What are the symptoms of bowel cancer?

Bowel cancer develops in the large intestine, a long tube that forms the final part of the digestive system and converts food into stool.

Bowel cancer is the 4^th most common cancer in the UL¹. However, many of the symptoms of bowel cancer are not noticeable until the cancer has grown and reached an advanced stage.

In this article, we’ll cover:

• The symptoms of bowel cancer
• The early warning signs of bowel cancer
• Whether bowel cancer can be cured
• What else could be causing these symptoms

Bowel cancer can cause many symptoms. This is because the symptoms will depend on the size of the cancer and its exact location within your bowel.

Other common conditions can also cause the same symptoms as bowel cancer. Being aware of these symptoms will help you get tested for bowel cancer early, when it’s most easy to treat.

Symptoms of bowel cancer include:

• A change in bowel habits: this can mean you are having diarrhoea or feeling constipated more frequently. If this doesn’t settle down in a few weeks it’s important to get checked out.
• Stomach discomfort: cramps or pain that persists. This can be anywhere in the stomach or pelvis. Seek medical attention if the pain gets worse very quickly, if you begin to suffer constant vomiting, and if it happens several times a week.
• Blood in the stool: the blood can be either dark red or bright red and can be seen in the toilet bowl, mixed in the stool, or on wiping. It is important to look at your stool before flushing, and at the toilet paper after wiping. It can feel strange looking at the stool and the toilet paper, but you only need to take a good look for a few seconds.
• Weight loss without trying: you may notice that your clothes are looser.
• Weakness and tiredness: anaemia is a condition in which your blood count is low, causing you to feel fatigued. Sometimes, this is caused by blood from a bowel cancer in the stool that isn’t visible but can be detected with a stool test. A blood test can also determine if your fatigue is caused by anaemia.
• Feels like your bowels aren’t emptying: a feeling that you have not completely emptied your bowels after going to the toilet. This is called “tenesmus”.

It’s important to note that these symptoms aren’t always caused by bowel cancer. However, if you start experiencing any of the symptoms above, you should contact your GP.

What are early warning signs of bowel cancer?

Unfortunately, symptoms of bowel cancer don't usually arise until the cancer has grown quite large. This means there are no “early” warning symptoms for bowel cancer. However, many bowel cancers can bleed leading to microscopic amounts of blood in the stool we can test for for a qFIT test. It’s much better to pick bowel cancer up with a qFIT bowel cancer screening test before you have any symptoms.

However, if you keep track of your bowel habits and look at your stool and tissue paper after wiping, you will at least be in a good position to get tested and seek medical advice as quickly as possible. In particular, the sight of blood after opening your bowels and any change in how often you open your bowels are warning signs.

Some people have factors that put them at increased risk of developing bowel cancer. These are:

• Age: most people who develop bowel cancer are over 50. However, the risk begins to increase after the age of 40.
• Family history: if a first-degree relative has developed bowel cancer, then your risk of developing bowel cancer is higher. This is particularly the case if your relative was under 50 when they were diagnosed.

If any of these apply to you, it is worth being extra-vigilant for the symptoms of bowel cancer and getting tested as soon as you notice them.

You can start testing for bowel cancer at home with a qFIT test. You simply need to collect a stool sample at home and then send it off via the post to be tested.

How long can bowel cancer go undetected?

Bowel cancer can go undetected for several years. This is because the tumour grows slowly before causing any symptoms. This is why bowel cancer screening is so important.

Some bowel cancer symptoms can happen earlier than others. For example, bowel tumours can often bleed. If this is only a small amount, you may well not notice any symptoms and you certainly wouldn’t see anything in your stool. If the amount of blood loss is a little higher, you’re still unlikely to see anything in your stool but may feel fatigued.

Symptoms like stomach pain, weight loss, visible blood in the stool, change in bowel habits or blockage of the bowel only tend to occur when the bowel cancer is quite large and may well be affecting other organs in your body.

This is why we use the presence of blood in the stool as a test for bowel cancer rather than relying on symptoms.

Is bowel cancer curable?

Bowel cancer is very treatable and the chances of cure are high if it is diagnosed at an early stage.

Around 90% of people who are diagnosed with stage 1 bowel cancer will survive for more than 5 years. Unfortunately, most people diagnosed with bowel cancer are already at stage 3 or 4 when it’s picked up. This means it’s begun to spread outside of the bowel. About 65% of people with stage 3 bowel cancer will survive 5 years and only 10% of people with stage 4 bowel cancer will survive this long².

These statistics show that early bowel cancer detection makes a huge difference. Early detection can be achieved by regular screening, being vigilant for the symptoms of bowel cancer and then taking action. This includes a qFIT test or simply making an appointment with your doctor.

There are many different types of treatment for bowel cancer. These include interventions via colonoscopy (a camera test for the bowel), chemotherapy and surgery. Most people would receive a combination of these.

After successful treatment of bowel cancer, there is still a chance the cancer can come back. The earlier the stage, the less chance there is of it returning. Doctors and nurses will continue to monitor for signs and symptoms of the cancer recurring for several years after treatment.

What else could your bowel symptoms be?

One of the difficulties with bowel cancer symptoms is that many other conditions can cause the same symptoms as bowel cancer. These include:

Haemorrhoids

• Also known as “piles.”
• Typically causes painless bright red blood on the stool or on wiping.
• Can also cause an itchy back passage.

Anal fissure

• This is a small tear in the anus that’s usually caused by hard stool.
• Causes pain upon passing a stool that can last for several hours.
• Can also cause bright red blood on the stool or on wiping.

Gastroenteritis

• This is a stomach bug or food poisoning.
• Can cause bloody diarrhoea, vomiting or abdominal pain. Symptoms usually only last a few days.

Irritable bowel syndrome (IBS)

• IBS is one of the commonest causes of bowel symptoms.
• IBS causes changes in bowel habits, bloating and stomach pain.
• There’s no specific test for IBS but it is important to rule out other conditions that cause similar symptoms.

Diverticular disease

• This is essentially “wear and tear” on the bowel and is very common as you get older. Around 30% of people over the age of 50 have diverticular disease and as many as 80% over 80 years.
• Diverticular disease can cause pain on the left side of the stomach, dark red blood in the stool and changes in bowel habit.

Inflammatory bowel disease (IBD)

• Common types of IBD are Crohn’s disease and ulcerative colitis.
• IBD is different to IBS because with IBD there is inflammation we can measure in the bowel. However, the symptoms of IBD and IBS can be similar.
• IBD usually starts in younger people, but can start at any age.
• IBD can increase the risk of getting bowel cancer in the future.

Coeliac disease

• Coeliac disease is an autoimmune condition triggered by eating gluten-containing foods.
• It’s pretty common, affecting about 1% of people and many don’t even realise they have it.
• Coeliac disease can cause stomach pain, bloating, diarrhoea and weight loss, just like bowel cancer.
• It’s easy to test for coeliac disease with a simple blood test.

Take a qFIT test to check for bowel cancer

The qFIT test is an easy, noninvasive test that detects blood in the stool. It’s the same test used by the NHS and the Bowel Cancer Screening Programme. You can order our qFIT test online and carry it out at home. 20% of profits from this test are donated to the St Mark’s Hospital Foundation to support bowel cancer research.