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olor

ecta

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hat i

s C

olor

ecta

l Can

cer?

1

hat c

ause

s C

olor

ecta

l Can

cer?

2

ympt

oms

of C

olor

ecta

l Can

cer

4

hatto

do

next

5

uest

ions

to a

sk y

our

GP

6

educ

e yo

ur r

isks

8

cree

ning

CC

lnfo

line

10

olon

Can

cer

Con

cern

12

Con

cern

ed a

bout

Col

orec

tal C

ance

r?

The

re is

a g

reat

dea

l of c

onfu

sion

abo

utth

e na

me

of th

is c

ance

r. It

can

be

refe

rred

to a

s bo

wel

or la

rge

bow

elca

ncer

, col

orec

tal

canc

er o

r ca

ncer

of

the

larg

e in

test

ine.

The

dia

gram

illus

trat

esth

e di

ffere

ntar

eas

conc

erne

d.

Wha

t is

Col

orec

tal C

ance

r?

Col

orec

tal c

ance

r ca

n de

velo

p w

ithin

any

par

t of t

he c

olon

or r

ectu

m a

nd c

an b

e ei

ther

ben

ign

(non

-can

cero

us)

or

mal

igna

nt (

canc

erou

s). M

ost c

olor

ecta

l can

cers

aris

e fr

om

the

grow

ths

know

n as

ade

nom

as. I

n th

e ea

rly s

tage

s th

ese

rese

mbl

e a

poly

p, a

term

for

an o

verg

row

th o

f cel

ls. I

n

som

e ca

ses,

ade

nom

as in

crea

se in

siz

e an

d un

derg

o

chan

ges,

bec

omin

g ab

norm

al in

func

tion,

str

uctu

re a

nd

shap

e. T

his

is c

omm

only

cal

led

a ca

ncer

or

mal

igna

ncy.

Gui

le

Sto

mac

h

Sm

all I

ntes

tine

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all b

owel

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Rec

tum

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us

Col

onLa

rge

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stin

e

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e bo

wel

)

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ance

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exa

ctca

use

of c

olor

ecta

l can

cer

rem

ains

unk

now

n,H

owev

er, t

here

are

fact

ors

that

mak

e pe

ople

mor

e at

ris

k,

Age co

lore

ctal

can

cer

can

deve

lop

in m

en a

nd w

omen

of

any

age,

but

itte

nds

to b

e a

dise

ase

of la

tem

iddl

e an

d ol

d ag

e. In

the

UK

, aro

und

75%

of c

ases

occ

ur in

peo

ple

over

the

age

of 5

5 w

ho h

ave

nopa

rtic

ular

fam

ily h

isto

ryth

at w

ould

influ

ence

thei

rris

k of

deve

lopi

ng c

olor

ecta

lca

ncer

.

Fam

ily H

isto

ry

In th

e U

K, l

ess

than

5%

of a

llpe

ople

dia

gnos

edw

ith c

olor

ecta

l can

cer

have

a fa

mily

his

tory

of t

hedi

seas

e. T

here

may

be

gene

ticco

nditi

ons

that

grea

tly in

fluen

ce th

e ris

k of

deve

lopi

ng th

edi

seas

e. O

ften,

if th

ere

isa

hist

ory

of c

olor

ecta

lca

ncer

with

in a

fam

ily, t

he d

isea

seap

pear

s at

an

earli

er a

ge (

unde

r 45

yea

rs) a

nd a

ffect

s tw

o or

mor

e cl

ose

rela

tives

(pa

rent

, bro

ther

sist

er).

Infla

mm

ator

y bo

wel

dis

ease

Peo

ple

who

hav

e an

infla

mm

ator

ybo

wel

dis

ease

or th

ose

who

hav

e a

tend

ency

to d

evel

op p

olyp

sm

ay h

ave

anin

crea

sed

susc

eptib

ility

tode

velo

ping

col

orec

tal c

ance

r.

)iet/L

ifest

yie

Die

ts h

igh

ri fa

t and

low

in v

eget

able

s, c

ombi

ned

with

a se

dent

ary

lifes

tyle

, can

incr

ease

the

risk

of d

evel

opin

g th

edi

seas

e.

