Several factors can increase the risk of developing bowel cancer. While some risk factors are not modifiable, others can be influenced through lifestyle changes or medical interventions. Common risk factors for bowel cancer include:
Age: The risk of bowel cancer increases with age, with most cases diagnosed in individuals over the age of 50. However, bowel cancer can occur at any age, and the incidence is rising among younger adults.
Family history and genetics: A family history of bowel cancer or certain genetic syndromes, such as Lynch syndrome (hereditary nonpolyposis colorectal cancer) or familial adenomatous polyposis (FAP), can significantly increase the risk of developing the disease.
Personal history of bowel polyps or inflammatory bowel disease: Individuals who have a history of precancerous bowel polyps (adenomas) or inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis, are at an increased risk of developing bowel cancer.
Lifestyle factors: Certain lifestyle habits and environmental factors can influence the risk of bowel cancer, including:
Race and ethnicity: Certain racial and ethnic groups, such as African Americans and Ashkenazi Jews, have a higher risk of developing bowel cancer compared to other populations.
Type 2 diabetes: Individuals with type 2 diabetes may have an increased risk of developing bowel cancer, particularly if the diabetes is poorly controlled.
Radiation therapy: Previous radiation therapy to the abdomen or pelvis, often used to treat other types of cancer, may increase the risk of developing bowel cancer later in life.
Environmental factors: Exposure to certain environmental pollutants or carcinogens may increase the risk of developing bowel cancer, although the specific factors involved are not yet fully understood.
Once bowel cancer develops, its progression can vary based on several factors, including the characteristics of the tumour, the stage of the cancer, and the individual’s overall health and response to treatment. While bowel cancer generally progresses slowly over time, it is a serious disease that requires prompt medical attention and appropriate treatment.
The progression of bowel cancer is typically classified into stages based on the extent of the disease and whether it has spread to other parts of the body. Early-stage colon cancer, such as stage I or II, may be confined to the inner layers of the colon or rectum and have a relatively favourable prognosis with appropriate treatment. Advanced-stage colon cancer, such as stage III or IV, may have spread to nearby lymph nodes or distant organs, making it more challenging to treat and potentially more life-threatening.
Colon cancer typically develops from benign growths called polyps, which can take many years to transform into cancerous tumours. This slow progression from benign to malignant can occur over a span of several years without causing noticeable symptoms.
Even after the development of colon cancer, it may still take additional time, sometimes years before symptoms become apparent or before the cancer is detected through screening tests or medical evaluation. This is because early-stage colon cancer may not produce noticeable symptoms, or symptoms may be nonspecific and attributed to other less serious conditions.
The survival rates for bowel cancer vary depending on the stage of the cancer at the time of diagnosis. Generally, survival rates are expressed as the percentage of individuals who are alive at a certain time point after diagnosis, typically five years. It’s important to note that survival rates are estimates based on statistical data and may vary widely among individuals depending on various factors, including age, overall health, response to treatment, and other factors.
Here are the approximate five-year survival rates for each stage of bowel cancer:
In some cases of bowel cancer surgery, particularly when a large portion of the colon or rectum is removed or when the bowel cannot be immediately reattached, a colostomy may be necessary. A colostomy is a surgical procedure that creates an opening (stoma) in the abdominal wall through which stool can pass into a collection bag outside the body.
There are different types of colostomies, depending on the location of the stoma and the portion of the colon involved. Some colostomies are temporary, meaning they are created to allow the remaining bowel to heal after surgery, and can be reversed later. Temporary colostomies may be used when the bowel needs time to heal, such as after extensive surgery or if there is concern about anastomotic leakage (leakage at the site where the bowel is reconnected).
Permanent colostomies, on the other hand, are created when the portion of the bowel that is removed cannot be reconnected, or when there is significant damage to the remaining bowel. In these cases, the stoma becomes a permanent part of the digestive system, and the individual will need to use a colostomy bag to collect stool for the rest of their life.
Adjusting to life with a colostomy can be challenging, both physically and emotionally, but with time and support, many people are able to lead full and active lives. Education, counselling, and support from healthcare providers, ostomy nurses, and support groups can be invaluable in helping individuals adapt to life with a colostomy and manage any concerns or challenges that may arise.
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