Colorectal (Bowel) Cancer

Cancer of the large bowel, also known as colorectal cancer is a common form of malignancy in developed countries. Within the UK it is the third commonest form of cancer after breast and lung. Almost 40,000 new cases were diagnosed in 2007, with two thirds being in the colon and one third in the rectum (lowest part of the large bowel). Bowel cancer is inherited in a small minority of people at an early age. The majority of cases however are related to increasing age with more than 80% of cancers occurring in people over 60 years of age. It is slightly commoner in men than women.

Symptoms from bowel cancer vary depending on its position within the large bowel but can include rectal bleeding, a change in the bowel motions or anaemia (picked up on routine blood test, or symptoms such as feeling tired, breathlessness or palpitations when severe). Occasionally it can present as a surgical emergency with pain due to perforation or vomiting and bloating due to a blockage in the bowel.

When there is concern about the possibility of bowel cancer this is usually investigated with a special telescope examination of the large bowel called a colonoscopy. Further scans such as CT and MRI are often required to assess the size of the bowel cancer and whether it has spread to other parts of the body, such as the liver.

The majority of people with bowel cancer will require an operation to remove the affected part of the bowel. At Southampton about 80% of patients are able to have a laparoscopic (keyhole) bowel resection. This compares nationally where only about 30% of surgeons are able to offer keyhole surgery. The advantages are a much faster recovery time and shorter hospital stay, with fewer respiratory (chest) complications, less risk of infections, less abdominal scarring and quicker return to normal activities.