Eve

ry 1

5 m

inut

esso

meo

ne in

the

UK

is to

ld th

ay h

ave

colo

rect

alca

ncer

Bow

el C

ance

r F

orum

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ympt

oms

of C

olor

ecta

l Can

cer

The

sym

ptom

s of

col

orec

tal c

ance

r de

pend

upon

the

stag

e of

the

dise

ase

and

the

part

of

the

colo

n af

fect

ed a

nd m

ay in

clud

e an

y of

the

follo

win

g:

Ble

edin

g fr

om th

e bo

ttom

(re

ctal

ble

edin

g) w

ithou

t any

stra

inin

g, p

ain,

sor

enes

s, lu

mpi

ness

, sw

ellin

g or

itch

ing

A r

ecen

t or

pers

iste

nt c

hang

e of

bow

el h

abit,

suc

h as

goin

g to

the

toile

t mor

e fr

eque

ntly

, or

havi

ng lo

oser

stoo

ls, e

spec

ially

with

rec

tal b

leed

ing

Rec

tal b

leed

ing

if yo

u ar

e ov

er 5

5 -

pile

s m

ay b

e m

aski

ngm

ore

serio

us s

ympt

oms

Une

xpla

ined

ana

emia

,( w

hich

som

etim

es ta

kes

the

form

of e

xtre

me

tired

ness

or

fatig

ue)

and/

or s

ever

e gu

t pai

n

Alth

ough

all

of th

ese

sym

ptom

s ca

n be

cau

sed

by o

ther

con

ditio

nsit

is im

port

ant t

hat y

ou h

ave

them

che

cked

by

your

doc

tor.

Kee

p a

sym

ptom

dia

ry

Kee

p a

sym

ptom

dia

ry a

bout

you

r bo

wel

mov

emen

ts (

a co

py o

f our

Sym

ptom

Rec

ord

She

et c

an b

e ob

tain

ed fr

om C

CC

'S In

folin

e). T

his

shou

ld in

clud

e th

e da

te y

ou s

tart

ed th

e di

ary;

wha

t you

r m

otio

ns lo

ok li

ke, t

heir

colo

ur a

nd

cons

iste

ncy;

how

ofte

n yo

u ar

e ha

ving

you

r

bow

els

open

ed a

nd w

heth

er a

ny b

lood

and/

or m

ucus

(cl

ear

jelly

like

sub

stan

ce)

is

pass

ed. P

rovi

ding

mor

e ac

cura

te d

etai

ls o

f

your

sym

ptom

s w

ill h

elp

your

GP

dec

ide

on th

e ne

xt s

teps

to ta

ke.

Wha

ttodo

nex

t

Don

't be

em

barr

asse

d

Bow

els

are

the

bodi

es n

atur

al w

aste

sys

tem

- n

ot d

issi

mila

r to

our

was

te

bins

at h

ome!

We

all h

ave

bow

els,

but

they

are

a s

ubje

ct m

any

peop

le

find

diffi

cult

to ta

lk a

bout

.

See

k ad

vice

If yo

u no

tice

chan

ges

in y

our

bow

el h

abit,

then

don

t del

ay in

see

king

advi

ce. D

octo

rs a

nd n

urse

s ar

e ve

ry u

sed

to ta

lkin

g ab

out t

hese

par

ts

of o

ur b

ody

with

out m

akin

g it

emba

rras

sing

or

diffi

cult.

Rem

embe

r,

for

mos

t dis

ease

s an

d ill

ness

es, b

ut in

par

ticul

ar c

olor

ecta

l can

cer

-

early

det

ectio

n in

crea

ses

the

succ

ess

of tr

eatm

ent.

It is

alw

ays

impo

rtan

t

to r

emem

ber

that

mos

t sym

ptom

s do

not

turn

out

to b

e ca

ncer

.

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ions

to a

sk y

our

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llow

ing

ques

tions

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hel

p yo

u w

hen

you

see

your

and

if yo

u ha

ve k

ept a

sym

ptom

dia

ry d

on't

forg

et to

ke it

alo

ng to

the

cons

ulta

tion

Giv

en m

y se

t of s

ympt

oms

wha

t do

you

thin

k co

uld

be w

rong

with

me?

