Bowel cancer is not a death sentence but early diagnosis is vital to quality of life. Padraig O'Morain reports.
Some men could die of embarrassment because they feel inhibited about going to their GP with what may be the symptoms of bowel cancer, according to Prof Colm O'Morain, consultant gastroenterologist at Tallaght Hospital.
"Embarrassment is the major thing in it," the Professor of Medicine at Trinity College Dublin adds. "We say don't die of embarrassment, go see a doctor."
The symptoms include passing blood in bowel movements and rectal bleeding. On average, 520 men and 410 women in Ireland die from bowel cancer every year. It has overtaken lung cancer as the number one cause of death from cancer in Ireland and the EU.
The Irish Cancer Society has chosen bowel cancer as the focus of this year's Men's Cancer Action Week, currently under way. While it affects both men and women, experience elsewhere showed that men are far less likely than women to take up the offer of screening for the disease, Prof O'Morain notes.
He believes an effective screening programme, aimed at people over the age of 50, could, if introduced, prevent as many as 400 deaths a year. This assumed that the necessary resources were put into the programme and sufficient numbers of people were willing to undergo screening.
Bowel cancer develops from a polyp which could be present for 10 to 20 years before it becomes cancerous. If it becomes cancerous and if the patient is treated when the cancer is confined to the bowel wall, there is a 90 per cent chance of survival, he says.
But if the cancer has spread beyond the bowel, the survival rate is far lower and in some cases could be as low as ten per cent over five years. "Since it starts in pre-cancerous patients there is a chance to intervene in terms of screening," he says.
Screening typically involves testing a sample of the stool for 'occult' blood, which is blood invisible to the naked eye.
"Tests in the US, Denmark and Norway show that in people over the age of 50, two to three per cent will have a positive occult blood test," he says. "Up to 50 per cent of these will have some lesion. [OF THESE]the majority will have a pre-cancerous polyp. Instead of having an operation these polyps can be removed at colonoscopy."
Colonoscopy is a procedure for examining the interior of the colon and rectum. Of those who have a lesion, about 20 per cent will need an operation.
"The risk factors are first age and secondly family history," he says. "The stronger the family history the stronger the risk."
Preventive measures including eating vegetables and fresh fruits, avoiding too much fatty food or too much red meat in the diet, giving up smoking, exercising and avoiding obesity.
In other words, he says, activities which are good for the heart are also good for preventing bowel cancer. And people should lose their inhibition about getting checked out for bowel cancer, he says.
"Everybody goes every year to their dentist for a check-up but so far as I know nobody dies of dental disease. But you have one chance in 18 of dying from bowel cancer."
Over the average lifetime, there is an 11.7 per cent risk that a man will develop bowel cancer. The risk for women is 7.4 per cent. The incidence rate in Ireland is among the highest in Europe.
The Irish Cancer Society says while most men know what to do to reduce their chances of getting cancer, they don't necessarily follow through. While 97 per cent of men in a survey knew it was "important they should take charge and be responsible for their own health and to recognise early warning signs", only 26 per cent got regular check-ups with their GPs and only 39 per cent said they ate a healthy diet.
Only 13 per cent would recognise the early warning signs of cancer. The survey also showed that 69 per cent of men agree that most men ignore the warning signs if they think it might be cancer. Eighty five per cent of men agree that most men wait too long before going to the doctor for treatment.
Persons who are worried about their risk of cancer or about any issue in relation to a cancer diagnosis can call the Irish Cancer Society Helpline on 1800 200 700 for free confidential advice and information.