At Home with Chris Jessen 2018 - 82
More people in their 20s and 30s are
experiencing bowel cancer. The key
to a good outcome is early diagnosis
iagnosing colorectal cancer
is always devastating, but
especially so if the patient is
only 25 and has been to the
GP several times with vague symptoms,
only to be told it's haemorrhoids.
It is known that colorectal cancer
(CRC), or bowel cancer, is a common
and lethal disease, but it is also one of
the most preventable cancers.
The second biggest cancer killer in
the UK (after lung cancer), it claims
16,000 lives each year. This is despite
the free national bowel cancer-screening
programme for those aged 60-75 years.
Measures have been taken to encourage
more people to be screened.
Of those 16,000 lives lost, 2,000
are young adults. Bowel cancer is
uncommon before the age of 40, but
the alarming fact is that there has been
a documented increase in young adults
aged 20-39. These younger patients
have significantly poorer outcomes
because they are being diagnosed later.
Many experience symptoms such as
rectal bleeding and abdominal pain, but
are overlooked or misdiagnosed as having
irritable bowel syndrome or haemorrhoids
simply because of their age.
As many as 35% of these young adult
cancers are associated with hereditary
syndromes (disorders passed from parent
to child that increase the risk of cancer).
The two most common are familial
adenomatous polyposis (FAP) and
Lynch syndrome, which account
for 5% of all CRC cases.
Both genetic and environmental
factors increase the likelihood of
developing CRC. However, the majority
of cases - 95% - occur in people without
a family history of cancer.
Screening saves lives
The growth from a pre-cancerous
polyp to invasive cancer can take up
to 15 years - this provides a unique
opportunity for the prevention and early
detection of colorectal cancer. In Lynch
syndrome, however, polyps develop into
cancer in less than three years typically.
Bowel cancer may present at any age
with well-known 'alarm features'.
These warning symptoms are:
Rectal bleeding/blood with stools
Persistent change in bowel habit
(especially frequent or looser stools)
Abdominal pain or mass
Unexplained weight loss
Such symptoms need an urgent GP
referral to gastroenterology. However,
CRC may have no symptoms in the early
stages, hence the need for the national
bowel cancer screening programme.
For younger people who are not
eligible for screening, vigilance is
required to spot the symptoms.
Investigations need to be performed
promptly, even if the symptoms do
not fulfil the 'urgent' criteria. Increased
awareness amongst GPs and the
population about the deadly disease
is vital to beat bowel cancer.
MEET THE EXPERT
Dr Lisa Das trained
at Guy's Hospital
training at the
Centre and a
fellowship at Columbia Presbyterian
Medical Centre, New York. She is
consultant gastroenterologist at The
Royal London Hospital, core member
of the colorectal multidisciplinary
team and an accredited bowel cancer
Dr Das also works at The London
Clinic, The BUPA Cromwell Hospital,
the London Independent Hospital, The
Harley Street Clinic and at Lyca Health,
Canary Wharf. Her specialist interests
include managing gastrointestinal
diseases, such as irritable bowel
syndrome, diarrhoea, constipation,
heartburn and abdominal pain. She has
a particular interest in improving the
patient pathway and outcomes. She
specialises in endoscopy
FOR MORE INFORMATION
Call 0790 693 0465