The symptoms of bowel cancer—also called colon cancer—can be subtle, but it’s important to look out for the warning signs of this common and potentially deadly disease. According to the American Cancer Society, it’s the third most common cancer diagnosed in the United States (excluding skin cancers), and is expected to cause approximately 52,580 deaths in 2022.
While warning signs of bowel cancer can mimic other types of gastrointestinal distress such as diarrhea, the symptoms are wide-ranging and can manifest both in and out of the bathroom. In Australia, where bowel cancer is the second deadliest form of cancer, a nurse missed a key symptom of the disease. Read on to find out what it was.
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Various names for cancers that occur in the same general region can be confusing, but the type of disease depends on where it originates. “Bowel cancer is a cancer that begins in the large intestine or colon,” explains gastroenterologist and laparoscopic GI surgeon, Samrat Jankar. “Colorectal cancer (or CRC) is a more general term: it refers to cancers that start in the colon or rectum.” Most people with bowel cancer or colorectal cancer don’t have symptoms “until the cancer is advanced and has spread beyond the colon and rectum,” Jankar warns.
Not only can the symptoms of these types of cancers be subtle, but many people fail to keep up with the kinds of screenings that can be very effective in catching the disease in its early stages. “Sixty percent of colorectal cancer deaths could be prevented with screening,” advises Fight Colorectal Cancer. But “one in three people are not up-to-date with colorectal cancer screening.”
Some of the most common signs of bowel cancer are changes that show up in the bathroom. “If a tumor blocks the bowel, the blood vessels in your intestines may rupture, causing blood in your stools,” says Jankar. In addition, “patients may describe having looser stools or a change in the frequency of bowel movements.” Diarrhea is also a symptom, as is abdominal pain.
Other symptoms may seem unrelated to your stomach or bowels. “As the cancer spreads to the lymph nodes, you may experience unexplained weight loss,” Jankar explains, who also notes that pain in your back, legs, or pelvis can be a warning sign, as well as fatigue when the disease causes a loss of nutrients and minerals.
“Regular screenings for colorectal cancer are crucial, especially if you’re at higher odds because of something like your family medical history,” reports WebMD. “The tests are the only way to spot early cancer.”
Miriam Van Zanten, a 49-year-old nurse with over 25 years of experience based in Sydney, Australia, was diagnosed with stage four bowel cancer after experiencing stomach pains (the disease began in her bowel, but had spread to her liver by the time she was diagnosed).
But even before the abdominal discomfort, Van Zanten had experienced a common—but subtle—symptom of bowel cancer.
“Looking back I can say I had some very mild constipation which I put down to not drinking enough,” she told 9News.”Being a nurse, not having enough time to drink, running around, not having time to even pee.”
“Constipation is a common symptom of bowel cancer, even though it’s also a symptom of many other conditions,” warns Jankar, who cites medications, lack of exercise, a diet low in fiber, and laxative abuse as other possible causes. “Constipation could be caused by an obstruction in the bowel due to a tumor or the presence of blood clots,” he says.
According to the Centers for Disease Control and Prevention (CDC), bowel cancer (or, more generally, colorectal cancer) “almost always develops from precancerous polyps (abnormal growths) in the colon or rectum.”
“Regular screening, beginning at age 45, is the key to preventing colorectal cancer and finding it early,” says the CDC. “The U.S. Preventive Services Task Force recommends that adults age 45 to 75 be screened for colorectal cancer, [and that] adults age 76 to 85 talk to their doctor about screening.”
In addition to regular screenings, bowel-healthy lifestyle choices are also recommended. Jankar suggests a diet that’s “rich in fiber and low in red meat;” regular exercise; consistently staying hydrated; and limited alcohol intake as part of your routine. “[Diet] is especially important if you are at high risk of developing bowel cancer. High-fiber foods include nuts, seeds, beans, whole grains, fruits, and vegetables,” Jankar says.