National charity Bowel Cancer UK has declared April as Bowel Cancer Awareness Month in a bid to highlight the potentially devastating impact of what might be called a hidden cancer. It would be distasteful to have a “hierarchy of cancers” but it’s clear that some conditions such as, say, breast cancer, have a higher public profile than others which might offer similarly disastrous outcomes.
As the second most common cause of cancer deaths bowel cancer is certainly among them. It kills nearly 16,000 people every year with 40,000 new cases diagnosed annually. The tragedy is that if caught early it’s eminently treatable. Disturbingly just 9% of cases are diagnosed at the very earliest stage although despite this survival rates are good – around 90% over five years.
A number of factors could be at play in the lack of early diagnoses. Public health screening is only routinely offered to older people – who are most susceptible to the condition – and access varies depending upon where you live. Scotland offers the most generous age band – between 50-74 years – with Wales the narrowest between 60 – 69. In Northern Ireland it’s 60-71 and England 60 – 74.
Then there’s the nature of the condition itself. Perhaps people are embarrassed to get checked out.
As the need for the charity’s campaign suggests, awareness is low and, therefore, also that of its risk factors.
Cancer is not something that necessarily strikes randomly. Genetic factors mustn’t be dismissed – 20% of people diagnosed with cancer have had a close or second degree relative with the disease. But our diet and lifestyles can also increase risk. There’s a role here for wellbeing and health programmes which are a frequent feature of private medical insurance policies, particularly those offered as part of an employee benefits package. For example Aviva offers its MyHealthCounts tool as a policy benefit. This helps you assess your health and provides tips on tackling potential problems. It won’t diagnose something like bowel cancer but is likely to point you in the right direction when it comes to avoiding risk factors associated with the disease.
Research suggests red and processed meats (sausages, ham, burgers etc) increase your risk of bowel cancer. Conversely high fibre, low saturated fat diets are reported to reduce risk.
It seems sitting around also increases your risk. Put more politely, being inactive is not good. An hour of vigorous exercise daily cuts risk by up to a fifth.
Obesity is an issue, particularly for men who are 50% more likely to have a bowel cancer diagnosis if they’re obese. The increase in risk is smaller for women although if they are morbidly obese they also hit that 50% risk increase figure.
No surprises here. It increases risk of cancers and heart disease by 25%.
Perhaps less obvious but an important consideration. The Europe Against Cancer EPIC Project found that for every two units of alcohol consumed daily, your risk increases by 8%.
Know your body, help a diagnosis
To secure an early diagnosis and improve your chances of responding to treatment it’s important to recognise the symptoms of bowel cancer – and act if you’re suffering from them.
Blood can be “hidden” in your stools or more obviously bleed from your bottom. Rectal bleeding does not necessarily indicate bowel cancer (it could, for example, be piles) but you should get it checked out.
Being extremely tired without apparent reason.
Whilst many of us strive to lose weight, unexplained weight loss can be a cause for concern.
If for three weeks or more you suffer diarrhoea, constipation or go to the toilet more frequently than normal.
A pain or lump in the abdomen. This may be caused by your bowel being obstructed and may also lead to vomiting.
If you suffer any of these symptoms you should get checked out by your GP. It may be nothing but if s/he is concerned they will refer you to a specialist. If you have a private medical insurance policy you will usually be able to choose your own consultant, and where and when you are seen. Cheaper policies will refer you to a consultant and a hospital of the insurer’s choosing but you will still be guaranteed to be promptly seen. Remember a swift diagnosis will increase the chances of treatment delivering a positive outcome.
Once a diagnosis is made treatment will depend upon how far the cancer has progressed and the size and location of your tumour.
If you’ve benefited from an early diagnosis and your cancer is at stage one (of five grades which identify the severity of the disease’s spread) then surgery will be the typical treatment.
Later stage diagnosis will likely involve a combination of treatments. Surgery to remove cancerous cells (and in some cases nearby lymph nodes) is likely to remain at the core for stage two and three diagnoses. This may be followed by chemotherapy to minimise the risk of the cancer returning
Radiotherapy may be used to reduce the size of a tumour prior to surgery to remove it. Radiotherapy involves the targeted delivery of high energy radiation. An MRI scan (Magnetic Resonance Imaging) will be used to ‘mark’ your tumour so that radiotherapeutic treatment can be accurately targeted. If you are to receive external radiotherapy this will be a daily treatment lasting weeks. Radiotherapy may also be complemented by chemotherapy. This is known as chemoradiation.
It is possible that before or after surgery you may need a stoma fitting (a colostomy – for more information and advice click here). This may be permanent or could be reversed at a later date.
For advanced cases biological therapies may be used in conjunction with chemoradiation. These are designed to boost the immune system which in turn can slow the progression of the disease and help minimise the side effects of other treatments.
It’s important to remember that treatment you are to receive will be determined only once your specific situation has been assessed by a multi-disciplinary medical team. The information given here details only the options that may be pursued.
Typically entry-level policies do not include cover for cancer treatment although it may be possible to supplement your basic protection with specific cancer insurance. More comprehensive policies may incorporate cancer diagnosis and treatments and offer quite significant benefits.
Key among these is the ability to see a cancer specialist (oncologist) quickly and locally – and receive diagnostic procedures such as MRI scans to determine if you have the disease and, if so, the stage it has reached. If you receive a positive diagnosis then you’ll also benefit from prompt treatment.
Many policies will allow you not just to select your consultant but the hospital or clinic where you will be treated. You may particularly appreciate this if your treatment involves external radiotherapy which may require daily hospital visits over several weeks. You may find this an important consideration when choosing your private healthcare provider as each offers their own hospital lists from which you can choose. Remember too that lower cost health insurance policies may offer only restricted hospital lists or require you to let the insurer decide which hospital you visit and which consultant you see.
To help you reduce your risk of contracting bowel cancer and other diseases and conditions, a number of policies will provide tools to help you assess your own health, identify potential risks and offer advice on addressing them. Some also incentivise you to live a healthier life by offering gym and health club discounts.
More information on bowel cancer
Bowel Cancer UK: Long-established charity offering advice, support and a wide range of downloadable resources. Organiser of Bowel Cancer Awareness Month.
Macmillan Cancer Support: National charity supporting those worried about or living with cancer. Offers wide-ranging support including specialist nurses, social care professionals and financial advisors.
NHS: The NHS website offers extensive information on the causes, symptoms and treatments of bowel cancer.
Beating Bowel Cancer: Charity dedicated to raising the awareness of symptoms, promoting swift diagnosis and access to treatment. Nurse-led support is provided via telephone, email, an online forum and social media.