Reducing Your Risk

Reducing the Risk of Dying from Bowel Cancer

The good news is that bowel cancer can be preventable and there is a high chance of cure if it is detected early. About 60% of people with bowel cancer are cured.

At The Endoscopy Clinic, we believe that colonoscopy is the best screening procedure currently available for the prevention and treatment of pre-cancerous growths and for the early detection of bowel cancer.

What is Screening?

Screening identifies people without symptoms who are more likely to have polyps or cancer from among the general population. Colon cancer screening has the ability to detect and, by colonoscopy, remove pre-cancerous polyps.

What is Surveillance?

Surveillance monitors those with a history of bowel cancer or polyps plus those with other high risk conditions such as inflammatory bowel disease –  IBD (Crohn’s disease or ulcerative colitis). If you have adenomatous polyps you should have regular follow up colonoscopies to check your bowel for further polyps that may have formed or for signs of early cancer. Your specialist will advise you when you should have another colonoscopy.

Some people who have had surgery to remove part of their bowel to treat bowel cancer are at risk of developing new bowel cancers and having their previous bowel cancer recur.  To lower your risk:

• attend follow-up visits and have regular colonoscopies as advised by your specialist
• even if you are having regular colonoscopies, report any symptoms to your doctor that are of concern or that may suggest the possibility of bowel cancer

People who have inflammatory bowel disease – IBD (either ulcerative colitis or Crohn’s disease) may be at increased risk of developing bowel cancer. The risk depends on how long they have had inflammatory bowel disease and how much of the large bowel is involved.

What is a Colonoscopy?

The most effective form of prevention is screening to detect polyps and pre-cancerous changes in the bowel. And the most effective form of screening is a colonoscopy.

A thin, flexible fibre optic tube containing a tiny video camera at its tip is introduced through the rectum into the colon and the entire large bowel. The last segment of the small bowel is able to be thoroughly examined by one of our specialists.

Before the examination the bowel must be empty and you will be given a special solution to help this occur.

You must be in reasonable health and must avoid certain supplements and medications such as iron, aspirin and Warfarin. The nurse will discuss this with you in greater detail before the examination.

The colonoscopy is conducted in hospital under sedation and you will usually remain there for up to three hours to allow time for recovery from the sedation and accompanying painkillers.

The frequency of colonoscopy required will depend on what is found at the time of the examination. A follow-up appointment will usually be arranged to discuss these findings and further treatment and/or examinations, if necessary.

Other Screening Options Available

While colonoscopy has a high degree of accuracy and during the procedure it is also possible to remove pre-cancerous growths (polyps), you may decide, for various reasons that a colonoscopy is not for you.

Other screening options include:

• Faecal occult blood testing (FOBT) – samples of your stool are tested for blood. It is inexpensive and easy to have done but it is not as accurate as other tests for detecting colon cancer.
• CT colonography – an advanced CT scanner gives a detailed view of the colon. While the procedure is less expensive than colonoscopy, and is a viable alternative for some people depending on age and status of health, it is not capable of treating polyps or taking biopsies.
• Flexible sigmoidoscopy – similar to a colonoscopy in that it uses an internally inserted video camera but it only covers the lower third of the bowel and misses the areas where at least half cancerous growths can occur. It is also inexpensive and doesn’t require sedation but it is rarely used these days.
• DNA stool testing – examines stools for genetic changes in cells shed from polyps. This is still being evaluated worldwide and it is not in common use.

Rules for a healthy lifestyle to Reduce the Risk of Bowel Cancer

• Maintain a high level of physical exercise – up to 30 minutes a day of vigorous exercise is suggested but can vary
• Avoid excess weight, preferably by increasing physical activity (BMI < 30)
• Eat plenty of fibre-rich food and wholegrains and less food containing sugars and products with white flour
• Aim to eat at least 5 portions a day of fruit and vegetables
• Avoid eating more than 500g of red meat per week. Do not overcook meat and avoid eating any charred parts.
• Eat very little processed meats.
• Moderate the intake of animal fat (that is dairy, fat and fatty meat) by choosing light dairy products and removing visible fat from meat and the skin from chicken. Fat derived from “added fat” during cooking can be replaced by vegetable oils and possibly extra virgin olive oil
• Drink plenty of water
• Drink less than 3 glasses of wine or beer a day
• Selection and storage of food is very important – look mainly for local and seasonal fresh or frozen foods
• Healthy cooking requires lowering the amount of added cooking oils, fats and seasonings. It also means shorter cooking times and lower temperatures.
• DO NOT SMOKE

A referral to The Endoscopy Clinic for bowel cancer screening can give you peace of mind.