GP's red flag bowel cancer symptoms people ignore and end up getting 'aggressive' treatment

A GP has spoken out about bowel cancer - and warned of the symptoms which are red flags for the disease and which should not be ignored. Dr Mark Porter, writing in The Times, said many people took too long to report symptoms to their doctors - because they are bowel related.

The charity Bowel Cancer UK has launched a new awareness campaign this month to prompt people with worrying bowel symptoms to seek help earlier. One reason is embarrassment and anxiety about the investigations required by health staff, Dr Porter said.

He explained that some symptoms were fairly ordinary but changes especially should be investigated. He said: “Common red flags include bleeding from your bottom (often not cancer but never normal) and/or an unexplained and prolonged change in bowel habit (more than a few weeks), typically to becoming looser rather than constipated.”

Dr Porter said that although sometimes it’s not all that easy, getting an appointment was crucial. He said: “Call or email your practice, outlining your symptoms (and any relevant family history of bowel cancer), stating that you are concerned. What happens next will depend on practice policy but will often start with a stool test that you can do at home to look for, or confirm, bleeding, as well as some blood tests, all followed by an appointment with the GP to run through your symptoms and results. And this will typically include a physical examination and a finger up your backside.”

He said innocent causes, which range from IBS to piles, can sometimes be identified at this stage but where there is any doubt the next step will be onward referral on the fast-track suspected cancer pathway and you will almost certainly be offered a colonoscopy to examine the inside of your bowel.

Dr Porter added: “The next hurdle is what the specialist finds but I can reassure most of you about this too: 90 per cent of people referred on the “two-week” pathway with suspected bowel cancer will turn out to have nothing of the sort. This still means 10 per cent will be given bad news but, assuming they sought help as soon as they could, there is a good chance they will be cured. The five-year survival rate after surgery alone for very early cancers is about 90 per cent, but this drops to 10 per cent for the most advanced cases.”

If someone gets a positive stool test at the resulting colonoscopy, 38 out of every 100 will be found to have normal bowel or minor problems like tiny polyps or piles that require no further treatment. However, just over half will be found to have polyps like mine that need to be removed. And 9 out of every 100 will have cancer, but hopefully still at an early stage when the outlook is excellent.

He warned: “So the message is clear. Your symptoms are probably not due to cancer but if they are and you delay, the treatment is only going to get more aggressive (chemo and possibly radiation in addition to surgery) and the outcome worse. Early presentation doesn’t always guarantee a less advanced cancer but it can only help.”