The 5-year relative survival rate for bowel cancer has increased from When someone is diagnosed with bowel cancer, one of the first questions they may ask is, 'What are the chances I will survive?
Statistics are estimates that describe trends in large numbers of people. How long someone will live after a bowel cancer diagnosis prognosis is affected by a range of factors, such as the specific characteristics of the individual, including their age and general health at the time of diagnosis, the type and stage of cancer they have and the treatments received.
Researchers usually give survival statistics as rates for specific cancer types. Disease-free and progression-free survival rates.
The 5-year relative survival rate includes people in remission. Remission is the temporary or permanent absence of disease. This survival rate also includes those still receiving treatment. You will be advised not to drive for 24 hours. In a small number of people, it may not be possible to pass the colonoscope completely around the bowel, and it is then necessary to have CT colonography.
Find out more about what a colonoscopy involves. CT colonography, also known as a "virtual colonoscopy", involves using a computerised tomography CT scanner to produce three-dimensional images of the large bowel and rectum. During the procedure, gas is used to inflate the bowel using a thin, flexible tube placed in your rectum. CT scans are then taken from a number of different angles. As with a colonoscopy, you may need to have a special diet for a few days and take a laxative before the test to ensure your bowels are empty when the test is carried out.
This test can help identify potentially cancerous areas in people who are not suitable for a colonoscopy because of other medical reasons. A CT colonography is a less invasive test than a colonoscopy, but you may still need to have colonoscopy or flexible sigmoidoscopy at a later stage so any abnormal areas can be removed or biopsied. If a diagnosis of bowel cancer is confirmed, further testing is usually carried out to check if the cancer has spread from the bowel to other parts of the body.
These tests also help your doctors decide on the most effective treatment for you. Once the above examinations and tests have been completed, it should be possible to determine the stage and grade of your cancer.
Staging refers to how far your cancer has advanced. Grading relates to how aggressive your cancer is and how likely it is to spread. This is important, as it helps your treatment team choose the best way of curing or controlling the cancer. A number of different staging systems are used by doctors. A simplified version of one of the common systems used is outlined below.
If colon cancer is at a very early stage, it may be possible to remove just a small piece of the lining of the colon wall. This is known as local excision. If the cancer spreads into muscles surrounding the colon, it will usually be necessary to remove an entire section of your colon.
This is known as a colectomy. During surgery, nearby lymph nodes are also removed. It is usual to join the ends of the bowel together after bowel cancer surgery, but very occasionally this is not possible and a stoma is needed.
Both open and laparoscopic colectomies are thought to be equally effective at removing cancer and have similar risks of complications. However, laparoscopic colectomies have the advantage of a faster recovery time and less postoperative pain.
It is becoming the routine way of doing most of these operations. Laparoscopic colectomies should be available in all hospitals that carry out bowel cancer surgery, although not all surgeons perform this type of surgery. Discuss your options with your surgeon to see if this method can be used.
There are a number of different types of operation that can be carried out to treat rectal cancer, depending on how far the cancer has spread. If you have a very small, early-stage rectal cancer, your surgeon may be able to remove it in an operation called a local resection transanal resection.
The surgeon puts an endoscope in through your back passage and removes the cancer from the wall of the rectum. In many cases, however, a local resection is not possible. Instead, a larger area of the rectum will need to be removed.
This area will include a border of rectal tissue free of cancer cells, as well as fatty tissue from around the bowel the mesentery. This type of operation is known as total mesenteric excision TME.
Removing the mesentery can help ensure all the cancerous cells are removed, which can lower the risk of the cancer recurring at a later stage. Depending on where in your rectum the cancer is located, one of two main TME operations may be carried out. These are outlined below. Low anterior resection is a procedure used to treat cases where the cancer is in the upper section of your rectum. The surgeon will make an incision in your abdomen and remove the upper section of your rectum, as well as some surrounding tissue to make sure any lymph glands containing cancer cells are also removed.
They will then attach your colon to the lowest part of your rectum or upper part of the anal canal. Sometimes they turn the end of the colon into an internal pouch to replace the rectum.
