Bowel Cancer

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Bowel Cancer Surgeon in Mumbai.

The bowel is part of the digestive system. It is made up of the small bowel (small intestine) and the large bowel (colon and rectum). The small bowel is longer and it gets its name from the fact it is much narrower than the large bowel.

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Bowel Cancer


The bowel is part of the digestive system. It is made up of the small bowel (small intestine) and the large bowel (colon and rectum). The small bowel is longer and it gets its name from the fact it is much narrower than the large bowel. Bowel cancer is also called colorectal cancer. It affects the large bowel, which is made up of the colon and rectum. 

The cells in your body normally divide and grow in a controlled way. When cancer develops, the cells change and can grow in an uncontrolled way.

Most bowel cancers develop from pre-cancerous growths, called polyps. But not all polyps develop into cancer.

Cancer cells may stay in the bowel or they may spread into the body, like in to the liver or lungs. 

How common is Bowel Cancer?

Facts and figures about bowel cancer 

These statistics can only give you a general idea of how bowel cancer is. They cannot tell you what will happen to you, as this depends on lots of things, like what treatment you have and at what stage you take treatment. The earlier you take steps when you get problems, the higher chances you achieve cure.

Colorectal cancer (CRC) is a formidable health problem worldwide.

It is the third most common cancer in men and the second most common in women.

The number of CRC-related deaths is estimated to be 8% of all cancer deaths and making CRC the fourth most common cause of death due to cancer.

In India, the annual incidence rates (AARs) for colon cancer and rectal cancer in men are 4.4 and 4.1 per 100000, respectively. The AAR for colon cancer in women is 3.9 per 100000.

Colon cancer ranks 8th and rectal cancer ranks 9th among men. For women, rectal cancer does not figure in the top 10 cancers, whereas colon cancer ranks 9th.

More than nine out of ten new cases (94%) are diagnosed in people over the age of 50, and nearly six out of ten cases (59%) are diagnosed in people aged 70 or over. But bowel cancer can affect anyone of any age.

1 in 15 men and 1 in 18 women will be diagnosed with bowel cancer during their lifetime.

How many people survive bowel cancer?

Bowel cancer is treatable and curable especially if diagnosed early. Nearly everyone survives bowel cancer if diagnosed at the earliest stage. However this drops significantly as the disease develops. Early diagnosis really does save lives 

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cancer symptoms


  • Bleeding from your bottom and /or blood in your poo
  • A persistent and unexplained change in bowel habit that is constipation altered with diarrhoea.
  • Unexplained unintentional weight loss.
  • A pain or swelling in your tummy

Most people with these symptoms don’t have bowel cancer. Other health problems can cause similar symptoms. But if you have one or more of these, or if things just don’t feel right, then please visit your doctor. 

Sometimes, a tumour can block the bowel, causing sudden strong pains in the stomach area, bloating and feeling or being sick. This is called a bowel obstruction. You may also be unable to empty your bowels or pass wind. If you think you have a blocked bowel, see your doctor immediately.


How many people survive bowel cancer?

There are several possible causes of bleeding from your bottom or blood in your bowel movements (poo). Bright red blood may come from swollen blood vessels (haemorrhoids or piles) in your back passage. It may also be caused by bowel cancer. Dark red or black blood may come from your bowel or stomach.

Change in bowel habit

You may have looser poo and you may need to poo more often than normal. Or you may feel as though you’re not going to the toilet often enough or you might not feel as though you’re not fully emptying your bowels.

Pain or lump

You may have pain or a lump in your stomach area (abdomen) or back passage.

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cancer risk factors

Who is at risk?

You are at risk if you have one or more of the following.

