Arab Times

Early ‘detection’ key to bowel cancer treatment

3rd most common cancer in Kuwait

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By Dr Aisha Bhaiyat Special to the Arab Times

stool, motion, poop or faeces. Whichever term you choose to refer to your bowel motions, I want you to talk about it. Jokes in our younger days about bowel habits have rendered us too embarrasse­d to talk seriously about our bowel habits. And yet bowel cancer affecting the colon and rectum is the third most common cancer in Kuwait as well as the third commonest type of cancer causing death. However, if bowel cancer is diagnosed at an early stage, it can be treated and cured. Unfortunat­ely, it is estimated that only 40% of bowel cancers are detected at an early stage, meaning that about 60% of those diagnosed with bowel cancer are diagnosed at a later stage. Had they been diagnosed earlier, there may have been better chances at being cured.

The symptoms of bowel cancer are varied. They can include loss of appetite, weight loss, a mixture of blood with stools, a change in bowel habit or feeling that the bowels have not been fully emptied despite having been to the toilet. If you are suffering with any bowel symptoms, please see your doctor as soon as possible for further tests, as early diagnosis and treatments can mean cure.

Recommende­d Bowel cancer mainly occurs in those over the age of 50. In the early stages, there may not be any symptoms. Hence, despite no exhibition of the symptoms of bowel cancer, screening for individual­s aged 50 or above is recommende­d in order to catch the cancer in the early and curable stage. In countries such as the UK and Canada, national bowel cancer screening programmes exist and invite individual­s to attend for screening. Such a national cancer screening programme doesn’t exist in Kuwait, but screening can still be obtained. There are several methods of screening for bowel cancer. In this article, I will talk about bowel cancer screening in those with average risk for bowel cancer. Those with a first degree relative with bowel cancer, previous bowel cancer, inflammato­ry bowel disease, some inherited diseases or previous non-cancerous bowel growths should discuss their individual situation with their doctor. The rest of us should begin to consider bowel cancer screening starting from the age of 50 years.

The simplest of tests is abbreviate­d to FOB. This stands for Faecal Occult Blood. This test identifies tiny amounts of unseen blood in the faeces. Tumours in the colon can lead to blood vessels releasing small amounts of blood which then can mix in with the faeces. A sample of stool is collected at home then placed on a stool collection card or in a container. If after the test blood in the stool is identified, further tests such as a colonoscop­y may be required to find the exact cause of the blood in the faeces. Blood can be present for many reasons; examples may include ulcers or haemmorhoi­ds. It is recommende­d that if this test is chosen, it should be done annually from the age of 50 years onwards.

Advantages Alternativ­ely, other tests can be chosen over the FOB test. The advantages of these tests are that they are better at diagnosing early bowel cancer and thus can be done less frequently. However they are more invasive, thus can be uncomforta­ble and in some rare instances cause complicati­ons such as causing a perforatio­n or bleeding in the colon.

A thin bendable tube with a light and camera at the end can be inserted through the rectum to view the bowel. As most cancers occur in the latter part of the large bowel, flexible sigmoidosc­opy looks at the lining of this part of the colon. If this method is chosen, it is advisable to have this done every 5 years. Colonoscop­y goes further to look at the lining of the whole of the colon and would be recommende­d to be done once every ten years. In both the sigmoidosc­opy and colonoscop­y, if a growth is found it would be removed and looked at under a microscope and wouldn’t require any further test for definitive diagnosis. Another test is a double contrast barium enema. This is where the rectum and colon are filled with a dye that can be seen by x-ray. This dye would up any abnormalit­ies in the lining of the bowels. It is recommende­d to use this type of screening every 5 years. Barium enema, sigmoidosc­opy and colonoscop­y, all require the bowels to be empty requiring eating light food and using laxative to empty the bowels in the days leading up to the test.

If you’re over the age of 50, don’t risk dying of embarrassm­ent. We wouldn’t be embarrasse­d to talk about other types of cancer, so why hesitate at bowel? Speak to your doctor, speak to your family, speak to your friends and anyone else who will listen. No more taboos about bowel cancer, let’s all talk and make informed choices about whether to be screened for bowel cancer and how to go about it.

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