Abdominoperineal resection is used to treat cases where the cancer is in the lowest section of your rectum. In this case, it will be necessary to remove the whole of your rectum and surrounding muscles to reduce the risk of the cancer regrowing in the same area.
This involves removing and closing the anus and removing its sphincter muscles, so there is no option except to have a permanent stoma after the operation. Bowel cancer surgeons always do their best to avoid giving people permanent stomas wherever possible. Where a section of the bowel is removed and the remaining bowel joined, the surgeon may sometimes decide to divert your stool away from the join to allow it to heal.
The stool is temporarily diverted by bringing a loop of bowel out through the abdominal wall and attaching it to the skin — this is called a stoma. A bag is worn over the stoma to collect the stool. When the stoma is made from the small bowel ileum it is called an ileostomy , and when it is made from the large bowel colon it is called a colostomy.
A specialist nurse, known as a stoma care nurse, can advise you on the best site for a stoma prior to surgery. The nurse will take into account factors such as your body shape and lifestyle, although this may not be possible where surgery is performed in an emergency. In the first few days after surgery, the stoma care nurse will advise on the care necessary to look after the stoma and the type of bag suitable. Once the join in the bowel has safely healed, which can take several weeks, the stoma can be closed during further surgery.
In some people, for various reasons, rejoining the bowel may not be possible or may lead to problems controlling bowel function, and the stoma may become permanent. Before having surgery, the care team will advise you about whether it may be necessary to form an ileostomy or colostomy, and the likelihood of this being temporary or permanent. There are patient support groups available that provide support for patients who have just had or are about to have a stoma.
You can get more details from your stoma care nurse, or visit the groups online for further information. Learn more about coping with a stoma after bowel cancer. Bowel cancer operations carry many of the same risks as other major operations, including bleeding, infection, developing blood clots, or heart or breathing problems.
The operations all carry a number of risks specific to the procedure. One risk is that the joined-up section of bowel may not heal properly and leak inside your abdomen. This is usually only a risk in the first few days after the operation. Another risk is for people having rectal cancer surgery. The nerves that control urination and sexual function are very close to the rectum, and sometimes surgery to remove rectal cancer can damage these nerves.
After rectal cancer surgery, most people need to go to the toilet to open their bowels more often than before, although this usually settles down within a few months of the operation. There are two main ways radiotherapy can be used to treat bowel cancer. It can be given before surgery to shrink rectal cancers and increase the chances of complete removal, or be used to control symptoms and slow the spread of cancer in advanced cases palliative radiotherapy.
External radiotherapy is usually given daily, five days a week, with a break at the weekend. Depending on the size of your tumour, you may need one to five weeks of treatment.
Each session of radiotherapy is short and will only last for 10 to 15 minutes. Internal radiotherapy can usually be performed in one session before surgery is carried out a few weeks later. Palliative radiotherapy is usually given in short daily sessions, with a course ranging from 2 to 3 days, up to 10 days. These side effects should pass once the course of radiotherapy has finished. Tell your care team if the side effects of treatment become particularly troublesome.
Additional treatments are often available to help you cope with the side effects better. If you want to have children, it may be possible to store a sample of your sperm or eggs before treatment begins so they can be used in fertility treatments in the future. There are three ways chemotherapy can be used to treat bowel cancer:. Chemotherapy for bowel cancer usually involves taking a combination of medications that kill cancer cells.
They can be given as a tablet oral chemotherapy , through a drip in your arm intravenous chemotherapy , or as a combination of both. Treatment is given in courses cycles that are two to three weeks long each, depending on the stage or grade of your cancer. Most people having oral chemotherapy take tablets over the course of two weeks before having a break from treatment for another week.
A course of chemotherapy can last up to six months, depending on how well you respond to the treatment. In some cases, it can be given in smaller doses over longer periods of time maintenance chemotherapy. These side effects should gradually pass once your treatment has finished. It usually takes a few months for your hair to grow back if you experience hair loss. Inform your care team or GP as soon as possible if you experience possible signs of an infection, including high temperature fever or a sudden feeling of being generally unwell.
