April 2018 is bowel cancer awareness month. Bowel cancer (colon cancer) remains a very common cancer with a poor prognosis, if identified at an established stage. These concerns were the driving influence towards the introduction of a national screening programme. We sat down with The GI Unit’s Consultant Colorectal and Laparoscopic surgeon Mr Romi Navaratnam to get his top tips on beating bowel cancer as well as when to seek medical advice for symptoms, diagnostic options and lifestyle advice.
The aim of effective bowel cancer screening is to identify asymptomatic patients with pre cancerous polyps or early cancers and successfully remove them, thus improving their long term outcomes.
An alteration in bowel habit (either constipation, diarrhoea or a combination of both), mucus discharge, the presence of rectal bleeding or a persistence of the above symptoms, should result in a referral to your GP or a GI (bowel) specialist.
Stool analysis previously utilised faecal occult blood (FOB) testing, which is a less accurate investigation and is due to be superseded by faecal immunochemical testing (FIT). If the test results are positive, colonoscopy and endoscopy are mandatory. The caveats with FIT, are the presence of an anaemia (low blood count) or symptoms associated with a well established bowel cancer.
A telescope is gently introduced into the colon under sedation after a prior laxative. A diagnosis is immediately established, which is a strong means of reassurance. The risk of complication is very low (1:1100) and is even less in experienced hands. Therapeutic procedures, such as banding of haemorrhoids and polyp removal can be undertaken simultaneously.
Is a lesser examination than colonoscopy. At best only 50% of the colon is examined. A proportion of individuals require additional colonoscopy at a later date.
Virtual Colonoscopy (VC)
Involves similar pre-operative laxative preparation to conventional colonoscopy and the introduction of a tube into the anus. It is particularly useful in the establishment of coincidental pathology outside of the colon, especially in frail patients.
It is less accurate than colonoscopy, for early or subtle flat lesions. Any lesion identified on VC, eg polyps, requires colonoscopy thereafter, for their removal.
Bowel Cancer Treatment Options
Any pathology identified, which cannot be immediately dealt with at colonoscopy, may require laparoscopic (key hole) surgery, which is associated with an enhanced recovery, compared to conventional surgery, with minimal lifestyle disruption and a rapid return to normal activity.
Consider screening to beat bowel cancer. Screening has a proven history in the USA and Europe, where the incidence of colorectal cancer is falling. The most accurate diagnostic tool remains colonoscopy, with virtual colonoscopy reserved primarily for elderly patients. Identification of early disease improves long-term prognosis. This is relevant in the high risk patient group, especially where there is a strong family history of colonic problems. The presence of normal investigations, can bring about significant reassurance and peace of mind.
Bowel Cancer Appointment
At The GI Unit we have a team of specialists including Mr Romi Navaratnam that are able to offer same day appointments for bowel cancer consultations. If you are concerned with any symptoms you may have and would like to book an appointment you can contact us by calling 020 7078 3802 or email us at firstname.lastname@example.org.