  • Age 50 or above – risk increases with age, but it can affect any age group.
  • Bowel cancer history in family, especially if the relative had cancer at early age.
  • Longstanding Inflammatory Bowel Disease (Crohn’s or Ulcerative Colitis).
  • History of any growths in your bowel (like polyps in the past).
  • Alcohol: Colorectal cancer has been linked to moderate to heavy use. Even light-to-moderate alcohol intake has been associated with some risk. 
  • Smoking: People who have smoked tobacco for a long time are more likely to develop colorectal cancer.
  • Diet: A diet that’s high in red meats (such as beef, pork, lamb, or liver) and processed meats (like hot dogs and some luncheon meats) raises your colorectal cancer risk.

Having a low blood level of vitamin D may also increase your risk.

Following a healthy diet that includes plenty of fruits, vegetables, and whole grains, and that limits or avoids red and processed meats and sugary drinks probably lowers risk.

  • No physical activity.
  • Obesity

Can it be Prevented?

There’s no sure way to prevent colorectal cancer. But there are things one can do that might help lower your risk, such as changing the risk factors that you can control.

Colorectal cancer screening:

Screening is the process of looking for cancer or pre-cancer in people who have no symptoms of the disease. Regular colorectal cancer screening is one of the most powerful tools for preventing colorectal cancer.

Cancer begins from single cell to grow into polys and into cancer. With regular screening, most polyps can be found and removed before they have the chance to turn into cancer. Screening can also find colorectal cancer early, when it’s small and easier to treat.

If you are above 50 years or older, and/or you have a strong family history of cancers running in your family, you should consult a specialist regarding what would be the best screening test for you. The most important thing is to get tested. 

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Can it be Prevented?


Obesity increases the risk of colorectal cancer in both men and women, but the link seems to be stronger in men. Keeping a healthy weight may help lower your risk.

Physical activity:

Being more active lowers your risk of colorectal cancer and polyps. Start regular activity like walking, jogging, cycling etc, as it lowers the risk. Also avoid sitting and lying down for longer hours. Be active and reduce your risk.


Diet high in vegetables, fruits, grains, and low in red , processed meats probably lowers the risk of colorectal cancer. Recently studies have shown that diet rich in fibre and whole grains probably reduces the risk of colorectal cancer.


Several studies have found a higher risk of colorectal cancer with increased alcohol intake, especially among men. It is best not to drink alcohol.

Not smoking:

Long-term smoking is linked to an increased risk of colorectal cancer, as well as many other cancers and health problems. Quite smoking as early as possible.

Be vigilant and have a regular follow up if you have been diagnosed and / or treated for inflammatory bowel disease or have had a polyp removed in the past. Keep a regular follow up with your doctor.

  • Where is the cancer located?
  • Has the cancer spread beyond where it started?
  • What is the cancer’s stage (extent), and what does that mean?
  • Will I need other investigations before we can decide on treatment?
  • If I’m concerned about the costs and insurance coverage for my diagnosis and treatment, who can help me?
  • What are my treatment options?
  • If surgery is part of my treatment, will I need a stoma (poo bag)? If so, will it be temporary or permanent? Who will teach me how to care for it?
  • What do you recommend and why?
  • What would the goal of the treatment be?
  • How quickly do we need to decide on treatment?
  • What should I do to be ready for treatment?
  • How long will treatment last?
  • What risks or side effects are there to the treatments? Are there things I can do to reduce these side effects?
  • What are the chances that I can be cured of this cancer with these treatment options?
  • What would my options be if the treatment doesn’t work or if the cancer comes back (recurs) after treatment?
  • How will I know if the treatment is working?
  • Is there anything I can do to help manage side effects?
  • What symptoms or side effects should I tell you about right away?
  • Do I need to change what I eat during treatment?
  • Can I exercise during treatment? If so, what kind should I do, and how often?
  • Do I need a special diet after treatment?
  • Are there any limits on what I can do?
  • What symptoms should I watch for?
  • What kind of exercise should I do now?
  • What type of follow-up will I need after treatment?
  • How often will I need to have follow-up exams and imaging tests?
  • When should my next colonoscopy be done?
  • Will I need any blood tests?
  • How will we know if the cancer has come back? What should I watch for?
  • What will my options be if the cancer comes back?

