Bowel Cancer in Elderly
What is bowel cancer?
Bowel cancer can affect any part of the colon, rectum or anus – the three main parts of the large bowel
Bowel cancer usually starts as slow growing polyps or ulcers attached to the inside of the bowel wall
These can gradually start to change and become abnormal over time. Untreated, these polyps and ulcers can gradually increase in size, becoming cancerous.
There are many common conditions that can affect the health of our bottoms and bowels
Many symptoms are similar to those of bowel cancer so it is important to get checked out by your ageing parent’s doctor. Their doctor will examine them and take a careful history to make sure that whatever is causing the problem is investigated properly and treated promptly
Your elderly relative should not be embarrassed, or put off
How common is bowel cancer?
Bowel cancer is the UK’s second biggest cancer killer – claiming a life every half an hour. Over 110 people are diagnosed with bowel cancer every day; that is someone every 15 minutes Over 41,000 people are diagnosed with bowel cancer each year and affects men and women almost equally.
Although it is most commonly associated with people over the age of 60, bowel cancer can affect anyone at any age
Despite these shocking statistics, at least one in four people are unaware of the disease, or the symptoms associated with it. The good news is that bowel cancer can be successfully treated in over 90% of cases, if it is diagnosed at an early stage, before it has had a chance to grow and spread
Bowel Cancer Screening
Regular bowel cancer screening has been shown to be very effective in detecting early changes in the bowel. Bowel cancer screening aims to detect signs of bowel cancer at an early stage before obvious symptoms occur
Bowel cancer screening is available to eligible people every two years and everyone that is eligible is urged to take it up when offered.
Screening kits are sent through the post automatically, to the address registered with the GP.
In England and Northern Ireland, screening is offered to people aged 60 and 69, though in England this is gradually being extended to include people aged 70-74. In Scotland, people are currently offered screening from ages 50-74, and in Wales people are offered screening from ages 60-74.7-10
If your ageing relative is over the eligible age for automatic screening, you can still request to be send a screening kit by calling the National Screening Helpline:
England: 0800 707 60 60
Scotland: 0800 012 18 33
Wales: 0800 294 33 70
Northern Ireland: 0800 015 25 14
The current screening programme – The FOB test
The existing screening programme is a simple FOB (faecal occult blood) test, which detects blood hidden in the small samples of poo. The test is completed at home over the course of a few days then returned by post to a central laboratory for testing
The FOB test does not diagnose bowel cancer, but can find blood in the poo. A positive test will trigger an invitation to retake the test, if this is also positive the patient will have further investigations (colonoscopy or sigmoidoscopy) to find out what is causing the bleeding
GPs are not involved in the process – the screening kit is sent to your home directly from the NHS screening programme.
It involves handling poo , so although the test is simple, people may be squeamish about taking samples of their poo
It is done at home and it is up to the patient to complete and return the test
What are the symptoms of bowel cancer?
We all experience problems with our bottoms and bowels from time to time. Usually there is nothing to worry about. However, if you or your elderly relative notices one or more of the following symptoms for more than three weeks, then their GP will want to see them
The early symptoms for bowel cancer can include blood in the poo, or loose stools for three weeks or more, although these are very similar to other, much less serious problems with the bowel. It is very important to be aware of what is normal, so you can recognise any unusual changes and act quickly to get them investigated
The Government is keen to raise awareness of the symptoms and has recently rolled-out a nationwide campaign Be Clear On Cancer
Anyone who may be worried should consult their GP
Chances are it’s nothing to worry about, but these symptoms could be signs of bowel cancer, so tell your parent’s doctor. Finding bowel cancer early makes it more treatable and could save your life
- Bleeding from the bottom (rectal bleeding) without any obvious reason, especially if it is unusual and does not respond to prescribed treatment for more common problems such as piles (haemorrhoids)
- A persistent change in bowel habit, especially if your parent is going to the toilet more often or experiencing unexplained looser stools. Symptoms may also include unexpected constipation and a feeling of fullness in the rectum (back passage) for three or more weeks
- Constant, unexplained pain anywhere in the abdomen especially if it is severe. It may also be linked to going to the toilet, or it might come and go like cramps or colic.
- An unexpected lump in your tummy,especially if it is on the right hand side.
- Unexpected weight loss perhaps due to lost appetite, or feeling bloated or sick.
- Unexplained tiredness, which is a symptom of anaemia.
- Most people with these symptoms DO NOT have bowel cancer, but your parent’s GP will want to examine them and may do further tests to rule it out.
• Whilst the exact causes of bowel cancer aren’t known, there are certain things that can be done to reduce the risk of bowel cancer, for example, not getting enough exercise, eating a poor diet, having a high alcohol intake or smoking) and sometimes there is nothing you can do about the risk for example your age or a family history
What else could it be?
