Bowel Cancer Awareness Month: Knocking the Bottom Out of Bowel Cancer

Posted April 01, 2013

As part of Bowel Cancer Awareness Month (April 2013), Consultant General & Colorectal Surgeon, Chelliah Selvasekar describes the signs and symptoms of bowel cancer, also known as colorectal cancer, and explains some of the diagnosis and treatment options available.

Colorectal cancer is the third most common cancer diagnosed in theUK, at over 35,000 new cases each year. It includes malignant tumours anywhere in the colon and rectum. With early diagnosis the disease can almost always be cured with minimal effect on a patient’s quality of life. However patients with early colorectal cancer typically have no, or non-specific, symptoms, making late diagnosis the norm.

Several screening regimens have been proven to be effective in reducing colorectal cancer deaths. The NHS has introduced a bowel cancer screening programme which involves a faecal occult blood test followed by a colonoscopy for patients aged 60-69 years, and up to 74 years in England. The FOB test is a simple stool sample which checks for unseen blood in the faeces, while the colonoscopy is an internal examination of the colon and rectum with a flexible tube and camera. In addition, people will begin to be invited at age 55 to have a one-off flexible sigmoidoscopy test to examine the lower bowel in a similar way to the colonoscopy.

This programme will lead to earlier diagnosis so it is important that the absence of symptoms should not be a reason to delay screening. Most colon cancers are believed to start as benign colon polyps and screening tests can detect these polyps before they become cancerous.

Later symptoms, which should not be ignored, include:

  • New and persistent bowel habit changes (diarrhoea, constipation, narrowing of stool)
  • Rectal bleeding
  • Cramping or persistent stomach pain
  • Decreased appetite
  • Weakness or fatigue
  • Jaundice

Treatment has also improved. Surgery is the main form of treatment and cures 60% of colorectal cancer overall. Traditionally this has been via the open approach but the recent move towards laparoscopic surgery has a number of advantages:

  • Smaller incisions:
    • Less pain
    • Less unsightly scarring
  • Faster recovery:
    • Earlier return of bowel function
    • Decreased length of hospital stay
    • Earlier return to work and/or recreation
  • Long term:
    • Lower risk of adhesions (internal scar tissue)
    • Lower risk of hernia

There is no difference in overall survival, disease free survival or wound recurrences. The morbidity and mortality rates for patients having laparoscopic surgery are also equivalent to those having open surgery. However, because of the benefits, NICE (National Institute for Health and Clinical Excellence) guidelines recommend laparoscopic surgery where both laparoscopic and open surgery are suitable for the patient and the surgeon is competent to perform laparoscopic surgery.

In addition, robotic surgery is offered for rectal conditions as the improved magnification, precise dissection with robotic instruments and better ergonomics offer the following benefits:

  • Reduced trauma to the body
  • Less anaesthesia
  • Reduced blood loss
  • Lower risk of infection
  • Effective control of disease
  • Less scarring and improved cosmetics
  • A shorter hospital stay
  • A faster recovery time and return to normal activities
  • Improved and early return of continence

The Christie Clinic uses a state-of-the-art operating theatre equipped with the cutting-edge Da Vinci® S robot to provide this service, and works with the leading robotic surgery experts in the northwest of England. We also have a highly experienced laparoscopic surgery team and can offer all the relevant diagnostic procedures and non surgical treatments.

Mr Chelliah Selvasekar MBBS, MD, FRCS, FRCS (Gen), Pg Cert (Med Ed) is a consultant general & colorectal surgeon at The Christie Clinic, Manchester. He is an expert in laparoscopic and robotic colorectal surgery, having performed over 300 of these procedures, and trains colorectal surgeons and specialist registrars in this discipline.

The Christie Clinic offers the full range of diagnostic and treatment services for people with bowel cancer or possible symptoms. We are proud to work with a team of internationally renowned specialists such as Mr Selvasekar in a safe and modern environment. There are no waiting lists and appointment times can be arranged to suit you. For more information on services at The Christie Clinic, or to make an appointment, contact us on 0161 918 7296.