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Bowel cancer: Treatment, symptoms, advice and help

About bowel cancer

Bowel cancer refers to the malignancy involving the small or the large intestine which are responsible for the digestion of food. Small intestine constitutes the duodenum, the jejunum and the ileum whereas the large intestine constitutes ascending colon, transverse colon, descending colon and rectum. The cancer (abnormal growth of cells) is commonly seen in the large intestine as compared with the small intestines which very rarely get affected with cancer. The cancer of the small bowel may be of different varieties namely adenocarcinoma which is the commonest presentation, lymphoma, sarcoma and carcinoids. The cancer of the large intestine usually develops in the glandular tissue.

Bowel cancer: Incidence, age and sex

Small bowel cancers are extremely rare as compared with large bowel cancers which may be commonly encountered. Bowel cancers are slightly more frequent in men as compared with women. Individuals of more than 50 years of age are more susceptible, though it may occur in any age group.

Signs and symptoms of bowel cancer: Diagnosis

Some of the clinical features of small and large intestines are similar and manifest with loss of weight, diminished appetite, persistent exhaustion, abdominal pain and anaemia. Following are the clinical features specific to both types of cancers:

  • Small bowel cancer: The affected individuals may complain of sensation of increased bloating, black tarry stools. Jaundice may also be observed in some individuals when the cancerous growth compresses and obstructs the bile ducts. Occasionally abdominal lump may also be experienced.
  • Large bowel cancer: The affected individuals may complain of flatulence and abdominal pain which may be vague or cramping in quality. Stool disorders like blood and mucous stained faeces or feeling of incomplete evacuation may be complained of. Any recent change in bowel habits or alternating occurrence of constipation and diarrhoea is quite characteristic of large bowel cancer.

Such features need to be evaluated comprehensively by a gastroenterologist who may conduct investigations like barium imaging studies and upper gastro-intestinal endoscopy in cases of suspected small bowel cancer. Proctoscopy and colonoscopy which help in direct visualization of inside of bowel is done in suspected cancers of the large bowel. Other tests like blood tests, faecal occult blood test and biopsy may aid in establishing the diagnosis. The cancer in later stages may spread to other organs like liver and lungs which may be detected by CT scan of chest and abdomen.

Causes and prevention of bowel cancer

Bowel cancer may be caused in individuals who have genetic disorders like ‘familial adenomatous polyposis’ and ‘hereditary non-polyposis cancer of the colon’. Such conditions are hereditary and characterised by abnormal growth in the lining of the wall of the bowel which may later develop into cancerous growths. Inflammatory bowel diseases like ulcerative colitis and Crohn’s disease damage the bowel and increase the likelihood of cancer. Other risk factors like excess alcohol consumption, smoking, obesity and exposure to radiation may also predispose to this cancer.

Bowel cancer: Complications

Bowel cancer may spread to other organs like the liver and the lungs through the bloodstream and lymphatic route.

Bowel cancer: Treatment

The primary treatment modality of cancer of the small bowel is surgical resection which can include radiotherapy and chemotherapy in instances of recurrence and spread to other organs. The management of large bowel cancer depends on the site, severity and spread of the cancer. The primary treatment modality is surgical resection of the cancerous part of bowel followed by end to end suturing. The treatment of choice in case of cancer of the colon is surgical resection followed by chemotherapy with 5-fluorouracil whereas cancer of the rectum is mostly managed by surgical resection followed by radiotherapy. In instances of spread of cancer to other organs, all the three modalities may be considered which may vary from individual to individual. The prognosis of bowel cancer is good if the cancer is diagnosed in the early stages.