancer is genetic, caused by a faulty gene that can be passed down within a family. Genetic conditions linked to bowel cancer include Lynch syndrome, FAP (Familial Adenomatous Polyposis) and MAP (MUTYH Associated Polyposis).
It’s not always known what causes colon and rectal cancer, but there are several risk factors. These increase your chance of developing bowel cancer.
Bowel cancer risk factors
- Being over 50
- Having a close relative with bowel cancer
- Not eating enough fibre
- Smoking
- Being obese
- Drinking a lot of alcohol
- Regularly eating red or processed meat
- Some bowel conditions, such as Crohn's disease pr ulcerative colitis
- Type 2 diabetes
Bowel cancer diagnosis
At GenesisCare, we diagnose and treat a wide range of cancers, and we understand that this can be a worrying time. Our diagnostic services are first-class, and our commitment is to give you the answers you need, as quickly as possible.
It‘s important to remember that symptoms can often be caused by other conditions and aren’t always bowel cancer. But, whatever your diagnosis, we can make sure you get the expert care you need – without delay.
How is bowel cancer diagnosed?
If you‘re concerned about bowel cancer symptoms, we offer specialist
bowel cancer tests and diagnostics in our centres. Here you‘ll see one of our expert consultants who specialise in cancers affecting the colon and rectum.
They‘ll assess your symptoms and, if necessary, refer you for diagnostic tests such as a digital rectal examination (DRE), faecal immunochemical test (FIT), flexible sigmoidoscopy, proctoscopy, colonoscopy, blood tests, biopsy or imaging scans (including CT, PET-CT, MRI or ultrasound). You may also need to see one of our specialist dietitians.
Bowel cancer screening
Bowel screening checks for signs of bowel cancer when there are no symptoms. This can help find cancer earlier. If you’re between 60 to 74 years old, the NHS offers bowel screening checks every two years. However, if you have symptoms you should speak to your GP or contact us, no matter your age.
Bowel cancer treatment overview
There are several options of treatment available for large bowel cancer, such as:
- Surgery - removal of part or all of the large bowel
- Chemotherapy - anti-cancer drugs which destroy the cancerous cells
- Radiotherapy - high-energy radiation beams which are targeted at the cancer cells
- MRIdian radiotherapy - advanced radiotherapy that can be used to eradicate secondary tumours
- Targeted therapy - a specialised groups of drugs that attack or block certain processes in the cancer cells
- Immunotherapy - drugs that help your body's immune system recognise and fight the cancer
Treatment side effects
No treatment is without side effects. These will depend on the extent and duration of your treatment. Your doctor will explain these to you before you start your treatment, together with the ways your treatment plan and supportive care can help manage or minimise these.
For some people, bowel cancer treatment has mild and temporary side effects. But for others, life will look a little different due to long-term or permanent changes to bowel habits, the bladder, or their sex life.
However, treatments and techniques are helping minimise the impact treatment has on you.
How is bowel cancer treated?
Surgery is the main treatment for bowel cancers that haven't spread. It’s usually part of an overall treatment and care plan for colon and rectal cancers.
There are several types of bowel cancer surgery. The best type for you depends on the location and size of your cancer.
- Polyp removal, or trans-anal endoscopic microsurgery (TEMS) - removing some of the bowel lining, for early-stage cancer
- Right of left hemicolectomy - removing part of the bowel for a more advanced tumour
- Total colectomy - removing the whole bowel, if there is more than one tumour or if there is another disease of the bowel that also requires treatment
Our consultants include expert surgeons who work in local and nationally renowned hospitals. They work closely with other cancer specialists to decide the best course of treatment for you.
If your consultant recommends bowel cancer surgery, this can be arranged conveniently at one of our partner hospitals. You can then continue your other treatments at GenesisCare.
They plan your treatment carefully, to avoid any unnecessary procedures and preserve as much bowel tissue as possible. But, depending on the extent of the surgery you need, it can mean significant changes to day-to-day life.
You may need to wear a temporary or permanent stoma bag, which collects stools outside your body. We’ll be here to help you adjust to life after bowel cancer surgery and make sure you can access any further support needed.
Our team also includes specialist dietitians, who may be involved in preparing you for surgery and helping with your recovery and rehabilitation.
Radiotherapy uses targeted, high-energy radiation beams to destroy cancer cells. It can be used for rectal cancer and metastatic colon cancer (that has spread outside the bowel).
At GenesisCare, we're the leading private provider of radiotherapy in the UK and offer world-class expertise and state-of-the-art facilities that specialise in advanced radiotherapy techniques. Our latest-generation radiotherapy machines (called linacs) deliver highly targeted radiation beams that are designed to be effective while minimising the radiation dose to healthy tissues.
Your treatment is overseen by our multidisciplinary team (MDT), which includes surgeons, radiotherapists and dietitians who work together to make sure you receive the highest standard of care, tailored to you.
Radiotherapy techniques for rectal cancer
Volumetric modulated arc therapy (VMAT) is a modern radiotherapy technique that directs beams of radiation in an arc across the treatment area. Together with surface-guided radiotherapy (SGRT), it’s possible to precisely target areas of cancer, adjusting the beam and intensity of the radiation dose to allow for movements in the body and avoid healthy tissues. Treatment is usually given before surgery, and depending on number of criteria, it might involve five days of treatment over a week, or daily treatment for five weeks alongside chemotherapy.
Side effects of radiotherapy occur when healthy tissues receive radiation, so using this technique helps to limit the dose to tissues and organs surrounding the tumour. At GenesisCare, we offer VMAT wherever possible because it’s widely recognised to be the highest standard of care currently available for patients needing this type of radiotherapy.
