Bowel Cancer

Sometimes when people  find out they have bowel cancer, they never knew they had a problem.

There are a number of symptoms or changes in your body you should look out for, including:

• some blood in your poo or on the toilet paper after a bowel motion
• changes when going to the toilet such as trouble doing a poo (constipation) or having very runny poo (diarrhoea)
• losing weight without meaning to
• pain in the belly area or when you go to the toilet (rectal/anal pain)
• a feeling like you’re bowel isn’t completely empty after going to the toilet
• low levels of iron in the blood (anaemia)
• feeling really tired.

Having these symptoms may not mean you have cancer, but it is really important to check. 

If you have any of these problems, or are worried about something else, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Bowel cancer can develop without any symptoms.

The good news is, there is a simple test that can help find bowel changes early. Australians between the ages of 50 and 74 years are sent a free bowel screening kit in the mail. If you receive a kit in the mail, do it, even if you feel well. It could save your life!

If found early, bowel cancer can be successfully treated.

For more information about how to get tested for bowel cancer, visit the National Bowel Cancer Screening Program website, or call the information hotline on 1800 930 998 or ask your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

After a bowel cancer screening test, the bowel screening program might tell you that you need more tests, or you might have symptoms that might be bowel cancer.

You won’t know if you have bowel cancer until your doctor has talked to you, completed a physical examination and done some more tests.

Having these tests does not mean you have cancer, but it is really important to check.

The tests might include:

• a blood test
• a colonoscopy, a procedure where your doctor can view your bowel on a screen by inserting a long tube into your backside.
• a CT scan or MRI scan to see what your insides look like
• a biopsy, where a tiny bit of your bowel is taken out during the colonoscopy, and they use a microscope to look at it. 

If you have bowel cancer, you might be told it’s at a certain stage. This describes whether or not it has spread to other parts of your body, and how far it has spread in your body. Knowing the stage of the cancer helps you and your doctors to decide on the best treatment for you.

• Stage 0: This is not really cancer, but it might become cancer.
• Stage 1: The cancer is small and located only in the bowel.
• Stage 2: The cancer is bigger and might be touching other organs close to the bowel.
• Stage 3: The cancer has spread to nearby lymph nodes.
• Stage 4: The cancer has spread to other parts of the body such as the liver, lungs or lymph nodes far away from the bowel – this is also known as late stage or metastatic cancer.

With all stages of bowel cancer, there is plenty of treatment and support that can help you, including traditional medicine and practices like ceremony and being on Country.

Most people with bowel cancer have surgery. Some also have radiotherapy or chemotherapy. If you have bowel cancer, you might need one of these, or a combination of them.

Your doctors will talk to you about what treatments they recommend and what your options are throughout your treatment plan, so there won’t be any surprises.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about which treatment/s you might have and how you would like to incorporate traditional medicine and/or cultural practices as part of your treatment plan.

Surgery

Surgery is done to take out the cancer and help to stop it from spreading to other parts of your body. Surgery involves staying in hospital and having anaesthetic and an operation.

Some people  just have the cancer removed, with a small bit of tissue around it taken too.

Some people have a section of the bowel removed. The doctor will talk to you beforehand about what is going to happen.

After surgery, some people end up with their poo going into a bag attached to their belly. This is called a stoma or a colostomy. If you are told you might have a colostomy, read more here.

Yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander health worker or social worker about your surgery and what support you and your family need before, during and after surgery. Being away from Country and family can be distressing so making sure you have the right support is important. 

Read more about surgery.

Radiotherapy

Radiotherapy, also called radiation therapy, uses X-rays to destroy cancer cells in one part of your body.

Most people who have radiotherapy have it 5 days a week for 4 to 6 weeks, and each session can take 15 minutes. But it might be different for you.

You can only have radiotherapy in cities and some big towns – see this list. If your doctor thinks radiotherapy would help, and you don’t live near a radiotherapy site, there is help to find somewhere to stay, support to keep you connected to family  and assistance to cover expenses.

Having family with you during radiotherapy treatment is an important support that helps keeps you strong.

Yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander Health Worker or social worker about your surgery and what support you and your family need before, during and after surgery. Being away from Country and family can be distressing so making sure you have the right support is important.

Read more about radiotherapy.

Chemotherapy

Chemotherapy or ‘chemo’ involves you taking strong drugs to kill the cancer cells.

Most chemo comes as injections into your arm or hand that drip in over a few hours and some need you to take home a small bottle home for two days then come back to take it off again. If you’re having chemo, your doctor will tell you exactly how it will work for you.

Many people have chemo in cycles – such as every day for two weeks, then a week off. You may also need to have chemo at the same time as the radiotherapy. Or two days every two weeks, or one day every three weeks. Some people have chemotherapy tablets at home, but most need to go to a hospital or clinic to get the drip. But you usually don’t need to stay in hospital for chemo.

Chemo can make people feel sick for a while, but there are things they can do and take to help.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Read more about chemotherapy and side effects.

It is important for you to understand why you are getting the treatment your doctor chooses and how it is supposed to help you.  Different treatments try to do different things. It depends on what cancer you have, and whether it has spread to other parts of your body, and where you live, and what you want. Ask your doctor or specialist if the treatment they suggest:

• is meant to cure you, by getting rid of the cancer and stopping it coming back, or
• won’t cure you, but is meant to prolong your life, or make you feel better.

Your doctors should talk to you and explain this. You can talk to them and tell them what you think, and what you want. Some people  will want to try everything possible to kill the cancer to stay alive. Others want simpler treatments, or don’t want to leave family or Country for treatment, or don’t want any treatment. It’s your choice. You can include traditional medicine and cultural practices. You can also talk to another doctor to help you decide.

It can take time to decide about treatment. There are usually some options to hear about and choices to make.

It can be helpful to write things down, have someone else come to appointments to help remember information.

Yarn with your doctor, specialist, nurse or Aboriginal and/or Torres Strait Islander health worker.

Read more about treatment.

Always ask about the cost of treatment. Many treatments are free through public hospitals, but some are not. Ask your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Read more about financial support.

It all depends on the type of treatment you’re having. People will have treatment for different durations of time.

After treatment is finished, you might keep in touch with your doctors will keep in touch with you to for years so they can check how you’re going. Your cancer journey gives you an opportunity to build trust and safe relationships with your doctors and medical team that may last for many years.

It is not possible to say what causes bowel cancer in a single person. We do know there are some features that are more common in people who develop bowel cancer. These features are called ‘risk factors’.

But it is usually hard to be sure whether a risk factor contributed to the development of the cancer. And having one or more risk factors for bowel cancer does not mean that someone will definitely develop this cancer. In fact, many people with bowel cancer have no obvious risk factors.

Some factors can even lower your risk of developing bowel cancer.

Risk factors for bowel cancer you can change:

• being overweight
• lack of exercise and not being physically active
• eating a lot of processed and take-away foods
• drinking alcohol
• smoking.

Risk factors for bowel cancer you can’t change:

• age over 50 years – your risk increases with age
• history of inflammatory bowel disease
• strong family history of bowel cancer
• some gene mutations
• previously had polyps or adenomas in your bowel.

If you have any of these risk factors or you’re worried about your risk for bowel cancer, yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander health worker.

Clinical trials might be an option for you. Talk to your doctor to help you decide if taking part is a good option. Read more about clinical trials.

Read more detail on bowel cancer here.