Along with these sample questions, be sure to write down some of your own.

If one takes stool examination test and there is blood cells seen, your doctor after assessing you may advice colonoscopy and or people who undertake screening colonoscopy in such patients colorectal cancer can be picked up in its early stages. Sometimes, these tests can even prevent colorectal cancer by finding polyps before they become cancer.

If you are having signs and symptoms or things are pointing to cancer, your doctor will order some of the following test after assessing you.

Colonoscopy: A colonoscopy is a test where a thin tube with a light on the end (called a colonoscope) is put through the anus, into the rectum and colon to look closely at the inside. If any abnormal lump (mass) or polyp is found, a piece of it can be taken (a biopsy) and checked in the lab for cancer cells.

CT or CAT scan: A CT scan is like an x-ray, but the pictures of your insides are more detailed. CT scans can also be used to help do a biopsy and can show if the cancer has spread.

Ultrasound: For this test, a small stick is moved on your skin and it gives a view of your internal organs. It’s used to help find cancer and see if it has spread.

MRI scan: This test uses radio waves and strong magnets instead of x-rays to make detailed pictures. MRI scans are helpful for looking at the liver and the brain and spinal cord.

Chest x-rays: X-rays may be done to see if the cancer has spread to your lungs.

Blood tests: Certain blood tests can tell the doctor more about your overall health.

PET scan: A PET scan uses a kind of sugar that can be seen inside your body with a special camera. If there is cancer, this sugar shows up as “hot spots” where the cancer is found. It can help show if the cancer has spread.

Biopsy: During a biopsy, the doctor takes out a small piece of tissue where the cancer seems to be. The tissue is checked for cancer cells. This is the best way to know if you have cancer.

Together, these tests can tell you for certain whether you have cancer. If you do have cancer, they can also help your doctor work out how advanced it is (its stage).

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Bowel cancer is a serious illness. But many people are cured with correct treatment. Earlier you get diagnosed, earlier the stage of your cancer, the better. But, remember, every cancer in every patient behaves differently, you are not a statistic. No one can say exactly what will happen to you.

There are many ways colorectal cancer can be treated:

  • Surgery and radiation therapy are mainly used to treat only the cancer. They do not affect the rest of the body.
  • Drugs such as chemotherapy, targeted therapy and immunotherapy go through the whole body. They can reach cancer cells almost anywhere in the body.

Two or more types of treatment may be used at the same time, or they may be given one after the other. The treatment plan that’s best for you will depend on:

  • The stage at which your cancer is.
  • Your age.
  • Medical problems that you may have will guide as to which treatment will work for you.
  • Your feelings about the treatment and the side effects that come with it
  • The specific genes or proteins your cancer might have
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In early stages, a proper surgery removing the involved bowel along with the lymph nodes is curative. The cancer bowel, a small part of normal colon on either side of the cancer, and the surrounding lymph nodes are often removed. The 2 ends of the colon are then put back together.

For most colon cancers, an opening on the belly to get rid of body waste (poop) is not needed, but sometimes one is used for a short time. This opening is called a stoma. If in case you will need a stoma for a short time, your doctor will tell you more about how to take care of it and when it can come out.

If the rectal cancer is very close to the anus, surgery will be done to take out the cancer and an end stoma will be made. You will need it for the rest of your life.

You’ll have regular check-ups after being treated for bowel cancer. There’s good research to show that being checked on regularly can help you live longer. If your cancer does come back, regular check-ups mean that it will get picked up and treated sooner. However, if you get any symptoms that worry you, see your doctor straight away. Don’t wait for your next check-up.

Follow up is must!

You’ll have regular check-ups after being treated for bowel cancer. There’s good research to show that being checked on regularly can help you live longer. If your cancer does come back, regular check-ups mean that it will get picked up and treated sooner. However, if you get any symptoms that worry you, see your doctor straight away. Don’t wait for your next check-up.