We also offer palliative VMAT radiotherapy for those living with advanced bowel cancer that has spread elsewhere in the body, to improve pain and increase mobility. We understand that fast access to palliative care is extremely important, so we usually provide treatment within 48 hours of your planning imaging scan.
Stereotactic ablative radiotherapy (SABR) is an advanced radiotherapy technique that uses very focused, high-energy radiation beams to eradicate tumours in five or fewer sessions. It’s often used instead of surgery. SABR may be useful to patients with advanced (metastatic) bowel cancer that has spread to the liver, lungs, bone, lymph nodes or brain.
The MRIdian MR linac, exclusively available at our GenesisCare centres in Oxford and Cromwell Hospital London, delivers MRI-guided SABR. For some hard-to-treat secondary tumours, we use this revolutionary treatment that combines an MRI scanner and a radiotherapy machine, to see exactly where a tumour is at the same time as treating it. We use MRIdian to treat multiple secondary tumours in the liver and lung and re-treat people who have previously had radiotherapy.
At GenesisCare, we offer all drug therapies that can be used to treat bowel cancer, including many of the newest treatments. Depending on the treatment, you may attend one of our private chemotherapy suites, which are staffed by our specialist nurses.
Our compassionate nursing teams are available 24/7 on a dedicated on-call telephone service and can answer any queries during your treatment. They'll be able to provide advice about side effects or symptoms and help arrange appropriate medical care when needed.
Our centres have all received the Macmillan Quality Environment Mark to reflect the quality of care we provide for people living with cancer.
There are different types of drug treatments, also called systemic anti-cancer therapies. Our expert teams continually review and assess new treatments to make these available to GenesisCare patients as early as possible.
Chemotherapy for bowel cancers
Chemotherapy uses anti-cancer drugs to destroy cancer cells. Chemotherapy for bowel cancer can be delivered on its own or with radiotherapy (chemoradiation). You may be offered chemotherapy or chemoradiation before surgery to reduce the size of your tumour before the operation, or after surgery to reduce the chance of the cancer from coming back. Chemotherapy is also used when the cancer is more widespread to prolong life expectancy and control cancer-related symptoms.
Targeted therapy and immunotherapy for bowel cancers
Targeted therapies or biological therapies are a specialised group of drugs that have been designed to attack or block specific processes in cancer cells that tumours depend on to survive and grow.
Immunotherapies are a type of targeted therapy that work by helping your body‘s immune system to recognise and fight the cancer.
You may have these therapies as part of your treatment for advanced or metastatic bowel cancer, where it has spread to other parts of your body. At GenesisCare, we offer the following treatments for bowel cancer:
- Monoclonal antibody (MABs) – recognise and bind to proteins on the outside of cancer cells that encourage them to divide
- Anti-angiogenesis inhibitors – stop cancer cells from producing new blood vessels that supply them with the nutrients and oxygen they need to grow
- Cancer growth blockers – block proteins in cancer cells that encourage them to grow, and are given intravenously or orally
There may also be opportunities to access clinical trials for the newest treatments for bowel cancer.
For some advanced cancers, we use specialist tests such as liquid biopsy or genomic testing to understand cancer cells’ genetic makeup. This can identify which drugs could be effective based on the particular genetic mutations in your cancer. This helps to start effective treatment confidently and without delay, or can provide access to a clinical trial of a novel treatment.
Why choose us?
From prompt investigation of worrying symptoms through to comprehensive treatment of advanced bowel cancer, we offer world-class treatment and care tailored to every patient.
We equip our centres with the latest technologies and offer many of the newest bowel cancer tests, scans and treatments that are proven to be safe and effective. Our consultants are regional and national cancer experts who focus on you to achieve the best outcomes possible and minimise side effects.
With us, you’ll receive the very best personalised care and a treatment plan that embraces lifestyle-enhancing approaches through our integrative cancer care programme, including exercise medicine and wellbeing therapies.
Book an appointment
Contact us today to find out more about our bowel cancer services and how we can help you
FAQs
Changes in bowel habits mean anything that isn’t normal for you.
This could be:
- Bleeding from your rectum
- Blood in your stools
- A persistent and unexplained change in bowel habits
- Extreme tiredness
- A pain or lump in your abdomen
- Unexplained weight loss
- Pain during bowel movement
- Feeling like you've not emptied your bowels after a bowel movement
If you have changes to your bowel habits that last more than three weeks, contact your GP or contact us directly and be seen by a leading cancer expert within days. book an appointment.
Bowel cancer pain or discomfort can be in your abdomen (stomach), rectum (back passage), or lower back. It can feel like a cramp and may be felt more on your right side. It may start when you’ve eaten something.
Bowel cancer can cause a complete or partial blockage of the large bowel, causing;
- Severe abdominal pain
- Vomiting
- Constipation
- Bloating
If you’re experiencing symptoms of a bowel blockage, go to your nearest accident and emergency department (A&E) immediately.
According to Cancer Research UK, the number of people diagnosed with bowel cancer rises at age 50+, with the highest rate of bowel cancer being diagnosed in people between 85 to 89.
You can get bowel cancer at a younger age, but it’s rare. If you think you might have bowel cancer or have symptoms, speak to your GP.
Bowel cancer in your 20s is rare. Although there are cases of bowel cancer being diagnosed in people in their 20s, it’s very unlikely.
If you’re worried or have symptoms, you should speak to your GP as other conditions can also cause similar symptoms to bowel cancer.
Bowel cancer in your 30s is rare. If you’re experiencing symptoms or are worried about bowel cancer, you should speak to your GP. Other conditions can cause symptoms that are similar to bowel cancer.
Reviewed by:
Dr James Good
Clinical Oncologist
May 2024
