Trust — and test — your gut instinct
Ashkenazi Jews are more likely to suffer from bowel cancer, reports Gaby Wine so it’s essential to be alert
STUNNED” IS how Angela Kirby describes her reaction to the news in August that she had colon cancer. There hadn’t been any signs that anything was the matter. “I was functioning and eating normally and walking an hour a day.” She should have received a standard home test kit in March, but the pandemic meant that screening for colon cancer had been put on hold. “I chased it for four months and even wrote to Matt Hancock. Eventually, the test kit arrived in mid-July.” Known as the FIT kit, it involves sending off a stool sample for analysis.
When Angela’s result came back positive, she was sent for a colonoscopy, a biopsy and a CT scan, which revealed a grade three tumour.
“My mother had stomach cancer and my father had colon and kidney cancer, so once I realised it was cancer, I pushed to get treatment quickly.” She underwent surgery, followed by chemotherapy and is now “under surveillance” and going for regular check-ups. “I’m now fine, although I have days when I get very tired, or my internal system plays up, and I have to pace myself.”
Bowel cancer, also known as colorectal cancer, is the fourth most common cancer in the UK, diagnosed in over 42,000 people every year. One in 15 males and one in 18 females will be diagnosed during their lifetime, and according to Bowel Cancer UK, it is the UK’s second biggest cancer killer. Risk factors include age (94 per cent of cases are diagnosed in people over 50), genetics, family history, diet and lifestyle, as well as pre-existing medical conditions, such as type 2 diabetes, Crohn’s disease and ulcerative colitis.
Research has found that Ashkenazi Jews have a greater lifetime risk of colorectal cancer, with nine to 15 per cent risk compared to the five to six per cent among the general Western population. This is partly due to the prevalence of certain genetic mutations. Another study found that carriers under 50 of the BRCA1 gene mutation, which is more widespread among Ashkenazi Jews, were also at greater risk of colorectal cancer.
From this month, anyone between the ages of 50 (it was previously 60) and 74 will be sent a home-screening kit every two years — the same test that Angela Kirby, who is 61, took. It involves posting a stool sample to a laboratory to check for tiny amounts of blood, which could be an early indication of bowel cancer. If the results are abnormal, the next stage is a colonoscopy to check for cancer or polyps. Polyps are small growths in the bowel, which could grow into cancer if left untreated. Yet, less than 60 per cent of people who are sent the home test actually take it.
Daren Francis, consultant colorectal surgeon at the Royal Free London NHS Foundation Trust and a medical patron at Chai Cancer Care, urges people to get screened, explaining: “Colorectal cancer most commonly starts as a polyp, which can be removed, so it never becomes a cancer. Prevention is better than cure.”
Signs of bowel cancer include rectal bleeding or blood in the stool, a change to normal bowel habits, unexplained weight loss, persistent abdominal discomfort or a lump in your tummy. Francis says that if you have any of these symptoms “you must 100 per cent go and see your doctor, who might then send you for a colonoscopy. It’s a 30-minute investigation that could save your life. If colorectal cancer is picked up early enough, there is a 95 per cent chance of cure.”
Gideon Josephs from Borehamwood discovered he had bowel cancer after experiencing “unbearable abdominal pain” while on holiday in Israel in 2018. “The tumour was totally out of the blue. No one in the family had had bowel cancer.” In hindsight, he says that his wife had noticed a change in his bowel movements, but thought he might have Crohn’s or IBS.
The 43-year-old father of three underwent surgery and chemotherapy and had to use a colostomy bag for six months. “Life became very challenging. I wasn’t able to help my wife in any way, and I wouldn’t go out since I was worried that the bag would leak. I became very low and depressed.”
He reached out to Chai Cancer Care for individual counselling and also for couples’ counselling. “We hadn’t fallen out of love. There had just been a lot of focus on the illness and the children, and not on our marriage. We decided on counselling to get back to the level we were at before the illness.”
Now in complete remission, Gideon recently qualified as a cancer rehabilitation specialist personal trainer “to help people with cancer get back to full fitness. Chai helped me so much that I decided I wanted to give something back.”
Lisa Steele, CEO of Chai Cancer Care, is concerned that there is going to be “a major surge” in cancer patients as a result of screenings being postponed and the fear of going for hospital appointments during the Covid pandemic. “People are getting diagnosed at a later stage, so the impact on families is so much greater.”
She warns people not to ignore screenings. “You have a duty to care for yourself. It’s also empowering to take control of a situation.”
Angela, whose most recent scans showed she was clear of cancer, couldn’t agree more. “For a few minutes of mess and personal embarrassment, you could end up saving your life. I have a number of friends in their 60s who have never taken a home test, and I’ve told them that they should do it. Late detection is shattering — physically, mentally, emotionally and also financially.”
She describes having cancer as “a lonely road”, which was exacerbated by lockdown. Living by herself, but always with an active social life, she recalls: “Sometimes, when it was dark and cold, I couldn’t get out for a walk and I felt completely isolated.” A self-employed business administrator, Angela was forced to stop working during treatment and lockdown.
She credits her sister, the community at Barnet Synagogue and Chai Cancer Care for keeping her going. “Chai offered me a psychotherapist for weekly chats. However supportive the community and friends are, it’s not the same as talking to a stranger, who has experience of supporting other people (with cancer).”
With the easing of restrictions, Angela was recently able to go for a massage at Chai to help with the side effects of chemotherapy and is thinking of joining some of their craft classes. “I think it’s important to create some kind of normality and some sort of independence, however little that is. You have to have a positive attitude and believe that however long the tunnel is, there is something at the end of it.”
Grateful to now be recovering, Angela has a clear message to anyone who feels ambivalent about taking a home-screening test. “Don’t delay. Test today. By the time you have put the kettle on and made yourself a cup of tea, you could have done your test.”
For a few minutes of mess you could save your life. Don’t delay, test today
If you are 75 or over, you can ask for a kit every two years by calling the NHS bowel cancer screening helpline: 0800 707 60 60. www.bowelcanceruk.org.uk www.chaicancercare.org