Dr Norman Swan
A diagnosis of cancer is something no one wants to hear. Most of us think of cancer as a life sentence but that’s not always true. One cancer that’s preventable, treatable and beatable is bowel cancer and June is Bowel Cancer Awareness Month.
Australia has one of the highest rates of bowel cancer in the world. Just over 15,000 Australians are diagnosed each year. And although the majority of people are over the age of 50, 2,000 are under the age of 55 and that number is increasing. It’s Australia’s second deadliest cancer with around 84 Australians dying of bowel cancer each week. If found early, nine out of 10 cases of bowel cancer can be successfully treated.
So what is bowel cancer? It can affect any part of the large bowel or rectum. Most bowel cancers start as benign lumps or polyps. If these are left undetected they can develop into cancer.
Tammy, Bowel Care Nurse, Bowel Cancer Australia: Screening is important for bowel cancer because it is one of Australia’s silent killers and unfortunately not a lot of people get warning signs. That is why it is important to be bowel cancer aware.
Anton Enus, Bowel Cancer Australia Ambassador: Well, I was part of the National Bowel Cancer Screening Programme. When you turn 50 you get these parcels in the mail that said please do the sample test, send it back. Lots of people don’t and I think my main goal is to tell people to do that test because it could save your life. What happened was that I studiously sent back the test and when I turned 55, there was a minute bit of blood in the stool which triggered a letter which said please discuss this with your GP and that started the process.
Dr Norman Swan: If you are between 50 and 74, you should have regular bowel cancer screening every two years. The Faecal Immunochemical Test is free and aims to help to detect bowel cancer early.
Tammy: Bowel Cancer Australia recommend that people participate in bowel cancer screening appropriate to your personal level of risk. So therefore, if you are a young person with a family history or have a genetic link to bowel cancer, it is important that you get tested.
Anton Enus: There is no question in my mind that the National Bowel Cancer Screening Programme, if it didn’t save my life, it came very close to doing that because it allowed an early enough diagnosis so that we could actually do something and get a positive outcome. So I really think I’m one of the lucky ones so I took part in the screening course, it’s completely free of course. It’s just a case of getting people to do the test. It’s a simple test, it takes five minutes, it’s not gonna, it’s no more invasive than changing a baby’s nappie. I try to think of it in those terms. There is the kind where they call the yuck factor. People don’t like to get involved with talking about things that are awkward. This thing is something that could save your life.
Dr Norman Swan: And if you develop any of the symptoms of bowel cancer such as blood in the stool or rectal bleeding, a recent, persistent change in bowel habits, change in the shape or appearance of your stools, abdominal pain, especially if severe, or unexplained anaemia, you should see your doctor as soon as possible to discuss diagnostic tests.
Tammy: If you are having signs or symptoms of bowel cancer the first step is to go and see your GP. The GP may then refer you on for a colonoscopy. If you have a colonoscopy, this is a procedure that will have a look into the rectum and the colon looking for any possible polyps, abnormal findings or possibly cancer. Now it’s important to remember not all polyps are cancerous. There are some precancerous polyps that are sitting in the bowel and if left long enough, can actually become a cancer.
Anton Enus: It was a bit surreal actually. You have this kind of twilight sedation that they do the colonoscopy under, and when I was coming out of it, just sort of in that slanty, woozie state, I was told that yes, there were polyps and they were removed but there was also a tumour that was estimated to be seven to eight years old. So it was quite well developed and my first reaction was I didn’t really believe that. I thought maybe I’m dreaming this. Maybe I didn’t hear properly. I’m a bit sort of under anaesthetise, I wasn’t quite understanding what the ENT guy was saying and then it took a while to sink in.
Tammy: So if you do get a positive result with your colonoscopy and are told you have bowel cancer they might talk to you about different treatment options and these would include surgery, chemotherapy, radiotherapy and more targeted therapies.
Dr Norman Swan: The risk factors that you can’t change are your age, family history, and genetic predisposition. But remember, early detection can be done and it saves lives. There are a number of risk factors that you can change and these are be physically active as part of everyday life, eat whole grains and naturally high fibre foods, maintain a healthy weight and waist circumference, avoid processed meats and limit the amount of red meat. If you choose to drink alcohol, limit the amount to no more than two standard drinks a day, and certainly quit smoking.
Anton Enus: I’m a pretty healthy person, I recon. I ticked all the boxes for lifestyle, exercise regularly, I’ve run marathons, I play tennis, I do yoga, I swim. I haven’t eaten red meat, I haven’t eaten meat of any kind in fact for over three decades, non-smoker, very light drinker, no family history, so it was quite a surprise, actually, when I was told that the test had come back positive. It was the last thing I was expecting to hear.
Tammy: This month is Bowel Cancer Awareness Month. It is Australia’s second deadliest cancer. Please, be bowel cancer aware. Make sure that you have the conversation and if you have any signs or symptoms, or any concerns, talk to your GP.
Anton Enus: I decided to go public with my experience and maybe raise a bit of awareness and the response I’ve had has been quite phenomenal. Strangers stop me in the street and cafes, on sports fields just to say thank you for doing that and I did the test and that’s really, I’m very gratified by that. That’s the main reason I do this ambassadorial work is to get people to do the test. It’s such a small test, such a little thing to do, that could lead to fantastic outcomes because the earlier we get the diagnosis, and we know it’s a big, big cancer threat for Australia. The earlier we get the diagnosis, the best chance that people will have of getting a positive outcome.
Dr Norman Swan: Let’s save lives through early detection and prevention and support Bowel Cancer Australia this month. Follow these links for more information: