Bowel cancer symptoms – bloated, gassy, diarrhoea, constipation? 1 July 2019 These symptoms can happen from time to time depending on what foods we eat, how much water we drink, if we can get to the toilet when we need to and the level of stress we’re dealing with, BUT these symptoms, if persistent, can also be symptoms of bowel cancer. Bowel Cancer Australia report that currently one in 13 Australians will develop bowel cancer in their lifetime. Researchers looked at the whether people living with diabetes, including those requiring insulin, had an increased risk and found that living with diabetes did increase the risk of bowel cancer. The GOOD news is that 98% of bowel cancer cases can be treated successfully if found early. The SAD yet very important news is that fewer than 50% of cases are detected early and that is WHY SCREENING is SO SO important!!! Bowel cancer is now the second most life-threatening cancer in Australia. What is bowel cancer? Bowel cancer is also known as colorectal cancer or colon (large bowel) cancer, it can also be called rectal cancer depending on where the cancer is located in the bowel. Most bowel cancers start as polyps – non-threatening (benign) growths. However, cancerous (adenomatous) polyps, if left undetected, can develop into cancerous tumours. What are the other symptoms of bowel cancer? Often there are no symptoms at all, hence why screening is so important! Other symptoms can include: Light or dark red colour or mucus in stools Unexplained low iron levels (anaemia), weakness or weight loss Pain and or a lump(s) in stomach or anus What are the risk factors for developing bowel cancer? With many health conditions there are often risk factors that can be changed and there are those that we can’t do anything about. Family history or hereditary reasons account for 30% of all bowel cancer cases but that leaves 70% of cases with no genetic link. What are the risk factors that we can’t change? Age; being 50 years or over (although current research is suggesting this is lowered to 45 years and up) Family history; having a close relative (first or second degree) diagnosed with bowel cancer Hereditary conditions known as HNPCC, FAP and MAP Personal health history including inflammatory bowel disease eg inflammatory bowel diseases (IBD) such as ulcerative colitis and Crohn’s disease and diabetes What are the risk factors that can be altered, worked on, changed? Getting screened at 50 years, or sooner when there is family history of bowel cancer Smoking Drinking alcohol A low fibre dietary intake ie low intake of vegetables (including legumes eg chickpeas, lentils), wholegrains (eg oats) and fruits (eg kiwi fruit, apples) Regular/ daily processed meat(s) intake (eg bacon, salami, ham, beef jerky) A lack of screening is a risk factor that we can do something about immediately. As mentioned earlier, screening and early detection means 98% of bowel cancer cases be treated successfully. GREAT NEWS, 98% is very close to 100%; nearly all cases of bowel cancer can treated successfully if found EARLY!! What can we do to prevent bowel cancer? Screening, screening, screening! Book an appointment with your GP to talk about bowel cancer screening today or talk to Bowel Cancer Australian (1800 555 494) or your Pharmacist for a screening kit if you are not currently eligible for a FREE screening kit. If you’re 50 years and over with no family or personal history of bowel cancer: Complete a Faecal Immunochemical Test (FIT) kit every one to two years (By 2020 all Australians aged 50-74 years of age will receive the tax-payer funded National Bowel Cancer Screening Program screening test kit in the mail every two years) If you have a family history of bowel cancer and or other increased risk factors such as an inherited gene mutation please talk to your GP about additional screening which may include a colonoscopy every five years or sooner For those who are not eligible for the government program a screening test kit can be purchased through BowelScreen Australia, participating Pharmacies or call Bowel Cancer Australia’s helpline for further support 1800 555 494. Reduce or ideally quit smoking Smoking cigarettes greatly increases the risk of bowel cancer diagnosis and death. There is lots of support out there to help with QUITTING smoking. Talk to your GP, Healthcare Team, Pharmacist or the Quitline: 13 78 48 Reduce alcohol intake Drinking two or more alcoholic drinks per day significantly increases bowel cancer risk. If you choose to drink alcohol start reducing the amount, ideally to less than two standard drinks per day and a few alcohol-free days per week 1 standard drink = 285 mL of full strength beer (4.8% alc. vol)375mL of mid strength beer (3.5% alc.vol)425 mL of low strength beer (2.7% alc. vol)100 mL of wine (red – 13% alc. vol, and white – 11.5% alc. vol)100 mL of champagne (12% alc. vol) 330 mL of spirits (40% alc. vol)275 mL bottle of ready-to-drink beverage (5% alcohol content) Increase fibre-rich food intake Enjoy vegetables including legumes, fruits, nuts, seeds and whole grains Fibre-rich foods decrease the risk of bowel cancer, helps make going to the toilet easier, and is also food for the ‘helpful gut bugs’ which protect the bowel from cancer. Currently only ~3% of Australian adults are eating the recommended five serves of vegetables per day Try to increase your vegetables intake today, even just by 1 serve to start with: 1 vegetable serve = ½ cup cooked green or orange vegetables (for example, broccoli, spinach, carrots or pumpkin) ½ cup cooked dried or canned beans, peas or lentils (preferably with no added salt) 1 cup green leafy or raw salad vegetables ½ cup sweet corn ½ medium potato or other starchy vegetables (sweet potato, taro or cassava) 1 medium tomato Increase water intake Water is important for helping to push fibre through the gut and making going to the toilet easier, among other things. Aim to have six to eight glasses of water a day (includes herbal teas, mineral water). Sit less, move more Being physically active can reduce the risk of colon cancer by 16% Aim to move more, sit less and work towards more movement as per the Australian physical activity guidelines: Be active on most, preferably all, days every week Aim to do 30 minutes per day or three lots of 10 minutes of moderate intensity physical activity most days of the week Aim to do muscle strengthening activities at least twice a week Work on reducing stress Current levels of evidence do not show a strong link between stress and increased bowel cancer risk. More research is needed! However psychological stress and cancer links can arise indirectly, for example managing stress with increased alcohol and or food intake, or using cigarette smoking as a stress management support. Aim to talk to you GP or Healthcare Team if you are dealing with excessive stress. Through a Mental Health Plan completed by your GP and yourself, you can access a psychologist several times subsided by Medicare. Diabetes Australia now has the Diabetes Counselling Service available to take calls several times a week. The above prevention strategies are also very effective for diabetes management and preventing and or delaying diabetes complications. For further information about bowel cancer, the increased risk when living with diabetes and or prevention strategies, please talk to your Healthcare Professional Team which includes your GP. The NDSS and Diabetes Australia helpline has health professionals you can speak with on 1300 136 588 should you need.