Don’t die of shame
Embarrassment prevents a significant number of sufferers from seeking advice on signs that may indicate cancer, writes Gabrielle Fagan
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IF YOU pride yourself on showing a typically British reserve and relish traditional “fry-up” foods such as bacon and sausages, you could be putting your health in danger.
Those are two key factors implicated in bowel (or colon) cancer, which claims 16,000 lives a year in Britain, with lung cancer the only form of the disease to kill more.
About 35,000 people, mostly those over 60, are diagnosed annually with the disease – which is one of the most treatable cancers if caught early.
Yet apart from a few exceptions – including footballer Bobby Moore and TV presenters Lynn Faulds Wood and Sharon Osbourne – few well known people have spoken out about the disease. Embarrassment generally over discussing telltale signs such as diarrhoea or rectal bleeding leads to thousands of victims a year not seeking help until it is too late.
About 84% of people would rather ignore their symptoms than talk to their doctor, according to one survey.
There’s also little awareness of the role diet can play in raising risk of the disease.
Fewer than one in three people, according to latest research by the World Cancer Research Fund, realise that even small amounts of processed meat in the diet increase the likelihood of bowel cancer by 20%.
Charity Bowel Cancer UK (www.bowelcanceruk.org.uk) is shining a spotlight on the disease during April’s Bowel Cancer Awareness month.
Its medical adviser, Dr Rob Glynne-Jones, who is Macmillan Gastro-Intestinal lead clinician at Mount Vernon Cancer Centre, says the outlook for countering the disease is positive.
“While there are still 100 people daily being diagnosed with bowel cancer, we are making rapid strides medically, not just with more targeted, effective treatments, but also research to help prevent this disease,” he says.
“Surgery and drug treatments have improved enormously over the last 10 years and nowadays around 90% of people diagnosed early survive. But in the next decade we should see dramatic improvements in survival rates, earlier detection and, hopefully, reductions in the numbers of those developing it.”
Currently, the UK has about a 15% higher rate of late diagnosis compared with other European countries, but a nationwide bowel cancer screening programme, launched in 2006 and which will have full UK coverage by 2009, aims to improve this situation by detecting bowel cancer at an early stage – in people with no symptoms – when treatment is more likely to be effective.
Glynne-Jones says: “Although it’s in its early stages, bowel cancer screening is already reportedly having an effect. In Nottinghamshire, for instance, they’ve seen a dramatic fall in the number of emergency bowel operations. These are typically needed when a cancer is at a late stage and is causing an obstruction.”
He, in common with other experts in the field, believes the screening programme is key for detecting polyps, too.
“These are not cancers, but may develop into cancers over time. They can easily be removed, reducing the risk of bowel cancer developing.
“We hope that the screening test will evolve over time into a more sophisticated diagnostic tool and eventually be able to pick up ‘tumour’ DNA.”
Meanwhile, research is ongoing into, among other things, the role that drugs such as aspirin, and even turmeric, an ingredient commonly used in curry, could play in reducing the risk of bowel cancer – although this is in its early stages and should not be experimented with at home.
Glynne-Jones says: “We’re unravelling the genetic and biological disposition that people have to this cancer and, coupled with identifying lifestyle changes that may make an impact – such as exercise and a balanced diet – we’re gaining ground in the fight against a disease that needlessly claims too many lives.”
And he stresses: “Greater awareness – so that people get any concerns checked out and also are alert to symptoms – is vital. Bowel cancer need not kill if caught early enough.”
Follow our experts’ advice on checking for symptoms and improving health and lifestyle to help reduce your risk of developing the disease.
AM I AT RISK?
TV presenter Lynn Faulds Wood, 60, who had bowel cancer 16 years ago, says: “First the comforting news. Most of us have bowel problems at some time in our lives, but most symptoms do not turn out to be cancer.”
She runs a charity, Lynn’s Bowel Cancer Campaign, and points out that lots of people have common conditions like Irritable Bowel Syndrome (IBS) and piles, while one in 20 of us has bleeding from the bottom (rectal bleeding), especially younger people, but most people with rectal bleeding do not have cancer.
Also, she says, while bowel cancer affects one in 10 families, it doesn’t mean that you’re going to get it just because it is in your family.
She advises, as a rough rule of thumb, that the closer any affected relatives are to you (brother, sister, mother, father, child) and the younger they are, the more you need to do something about it, such as ask for screening or seek advice from a doctor.
WHAT ARE THE SYMPTOMS?
Faulds Wood says: “The commonest symptoms are change of bowel habit and rectal bleeding – it’s important to know the higher risk symptoms and to see your GP if you think you might have them.”
They are:
Change of bowel habit – a recent, persistent change which lasts for a few weeks without returning to normal. Going to the loo, or trying to go, several more times than is normal for you. Or looser, more diarrhoea-like motions – this is especially important if accompanied by bleeding.
Rectal bleeding – which persists without an obvious reason like straining, sore bottom, lumps and itching. Bleeding from the back passage persistently without any of these symptoms should be investigated.
Unexplained anaemia – men with iron-deficient anaemia should usually be investigated for bowel cancer. Women after the menopause should also be investigated.
Lynn’s Bowel Cancer Campaign 24-hour Symptoms Hotline: 0870 24 24 870 and www.bowelcancer.tv
Charity Bowel Cancer UK also has an advice service: 0800 840 3540/ www.bowelcanceruk.org.uk
TOP TIPS
SCREENING: Take part in a screening programme if you are eligible. In Scotland, people aged 50-74 will be screened every two years. Screening involves a simple home-testing kit which you then send to a laboratory. The NHS Bowel Cancer Screening Programme helpline: 0800 707 60 60.
DIET: Improve your diet and include fish and fibre-loaded fruit and vegetables.
But Professor Martin Wiseman, medical and scientific adviser for the World Cancer Research Fund, warns that eating 1.8oz (50g) of processed meat a day – the equivalent of one sausage or three rashers of bacon – raises the likelihood of bowel cancer by one-fifth.
“We are more sure now than ever before that eating processed meat increases your risk of bowel cancer and we recommend that people avoid eating it or cut it out as much as possible.”
Processed meats – those preserved by smoking, salting and any other method apart from freezing – include bacon, ham, pastrami, salami and hot dogs. Sausages, hamburgers and mince fall into that bracket if they have been preserved with salt or chemical additives.
The WCRF also advises that any meat bought should be as lean as possible, with visible fat trimmed before cooking.
VICES: Smoking and heavy drinking, especially beer and spirits, can increase your chances of getting bowel cancer. For help stopping smoking, try the Quitline on 0800 002200.
EXERCISE: Being fat can increase your risk. Even if you’re fit and fat, you’re still at increased risk of bowel cancer. Opt for a big breakfast, a middle-sized lunch and a small dinner; have only fruit as snacks between meals, and factor in exercise – even 30 minutes daily walking can help.
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