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Alarm symptoms missed in bowel cancer emergency patients

October 03, 2016

Dr George Webster, Consultant Gastroenterologist at The Physicians' Clinic, comments on a recent study that highlights the importance of alarm symptoms in bowel cancer:

Bowel cancer is one of the commonest malignancies in the UK, with more than 40,000 new cases diagnosed each year, and a steady increase in the number of people diagnosed over the last 40 years. Treatment has greatly improved over that time, with a higher proportion of affected individuals cured of their disease than ever before. However, the complexity and success of treatment is hugely affected by the stage at which the cancer is diagnosed. This has led to an increased emphasis on trying to diagnose colon cancer at an early stage (at which point complete cure may be expected in > 90% of patients). Individuals with an increased risk of colon cancer (e.g. a family history) or with other concerns (e.g. blood detected in stool, even without symptoms) may be considered for a colon examination (colonoscopy), which may both diagnose small cancers, or more often identify pre-malignant polyps, which can be straightforwardly removed before they might become malignant.

A recent study from London has shown that 35% of patients are first diagnosed with colon cancer after an 'emergency' presentation. Developing significant symptoms (such as a blockage) often suggests more advanced cancer, requiring more difficult treatment. In the study, researchers showed that many patients had seen their GPs on several occasions over the preceding months, often with a range of important 'red flag' symptoms, including blood in the stool, weight loss, fatigue (which may relate to anaemia), and a change in bowel habit. Whilst these symptoms may be explained by problems other than cancer, they need to be checked out early. Prompt referral to a gut specialist (gastroenterologist) may allow rapid investigation, often including a colonoscopy, to establish the diagnosis on commence whatever treatment may be necessary.

This study, and the proven success of screening colonoscopy, reiterates the necessity of getting bowel symptoms investigated at an early stage.

You can read the original article here http://www.bbc.co.uk/news/health-37493706

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