Why

do

you

thin

k I n

eed

to s

ee a

cons

ulta

nt a

t the

hos

pita

l?

Are

ther

e an

y te

sts

that

can

be

done

at th

e su

rger

y?

How

qui

ckly

will

I be

see

n? A

re y

oure

ferr

ing

me

as 'u

rgen

t' or

'non

urg

ent'?

Am

I m

ore

likel

y to

get

colo

rect

al c

ance

r th

an a

nyon

e el

se?

Is th

ere

anyt

hing

I ca

n do

to le

ssen

the

risk

of g

ettin

g co

lore

ctal

can

cer?

Wha

t do

Isay

to m

y fa

mily

?

Do

I com

e to

you

if m

ysy

mpt

oms

chan

ge o

r w

orse

n?

If I a

m w

orrie

dw

ho c

an It

alkt

o?

Eve

ry y

earie

r33

,000

peo

ple

are

affe

cted

by

colo

rect

alca

ncer

and

nea

rly16

,000

peo

ple

die

ort -

dise

ase

Can

cer

Res

earc

h U

1998

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3duc

e yo

ur r

isks

ere

is a

lot y

ou c

an d

o to

red

uce

the

risk

ofve

lopi

ng c

olor

ecta

l can

cer.

Her

e ar

e so

me

eful

mea

sure

s yo

u ca

n ta

ke:

t to

know

you

r bo

wel

pat

tern

IThi

s

will

ena

ble

you

to k

now

wha

t is

norm

al fo

r yo

u an

d to

rec

ogni

se

whe

n an

d if

any

chan

ges

occu

r. L

ook

in th

e to

ilet b

owel

and

look

for

chan

ges

in y

our

mot

ions

.

oid

cons

tipat

ion

IIfyo

u ar

e st

rain

ing

to g

o to

the

toile

t or

are

pass

ing

hard

dry

mot

ions

, you

are

mos

t lik

ely

to b

e co

nstip

ated

. Con

stip

atio

n sl

ows

dow

n th

e pa

ssag

e of

was

te p

rodu

cts

thro

ugh

our

dige

stiv

e sy

stem

, allo

win

g w

aste

to r

emai

n in

the

syst

em fo

r lo

nger

than

nor

mal

. Mot

ions

sho

uld

be k

ept s

oft t

o m

ove

thin

gs q

uick

ly th

roug

h th

e co

lon.

:rea

se th

e am

ount

of f

ibre

Fib

re h

elps

bul

k th

e m

otio

ns a

nd s

peed

s th

e pa

ssag

e of

was

te th

roug

h th

e

dige

stiv

e sy

stem

. Hav

ing

enou

gh fr

esh

frui

t and

veg

etab

les

in y

our

daily

diet

will

hel

p th

e co

lon

to e

mpt

y its

elf f

requ

ently

and

eas

ily (

at le

ast f

ive

port

ions

of f

ruit

and

vege

tabl

es p

er d

ay a

re r

ecom

men

ded)

.

wer

the

fat

IDie

ts

low

in a

nim

al a

nd d

airy

fats

are

kno

wn

to r

educ

e th

e ris

k of

deve

lopi

ng c

olor

ecta

l can

cer.

Cut

ting

dow

n on

vis

ible

fat s

uch

as fr

ied

food

, trim

min

g ex

cess

fat o

n m

eat a

nd p

oultr

y an

d re

duci

ng th

e am

ount

of 'h

idde

n' fa

t in

food

s su

ch a

s ch

ocol

ate,

bis

cuits

and

cak

es w

ill h

elp

the

func

tion

of th

e co

lon.

<e

enou

gh fl

uids

Drin

king

ple

nty

of fr

esh

fluid

s, w

ater

in p

artic

ular

, will

hel

p to

kee

p th

e

mot

ions

sof

t and

mov

ing

thro

ugh

the

colo

n. Id

eally

, we

shou

ld b

e dr

inki

ng

betw

een

2 an

d 3

litre

s (a

ppro

xim

atel

y 3.

