Early de­tec­tion is key to beat­ing New Zealand’s se­cond- dead­li­est can­cer.

North & South - - Four Corners -

The gov­ern­ment re­cently an­nounced a long-awaited na­tional screen­ing pro­gramme for bowel can­cer, de­signed to tackle our alarm­ing rates of the dis­ease, which kills 1200 New Zealan­ders a year. A pi­lot scheme that has run for the past five years in Auck­land’s Waitem­ata DHB has shown con­clu­sively that screen­ing saves lives.

“If bowel can­cer is de­tected early, it can al­most al­ways be cured,” says spe­cial­ist gas­troen­terol­o­gist Dr Alas­dair Pa­trick. “If it’s picked up re­ally early, we can now cut it out at the time of the colonoscopy. If that win­dow has passed, we can re­move the af­fected part of the bowel, of­ten by la­paro­scopic surgery.”

It’s only in the later, ad­vanced stages of the dis­ease that chemo­ther­apy and ra­dio­ther­apy are in­volved.

Bowel can­cer can move fast, how­ever, so the big­gest mes­sage is not to wait if you’re wor­ried: get checked. The most se­ri­ous symp­tom is rec­tal bleed­ing, which might be seen in the stool or on the toi­let pa­per. Other warn­ing signs in­clude a change in bowel habits, stom­ach pain, fa­tigue and un­ex­plained weight loss.

One per­son who feels pas­sion­ately about early de­tec­tion is the head of health prod­ucts at Sov­er­eign, Ni­cola Cress­well. “I urge peo­ple to seek help, it’s not worth lit­er­ally dy­ing of em­bar­rass­ment,” she says.

Cress­well has first­hand ex­pe­ri­ence. Her part­ner of 12 years was di­ag­nosed in his 20s. Luck­ily, he acted on his symp­toms quickly; de­spite hav­ing more than 20 tu­mours, there had been no spread of the can­cer. Ninety per cent of his large bowel was re­moved, but he didn’t re­quire chemo­ther­apy or ra­dio­ther­apy. “It was a good out­come for him,” says Cress­well.

But it wasn’t the end of the story. Be­cause of her part­ner’s his­tory ( his fa­ther died of bowel can­cer in his 50s), he has screen­ing ev­ery two years and has to take med­i­ca­tion to slow his di­ges­tion ev­ery time he eats. “He also has the oc­ca­sional bowel block­age, which is painful and scary.”

De­spite the on­go­ing ef­fects, Cress­well’s over­rid­ing feel­ing is of be­ing thank­ful her part­ner, now 20 years on from his di­ag­no­sis, sought help early.

Rates of oc­cur­rence are higher in men and statis­tics show they are more likely to die. This could be a re­sult of later pre­sen­ta­tion, due to not want­ing to talk about symp­toms, or the Kiwi bloke at­ti­tude of tough­ing things out.

“Bowel can­cer af­fects more men in New Zealand than prostate can­cer,” says Nick Stan­hope, Sov­er­eign CEO. “If it’s de­tected early enough, it can be cured in 75 per cent of cases, so I en­cour­age all the fa­thers, broth­ers, grand­fa­thers, hus­bands and best mates to talk to a doc­tor if they’re con­cerned. It’s time to start breaking down the stigma around this con­di­tion. The best de­fence is to ed­u­cate your­self and take charge of your health.”

The na­tional screen­ing pro­gramme will help – it’s aimed at those aged 60-74, which is where 80 per cent of cases in the pi­lot study were picked up. El­i­gi­ble peo­ple will be sent a stool test that checks for blood; then, if a cer­tain level is de­tected, they’ll be asked to un­dergo a colonoscopy (where a flex­i­ble cam­era is in­serted to ex­am­ine the length of the large bowel). While age is a risk fac­tor, there’s an in­creas­ing oc­cur­rence of the dis­ease in younger peo­ple so ev­ery­one needs to be vig­i­lant.

If you want to re­duce your risk, tack­ling a few life­style fac­tors and look­ing into your fam­ily his­tory is a good place to start. “Risk fac­tors in­clude obe­sity – and New Zealand has ex­tremely high rates,” Dr Pa­trick ex­plains. “Ge­netic fac­tors are sig­nif­i­cant, smok­ing is im­pli­cated and there’s a lot of talk around diet, pos­si­bly the ex­ces­sive con­sump­tion of pro­cessed meat.”

He’s cham­pi­oning the new screen­ing pro­gramme and hopes the age range will even­tu­ally start at 50, as it did in the pi­lot study. Dr Pa­trick is also hope­ful about im­proved sur­vival rates due to ad­vances in med­i­cal ther­apy. It’s now pos­si­ble to test can­cer cells for spe­cific ge­netic mu­ta­tions and to pro­vide more tar­geted chemo­ther­apy. “This is just starting and I think it will change how we treat bowel can­cer in the next five to 10 years.”

Sov­er­eign’s head of health prod­ucts, Ni­cola Cress­well, urges peo­ple with bowel can­cer symp­toms to seek help: “It’s not worth lit­er­ally dy­ing of em­bar­rass­ment.”

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