Medications used in chemotherapy can cause temporary damage to men's sperm and women's eggs. This means that for women who become pregnant or for men who father a child, there is a risk to the unborn baby's health.
It is therefore recommended you use a reliable method of contraception while having chemotherapy treatment and for a period after your treatment has finished. Find out more about chemotherapy. Biological treatments, including cetuximab, bevacizumab and panitumumab, are a newer type of medication also known as monoclonal antibodies. Monoclonal antibodies are antibodies that have been genetically engineered in a laboratory.
It is not uncommon for doctors to try multiple treatments. If the cancer does not respond to the first treatment, they may stop that treatment and start another instead. Doctors may also recommend radiation therapy in late-stage colon cancer to help reduce symptoms such as pain and discomfort. This treatment might even shrink the tumor for a time, but it will not usually cure the cancer. A hepatic artery infusion may be a treatment option for people with colon cancer that has spread to the liver.
Hepatic artery infusion is a type of regional chemotherapy, which involves delivering a chemotherapy drug directly into the hepatic artery in the liver.
This treatment may help destroy cancer cells without harming the healthy liver cells in the process. Ablation or embolization may be appropriate for people who have metastatic or reoccurring colorectal cancer that causes a few tumors in the lung or liver that are less than 4 centimeters across. Ablation uses either radio frequencies, microwaves, or alcohol — which people also call percutaneous ethanol injection PEI — to target and kill cancer cells while leaving the surrounding tissues relatively unharmed.
During embolization, a doctor will inject substances into the blood vessels to try to block or reduce the blood flow to cancer cells in the liver. In these cases, people may decide against medical treatment that seeks to cure the cancer and instead opt for palliative care to try to make living more comfortable. As the ACS note, colon cancer is the third most commonly diagnosed cancer in both males and females in the United States.
One in 22 men and one in 24 women will receive a colon cancer diagnosis during their lifetime. Stage 4 colon cancer is late-stage cancer in which the disease has spread to other tissues or organs in the body and is, therefore, more difficult to treat.
Treatment may only be partially successful, and cancer may be more likely to return after treatment. However, this does not account for other factors that may affect individual survival rates. For instance, the success of particular treatment methods may vary among individuals, with treatments that work very well for some people having little effect in others. Additionally, experts base these statistics on past cases. As treatments tend to get better over time, survival rates may also improve as more effective treatments become available.
For instance, the age and overall health of an individual may affect their responsiveness to treatment. The rate of cancer progression may change the outlook as well. We are calling on the Government, the NHS and professional bodies to work together to ensure all bowel cancer MDTs have access to and include established regional advanced bowel cancer MDTs in treatment decisions, including lung; liver; and pelvic specialists. An advanced bowel cancer MDT is made up of specialists based at the hospital or a regional centre who represent the range of specialties needed to effectively manage and treat every aspect of advanced bowel cancer.
The involvement of specialist surgeons in treatment decisions can increase the chance of advanced bowel cancer patients being offered potentially curative treatment options. To deliver the best outcomes for patients we need to establish and formulise advanced bowel cancer MDTs to ensure no patient misses out on the best life-saving treatment options.
These patients have poor survival rates; less than one in ten people survive for five years or more so they must not be denied access to surgery that could extend their life and in some cases offer hope of a cure.
We must do more to transform survival chances for advanced bowel cancer patients and access to specialist surgery is a vital component to ensure lives are not needlessly lost. Our healthcare systems must take significant proactive steps to ensure people are diagnosed at the earliest stages of bowel cancer when it is more treatable.
They must also ensure people who are diagnosed late are given treatment that is right for them and maximises their chance of surviving the disease. World Metastatic Colorectal Day is an international day to raise awareness and understanding of advanced bowel cancer.
France to increase survival rates, improve quality of life and reduce variation in access to best treatment and care for people living with metastatic colorectal cancer around the world. Find out more about the global Get Personal campaign.
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