5 pi

nts)

of w

ater

eac

h da

y.

Red

uce

the

caffe

ine

drin

ksD

rinks

suc

h as

tea,

cof

fee,

and

the

popu

lar

non-

alco

holic

bed

time

drin

ks c

onta

in c

affe

ine,

whi

ch e

ncou

rage

s th

e flu

id w

e dr

ink

to p

ass

quic

kly

via

our

wat

erw

orks

rat

her

than

circ

ulat

e

thro

ugh

the

colo

n. C

affe

ine-

free

flui

ds h

elp

to

mai

ntai

n a

soft

mot

ion

and

assi

st th

e tr

ansi

t of

was

te p

rodu

cts

thro

ugh

the

colo

n.

Red

uce

your

alc

ohol

con

sum

ptio

nN

o m

ore

than

3-4

uni

ts a

day

for

men

and

2-3

units

a d

ay fo

r w

omen

(on

e un

it is

hal

f a

pint

of b

eer

or a

125

ml g

lass

of w

ine)

as

alco

hol

may

wel

l be

a ris

k fa

ctor

.

Wat

ch y

our

wei

ght

8O

verw

eigh

t peo

ple

have

an

incr

ease

d ris

k of

dev

elop

ing

colo

rect

al c

ance

r.

You

can

mai

ntai

n a

desi

rabl

e bo

dy w

eigh

t by

bala

ncin

g w

hat y

ou e

at w

ith

phys

ical

act

ivity

. You

r G

P o

r P

ract

ice

Nur

se w

ill b

e ab

le to

dis

cuss

you

r

idea

l wei

ght a

nd th

e be

st w

ay fo

rwar

d if

you

need

to lo

se w

eigh

t.

Intr

oduc

e ex

erci

seT

he c

olon

nee

ds to

be

fit to

cop

e w

ith th

e da

ily w

ork

it ha

s to

dol

Abo

ut

20 m

inut

es o

f mod

erat

e da

ily e

xerc

ise

ever

y da

y w

ill h

elp

the

pass

age

of

was

te th

roug

h yo

ur s

yste

m.

Red

uce

smok

ing

If yo

u ar

e a

smok

er tr

y an

d re

duce

the

amou

nt y

ou s

mok

e, a

s th

is m

ay w

ell

be a

ris

k fa

ctor

.

way

s yo

u ca

nhe

lp y

ours

elf

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:ree

ning

yet i

n th

e U

K, t

here

is n

o na

tiona

l scr

eeni

nggr

amm

e fo

r co

lore

ctal

can

cer.

How

ever

, the

NH

S is

rren

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tudi

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exa

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stth

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ng fo

r th

e ge

nera

l pub

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det

ect t

he;e

ase

in it

s ea

rlier

sta

ges.

If yo

u no

tice

any

of th

e sy

mpt

oms

desc

ribed

in th

is

book

let o

r ar

e in

the

'at r

isk'

gro

up th

en m

onito

r yo

ur

tions

and

dis

cuss

the

chan

ges

with

you

r G

P.

:c In

folin

eC

CC

Info

line

is a

tele

phon

e in

form

atio

n se

rvic

e gi

ving

adv

ice

on a

ll

ects

of c

olor

ecta

l can

cer.

Our

nur

ses

are

avai

labl

e to

adv

ise

on a

ll

ies

incl

udin

g pr

even

tion,

sym

ptom

s, te

sts

and

trea

tmen

t opt

ions

.

Impo

rtan

ce o

f ear

ly d

etec

tion

Pat

ient

s w

hose

can

cer

has

not s

prea

d be

yond

the

inne

r

linin

g of

the

bow

el h

ave

a m

uch

high

er c

hanc

e of

succ

essf

ul tr

eatm

ent c

ompa

red

to th

ose

who

se c

ance

r

has

beco

me

mor

e w

ides

prea

d. E

arly

dia

gnos

is is

ther

efor

e

very

impo

rtan

t.

If di

agno

sed

in th

eea

rlier

sta

ges,

colo

rect

al c

ance

ris

hig

hly

trea

tabl

e

e ln

fohn

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