Bowel cancer is one of the most common cancers in the UK, with more than 42,000 people diagnosed with the condition every year.
Bowel cancer is a general term for cancer that begins in the large bowel, but depending on where the cancer starts it is sometimes called colon or rectal cancer.
Cancer campaigner and broadcaster Dame Deborah James, who died aged 40, gave candid accounts of her treatment on the BBC’s You, Me and the Big C podcast, as well as raising millions for cancer research.
Dame Deborah’s final wish was for everyone to “check their poo” to check for bowel cancer. The campaigner, who was known as BowelBabe on Instagram, died surrounded by her family, who released a statement in an Instagram post.
After announcing her death, they also shared a “few final things from Deborah”.
The post read: “‘Find a life worth enjoying; take risks; love deeply; have no regrets; and always, always have rebellious hope. And finally, check your poo – it could just save your life.”
But what are the signs and symptoms of bowel cancer, how should you check your poo and when should you see a GP?
Here’s what you need to know.
What is bowel cancer?
Bowel cancer is the fourth most common cancer in the UK, according to Bowel Cancer UK.
The charity explains that most bowel cancers develop from pre-cancerous growths - which are called polyps - but not all polyps develop into cancer.
If your doctor finds any polyps, they can remove them in order to prevent them becoming cancerous, Bowel Cancer UK adds.
According to the NHS, the three main symptoms of bowel cancer are:
- persistent blood in your poo – that happens for no obvious reason or is associated with a change in bowel habit
- a persistent change in your bowel habit – which is usually having to poo more and your poo may also become more runny
- persistent lower abdominal (tummy) pain, bloating or discomfort – that's always caused by eating and may be associated with loss of appetite or significant unintentional weight loss
However, the NHS notes that most people with these symptoms do not have bowel cancer, and other health problems can cause similar symptoms.
How to check your poo for bowel cancer
Persistent blood in your poo and a persistent change in your bowel habit can both be signs of bowel cancer.
There are several possible causes of bleeding from your bottom or blood in your poo. Bright red blood may come from haemorrhoids or piles in your back passage, but it may also be caused by bowel cancer. Dark red or black blood may come from your bowel or stomach. You should tell your doctor about any bleeding so they can find out what is causing it.
You might be bleeding from the bottom if you have:
- blood on your toilet paper
- red streaks on the outside of your poo
- pink water in the toilet bowl
- blood in your poo or bloody diarrhoea
- very dark, smelly poo (this can be blood mixed in poo)
You should also tell your GP if you have noticed any persistent and unexplained changes in your bowel habit, especially if you also have bleeding from your back passage. You may have looser poo and you may need to poo more often than normal, or you may feel as though you’re not going to the toilet often enough or as though you’re not fully emptying your bowels.
When should I see a GP?
The NHS says you should see a GP if you have any of the symptoms of bowel cancer for three weeks or more.
The GP may then:
- examine your tummy and bottom to make sure you have no lumps
- arrange for a simple blood test to check for iron deficiency anaemia – this can show whether there's any bleeding from your bowel that you have not been aware of
- arrange for you to have a simple test in hospital to make sure there's no serious cause of your symptoms
You should “make sure you see a GP if your symptoms persist or keep coming back after stopping treatment, regardless of their severity or your age,” adds the NHS.
Who is screened for bowel cancer?
NHS bowel cancer screening checks if you could have bowel cancer and is available to everyone aged 60 or over and 56 year olds.
You use a home test kit, called a faecal immunochemical test (FIT), to collect a small sample of poo and send it to a lab, where it is then checked for tiny amounts of blood.
Blood can be a sign of polyps or bowel cancer. Polyps are growths in the bowel. They are not cancer, but may turn into cancer over time.
If the test finds anything unusual, you might be asked to have further tests to confirm or rule out cancer, according to the NHS.
What are the causes of bowel cancer?
The exact cause of bowel cancer is unknown, but research has shown several factors may make you more likely to develop it, including age, family history, diet, smoking, alcohol, obesity, inactivity, digestive disorders and genetic conditions.
What is the treatment for bowel cancer?
Bowel cancer can be treated using a combination of different treatments, depending on where the cancer is in your bowel and how far it has spread.
The main treatments are:
- surgery – the cancerous section of bowel is removed. This is the most effective way of curing bowel cancer and in many cases is all you need
- chemotherapy – where medicine is used to kill cancer cells
- radiotherapy – where radiation is used to kill cancer cells
- targeted therapies – a newer group of medicines that increases the effectiveness of chemotherapy and prevents the cancer spreading
However, the NHS explains that as with most types of cancer, the chance of a complete cure depends on how far it has spread by the time it's diagnosed.
If the cancer is confined to the bowel, then surgery is usually able to completely remove it.
Keyhole or robotic surgery is now being used more often. This allows surgery to be performed with less pain and a quicker recovery.