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Health focus: Bowel cancer: Act fast to catch killer.

Byline: Miriam Stoppard

BOWEL cancer is the UK's second biggest cancer killer.

Each year, 35,600 people are diagnosed with the disease and half of them will die.

Yet it's one of the most curable of all cancers if caught and treated in time. Nine out of 10 cases could be treated successfully if caught at an early stage, as Dr Miriam explains.MANY people are unaware of bowel cancer symptoms or are too embarrassed to discuss them.

The first step in saving thousands of lives is to start talking about it.

Symptoms to look out for are a sudden change in bowel habit (looser stools, going to the toilet more often or feeling you have to), rectal bleeding with no underlying reason, like piles and abdominal pain starting out of the blue.

Where is it?

THE large bowel, also known as the colon, is a curved tube of muscle around four feet long. It joins the small bowel, above, to the rectum, below.

Its job is to absorb water and nutrients from the digested food that passes through it.

It is divided into three sections - the ascending colon (going up the right side of your abdomen), transverse colon (across the top) and descending colon (down the left side).

The rectum, at the end of the colon, is where waste matter collects and dries out before leaving the body when we pass a stool.

How bowel cancer strikes

THE building blocks of the body are made up of tiny cells repaired and replaced in an orderly way. But sometimes this process goes wrong.

It becomes haphazard and aggressive - cells divide and grow in an uncontrolled way, causing a lump or tumour.

If a tumour contains cells that can invade neighbouring tissues or organs, it's known as malignant cancer.

If the tumour grows slowly and doesn't invade structures around it, it's called benign. Bowel cancer can form in any part of the colon and rectum. If left untreated it will grow and can eventually block the bowel.

Aggressive colon cancer can also spread through the wall of the bowel into other organs within the abdomen. It isn't uncommon for bowel cancer to spread to the liver.

Less commonly, bowel cancer can spread to other, more distant organs such as the lung or brain.

In general, the further bowel cancer spreads from the original site, the less likely it is it will be cured. For this reason, early diagnosis and treatment are crucial.LYNN DICED WITH DEATHCAMPAIGNING TV journalist Lynn Faulds Wood, left, was diagnosed with bowel cancer more than a decade ago, at the age of 41.

Former Watchdog presenter Lynn, who is married to broadcaster John Stapleton, had a three-year-old son.

She said "I could easily have lost my life. In fact, one of the doctors said to me, 'Would it upset you to know you were probably only a month or two away from it maybe being too late?' "

Now given the all-clear, she has since worked tirelessly to help improve advice and diagnosis.Check out your family historyABOUT one in 18 people in the UK will develop cancer in their bowel or rectum (colorectal cancer) at some point in their lives. Cancer of the small bowel is much rarer.

The reason why some people get cancer and others don't is still unclear, but there are certain factors that can increase your risk:

Eating a diet with too little fresh fruit, vegetables and fibre.

An inactive lifestyle and a lack of regular exercise.

An inherited condition where benign growths called polyps form on the lining of the bowel.

Long-term inflammations of the bowel such as ulcerative colitis.

A history of the disease in close relatives.

A family history of a triad of cancers - bowel, ovary, breast - taking different forms in different family members.LOOKING FOR TROUBLEColonoscopy and sigmoidoscopy

THESE are investigations using a long, thin telescope (a colonscope or sigmoidscope) passed into the bowel through the anus so the doctor can see the bowel lining directly.

The same instrument can also be used to remove polyps and take a sample (biopsy) from areas that may appear abnormal.

These samples are sent to a laboratory for examination under microscope by a pathologist to see whether they're malignant or benign.

Barium enema

A FLUID containing barium, which shows up on X-rays, is run into your bowel. It helps to give a picture of the inside of the bowel on an X-ray so abnormalities can be seen more easily.

Blood tests

TESTS for anaemia (lack of iron in blood) and liver function tests may be done.

THE OPTIONSIF symptoms are caused by polyps, they can be removed during colonoscopy. Regular check-ups, including further colonoscopies, may then be all that is needed.

If bowel cancer is detected, further tests will assess if and how far the cancer has spread. This is called staging and helps your doctors to decide the most appropriate treatment for you.

Generally, bowel cancer is divided into four stages: Stage A when it's small and within the bowel; stages B and C are when it has spread into nearby tissue; and stage D when it has spread to distant parts of the body, including the liver.

Another system classifies the cancer into three types, depending on how deeply the cancer has gone into the bowel wall, whether lymph nodes (small glands that help to fight infection) are affected and whether cancer has spread to other parts of the body (secondaries).CUT IT OUTBEFORE surgery, treatment may be given to shrink the cancer.

The aim of surgery is to cut out the cancer with a section of bowel, and the healthy ends of the remaining bowel are joined up again.

This isn't always as simple as it sounds, particularly if the cancer has spread, and a colostomy may be necessary.

A colostomy involves diverting the end of the bowel above the tumour out through a hole in the abdominal wall.

A bag is then attached to collect waste matter. Specialist nurses (stoma nurses) can offer advice and support.

Courses of chemotherapy and/or radiotherapy may be needed in addition to surgery. These treatments destroy any remaining cancer cells and prevent it spreading further.

FOR a free copy of Lifting the Lid on Bowel Cancer, write to Beating Bowel Cancer, 39 Crown Road, Twickenham, TW1 3EJ, call 020-8892 5256 or visit www.beatingbowel


POSTER POWER: Raising awareness
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Title Annotation:Features
Publication:The Mirror (London, England)
Date:Apr 29, 2004
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