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Bowel Cancer, also known as colorectal cancer, develops from the inner lining of the bowel and is usually preceded by growths called polyps, which may become invasive cancer if undetected. Depending on where the cancer begins, bowel cancer may be called colon or rectal cancer. 

It is estimated that more than 15,300 people were diagnosed with bowel cancer in 2023. The average age at diagnosis is 69 years old. 

Bowel cancer is the fourth most commonly diagnosed cancer in Australia, and it is estimated that one in 20 people will be diagnosed by the time they are 85.

Bowel cancer - سرطان الأمعاء

Bowel cancer

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Treatment for bowel cancer will depend on which part of your bowel is affected and how far the cancer has spread.

Surgery typically serves as the primary intervention for bowel cancer and may be complemented by chemotherapy, radiotherapy, or biological treatments based on individual cases. Early detection allows for effective treatment, potentially curing and preventing the recurrence of bowel cancer. However, complete cure is not always achievable, particularly in advanced cases where complete surgical removal is challenging. In such instances, a combination of treatments can control symptoms and slow cancer spread.

Factors Influencing Treatment Decision:

Your care team considers various factors when determining the most suitable treatment, including cancer type, size, overall health, metastasis, and cancer aggressiveness.

Surgery for Colon Cancer:

For early-stage colon cancer, a local excision may suffice. If the cancer extends into surrounding muscles, a colectomy, involving the removal of a colon section, is often necessary. Open colectomy, laparoscopic colectomy, and robotic surgery are the three approaches, each with its advantages. Laparoscopic and robotic surgeries offer quicker recovery and less postoperative pain.

Surgery for Rectal Cancer:

Depending on the cancer’s spread, surgeries for rectal cancer vary. Local resection may be performed for small early-stage cancers. However, total mesenteric excision (TME) is more common, involving the removal of a larger rectal area. Stoma surgery might be considered to divert fecal matter temporarily for healing. Side effects, permanency, and alternatives are discussed with patients before surgery.

Side Effects of Surgery:

Bowel cancer operations entail standard risks such as bleeding, infection, blood clots, and potential heart or breathing issues.

Radiotherapy:

Radiotherapy plays various roles in bowel cancer treatment, including shrinking rectal cancers before surgery, replacing surgery for early-stage rectal cancer, and providing palliative care for advanced cases. External and internal (brachytherapy) radiotherapy sessions may cause short-term side effects like nausea, fatigue, and skin irritation, while long-term effects may include changes in bowel habits, blood in urine and feces, infertility, and erectile dysfunction.

Chemotherapy:

Chemotherapy is employed before surgery to shrink tumors, after surgery to reduce recurrence risk, and palliatively for advanced cases. Medicines killing cancer cells can be administered orally, intravenously, or through a combination. Cycles lasting 2-3 weeks may continue for up to 6 months, and side effects include fatigue, nausea, diarrhea, mouth ulcers, and, infrequently, hair loss.

Targeted Therapies:

Medicines like cetuximab and panitumumab target biological processes in bowel cancer cells, enhancing chemotherapy effects. They are used alongside chemotherapy for metastatic bowel cancer. Side effects may include skin rash, diarrhea, and sore eyes, with potential allergic reactions managed with anti-allergy medications.

In all treatments, the care team carefully weighs benefits against potential side effects, and discussions with patients help tailor the approach to individual needs and circumstances.

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