Symptoms could be caused by other common conditions, that can easily be treated and managed:
• Piles or haemorrhoids – soft swellings just inside the anus, often accompanied by other symptoms such as pain and itching. Piles can cause bright red bleeding from the bottom, and you might be able to feel them with a finger, especially after going to the toilet.
• Anal fissures – a tear in the skin around the opening of the anus, often caused by constipation, for example.
• Irritable bowel syndrome (IBS) – IBS is a collection of symptoms, such as stomach cramps or pain, diarrhoea and/or constipation, and a change in bowel habits caused by inflammation and infection in the lining of the bowel. People with IBS do not have higher risk of developing bowel cancer, or any other serious bowel condition.
• Crohn’s Disease, diverticular disease and ulcerative colitis – other common inflammatory bowel diseases with symptoms that include abdominal pain, tiredness, weight loss, sores, bloating, bleeding and mucus. These diseases can also put your ageing parent more at risk of developing bowel cancer and the GP should monitor them regularly.
Don’t sit on the symptoms!
If your ageing parent is experiencing any of these symptoms, they should see their GP straight away
They can offer practical advice, effective treatment and support. Don’t be embarrassed and don’t put it off
The GP will understand the concerns and is quite used to talking about intimate issues!
- When did your parent first notice the symptoms? It is important to tell the GP, as precisely as possible, when the symptoms started. This is equally important if they have been recent and persistent, or if they have been coming and going regularly over the last few months
- Have your parent noticed any bleeding from their bottom, or do their stools (poo) look any different to normal? Streaks of bright red blood, with or without mucus, or very dark coloured, shiny stools are all very significant symptoms
- How often are they going to the toilet now and how has this changed ?This is also a very important symptom, and people with several weeks’ history of changes in normal toilet habits may need further investigation
- Have they also noticed any other symptoms which are unusual?
- Does bowel cancer run in the family? Very rarely, inherited bowel cancer may appear to run in families, affecting younger people (under the age of 50). If there are several generations of bowel, or other cancers in your family, the GP will need to include this in your parent’s own medical history
What happens next?
The GP should then examine the tummy and do a rectal examination (a quick, internal check with a gloved finger) in order to feel for anything unusual in the back passage
He/she may also want to do a blood test to check for anaemia
If the GP does not refer you right away for further tests or investigations, do agree a time frame to go back, and make sure your parent does, if their symptoms do not settle down after any treatment they prescribe
Most people referred will not have bowel cancer, but the earlier they find this out, the better. symptoms
Coping with bowel cancer
A bowel cancer diagnosis can have a wide reaching and unexpected impact, both physically and emotionally. It can take time to come to terms with it, not only for the individual with cancer, but also for their family, carers, colleagues and friends, all of whom need support
As a relative, you may have just as many questions and concerns as your loved one. Beating Bowel Cancer’s carers forum is a great place to get information and support from a huge range of people who have also been affected by bowel cancer. The online community is a strong, friendly group of relatives and carers of patients at all stages of the bowel cancer journey and can be accessed online 356 days a year
Many UK hospitals have support groups and rehabilitation projects being run by individual colorectal and stoma specialist nurses, which focus on helping your ageing parent to develop coping skills and confidence in managing their symptoms and any side effects they may experience following treatment
Or you can discuss and share any issues on SHARE, myageingparent’s forum
Palliative Care
If your parent is are on a palliative care pathway, living with bowel cancer and having treatment to manage symptoms as they arise, then your parent can get the added support of a Macmillan specialist nurse in the community
He/she will help them to access the services and support your parent and you as a family, to remain as independent and active as possible
In addition, your elderly relative’s GP and Community Healthcare team should be their first source of support and advice if they are concerned about coping with the practicalities of living with, or beyond a bowel cancer diagnosis or treatment, once you have been discharged from hospital
The charity Beating Bowel Cancer provides clear information, support and guidance for anyone affected by bowel cancer. They publish a range of downloadable information booklets and leaflets to help patients and their carers during treatment and beyond
Factsheets from Beating Bowel Cancer
If you are worried about bowel cancer…
The Beating Bowel Cancer Nurse Helpline offers support to patients, their families and carers and answer questions and concerns
Anyone who is worried about any aspect of the disease – whether it’s about symptoms and you don’t know what to do, if your ageing parent has been diagnosed, or have questions about treatment options – then please call Beating Bowel Cancer’s confidential helpline, open from 9am to 5.30pm Monday to Thursday and from 9am to 4pm on Friday: Tel. 08450 719301 (low call rate)
