As Jeremy Bowen reveals bowel cancer diagnosis, how to spot symptoms of the condition

BBC Middle East editor Jeremy Bowen has opened up about being diagnosed with bowel cancer.

After noticing “funny pains in my legs and in my back” whilst in Iraq last May, the veteran journalist revealed on BBC Breakfast that he’d been diagnosed with the disease last October.

Doctors initially believed his pain was down to scarring from previous surgery, but following a colonoscopy – a camera inserted into the colon – doctors found a tumour, which they then removed.

He is now undergoing chemotherapy.

To coincide with Bowel Cancer Awareness Month, Bowen is opening up about his diagnosis to raise awareness of the disease.

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“I had no symptoms – none of the classic bowel cancer symptoms. Nothing at all. But I thought I should get a test”, he said.

“The key thing is: get tested. I’ve been saying to all my friends: get tested.

“Things to do with your bowels and poo are not things people normally want to talk about. But actually it’s part of all our lives and you need to work on it.”

That’s something illustrated by recent research that found despite early diagnosis being key to beating bowel cancer, nearly 50 per cent of Brits are not visiting their GPs when experiencing bowel problems.

Instead of going to their doctor, 77 per cent of people aged 25-34 admit they prefer to Google their symptoms.

Bowel problems are considered the second most embarrassing subject to talk about after sex.

The research, which was commissioned by leading bowel charity, Bowel & Cancer Research, has been published to coincide with Bowel Cancer Awareness Month and the launch of its fundraising campaign called ‘I’ve Got Guts’ also revealed that bowel problems are considered the second most embarrassing subject to talk about after sex.

Symptoms of bowel problems are also potentially being missed as nearly a third of people say they have never checked their stool for signs of blood.

Almost a fifth said the very thought of checking their stool put them off doing it, despite knowing they should do it.

But an early diagnosis means 95% of cases can be successfully treated, so it’s really time we started checking for symptoms.

“It may feel a little embarrassing for people to talk about, but we need to get rid of the taboo and start being more open about our poop in order to fight bowel cancer, among many other conditions,” says Dr Megan Rossi (@TheGutHealthDoctor), Registered Dietitian and nutritionist and founder of The Gut Health Clinic.

What is bowel cancer?

Bowel cancer is the third most common type of cancer globally. Approximately 41,700 people in the UK are diagnosed with Bowel Cancer each year, with roughly 110 new cases being diagnosed each day.

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“Bowel cancer can also be called colon or colorectal cancer, and is a cancer which affects the colon or rectum,” explains Professor Sina Dorudi, Consultant Colorectal Surgeon at the London Digestive Centre, based at The Princess Grace Hospital (part of HCA Healthcare UK).

“The cancer usually starts as benign polyps which grow on the wall of the bowel. If these aren’t spotted then certain types can turn cancerous and develop into a tumour.”

Signs and symptoms of bowel cancer

“Bowel cancer is the third most common cancer worldwide, claiming more lives each year than breast cancer, so it’s really important to keep an eye out for the key red flags, as early detection dramatically improves the outcome,” advises Dr Rossi.

She recommends looking out for any blood in your poop, unintentional weight loss and stomach pain or unexplained low blood iron levels (especially if you’re over 40) and any changes in your poop habits for six weeks (if you’re over 60).

Currently around half of all bowel cancer cases are simply being diagnosed too late – this is partially due to symptoms sharing similarities to those of digestive conditions such as IBS.

How is bowel cancer detected?

The NHS advises anyone who has one or more of the symptoms listed above and they have persisted for more than four weeks, to see their GP.

Your doctor may decide to carry out a simple examination of the tummy and bottom to make sure you have no lumps.

They may also arrange for a blood test to check for for iron deficiency anaemia, which can indicate whether there’s any bleeding from your bowel that you haven’t been aware of.

They will also arrange for you to have a simple test (colonoscopy) in hospital to make sure there’s no serious cause of your symptoms.

“There are two main types of screening for bowel cancer,” Professor Dorudi explains. “The standard process is for all NHS patients aged 60-69 years to be invited to provide a stool sample for testing.

“The advantage of this screening is that it’s very quick and simple for people to carry out, and is obviously pain free. However, unfortunately this method does have its limitations, and it’s estimated that it will only detect 60% of cancers effectively. The other disadvantage of this test is that it only targets people over 60. We know the age range of people susceptible to bowel cancer is much broader than this.

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“In my opinion, by far the most effective form of screening for bowel cancer is a colonoscopy,” Professor Dorudi continues. “This involves a tubular instrument called a colonoscope being inserted into the rectum. The colonoscope transmits an image of the lining of the colon to check for any abnormalities, such as pre-cancerous polyps.

“If anything abnormal is found, the doctor carrying out the procedure can remove small amounts of tissue for analysis. This early diagnosis means that any sign of cancer can be identified and removed as quickly as possible, either before the polyp has become cancerous or before the cancer develops further.”

Professor Dorudi says colonoscopy screenings are also available to NHS patients however, at the moment they are usually a follow up treatment if a stool sample shows any signs of abnormality.

Treatment for bowel cancer

According to the NHS the main treatments for bowel cancer are:

• surgery – the cancerous section of bowel is removed; it’s the most effective way of curing bowel cancer and in many cases is all you need

• chemotherapy – where medication is used to kill cancer cells

• radiotherapy – where radiation is used to kill cancer cells

• biological treatments – a newer type of medication that increases the effectiveness of chemotherapy and prevents the cancer spreading

“It is important to emphasise that if the tumour is caught early, then in most cases it can be removed in full, with surgery,” explains Professor Dorudi. “This is the only curative treatment for the disease and is effective in 95% of cases if removed in time.

“Unfortunately, the problems lie when patients experiencing the symptoms of bowel cancer don’t seek treatment in time, giving the tumour the opportunity to spread into other parts of the body such as the liver and lung.”

Risk factors

Though it isn’t known what causes bowel cancer the NHS advises that there are certain factors that could increase your risk of developing the condition.

These include:

• age – almost 9 in 10 cases of bowel cancer occur in people aged 60 or over

• diet – a diet high in red or processed meats and low in fibre can increase your risk

• weight – bowel cancer is more common in people who are overweight or obese

• exercise – being inactive increases your risk of getting bowel cancer

• alcohol

• smoking

• family history – having a close relative (mother or father, brother or sister) who developed bowel cancer under the age of 50 puts you at a greater lifetime risk of developing the condition; screening is

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Prevention

“While there is no sure fire way to prevent bowel cancer, studies have shown there are some simple things we can do to look after our gut health and reduce the risk of developing bowel cancer,” advises Dr Rossi.

• Be active: take the stairs, cycle to work or get off the bus one stop early and walk the rest.

• Make plant-based foods the base of your meals to increase your fibre intake.

• Watch your alcohol: try swapping your usual tipple for a low- or no-alcohol alternative – or even sparkling water, kefir or kombucha for added benefits.

• Keep your weight in check: eating high fibre foods will keep your gut bacteria well-fed and help keep the hunger at bay.

• Limit processed meats: sustain your muscles with protein from a wide range of foods including legumes, tofu, nuts, seafood and unprocessed meats.

“Not only is checking in with your bowel movements vital for spotting the warning signs, it can also provide invaluable insight into our overall health,” Dr Rossi advises.

“It’s a completely normal topic of conversation for me in my clinic and I encourage everyone to speak up if you have any concerns. Tests are very straightforward, so don’t let that put you off visiting your GP or Registered Dietitian.”

To learn more about how to get involved in the ‘I’ve Got Guts’ campaign, visit http://bit.ly/IGG19