Understanding Colorectal Cancer: A Q&A with Dr. Louise McElwee

Understanding Colorectal Cancer a Q&A with Dr Louise McElwee

In honour of Bowel Cancer Awareness Month, we spoke with Dr Louise McElwee, one of our physicians at Intelligent clinical, to answer some of the most common questions about this disease. Louise shares valuable insights on the symptoms, risk factors, screening and early detection, treatment, and ongoing clinical trials that are shaping the future of colorectal cancer care.

What are some of the symptoms of colorectal cancer?

The symptoms of colorectal cancer can vary depending on the location of the cancer in the bowel and the stage of the cancer. However, the main symptoms include an ongoing change in bowel habit; persistent pain in the abdomen; unexplained weight loss; a swelling or lump in the tummy; and blood in the stool or blood from the back passage. All these symptoms can also be caused by other health conditions, and so it is important to speak with your doctor if you are concerned that you may have the symptoms of bowel cancer.


Who is at risk for colorectal cancer?

Anyone can develop colorectal cancer, but the risk increases with advancing age. Some of the other risk factors for colorectal cancer are things that, like age, we cannot control. These include family history, genetics, and certain diseases that cause inflammation or polyps in the bowel. There are also lifestyle factors that can influence our risk and, the good news is, these are the things that we can change!

Some lifestyle adjustments that can be made to lower the risk of colorectal cancer include:

  • Eating plenty of fresh fruit, vegetables, and wholegrain foods.
  • Limiting the intake of red and processed meats.
  • Reducing alcohol intake.
  • Stopping smoking.
  • Maintaining an active lifestyle if you are able to exercise.

It is also important to ensure that you are registered with a GP, as this how is you will be invited to participate in the national colorectal cancer screening programme.


Why is screening for colorectal cancer important?

Bowel Cancer is the 4th most common cancer in the UK. Over 90% of cases affect people over 50, and this is the age group that is targeted with screening. We have a very effective bowel cancer screening programme in Scotland, and this can help to detect cancer in its earliest stages before symptoms even develop. The sooner cancer is detected, the sooner treatment can be started, and this is why screening is so important!


Who is eligible for screening and what is involved?

Those who are aged 50 – 74 who are registered with a GP will routinely be invited to take part in the national screening programme. However, if you are aged 75 or over, you can still take part by contacting the Scottish Bowel Screening Centre.

Those invited to participate will be sent a faecal immunochemical test (FIT) in the post every 2 years. In the kit you are supplied with everything that you need to collect and send a stool sample to the screening centre in a hygienic way. The sample is then analysed to detect any trace amounts of blood. There are many different reasons, other than cancer, that a person can have blood in the stool, such a haemorrhoids and polyps; and so those with a positive FIT will be offered further investigations, such as a colonoscopy, to find the source of the blood.

It is important to note that screening is a tool for healthy people without symptoms, and I would always recommend that those with any symptoms that they are concerned about, should discuss these with their GP.


Can you tell us about any ongoing colorectal cancer research?

There is a huge amount of research currently ongoing in the area of colorectal cancer, and our knowledge about the diagnosis and treatment of cancer is advancing all the time. Just last week, Cancer Research UK announced several interesting new colorectal cancer projects. These are being funded by the Bowelbabe Fund for Cancer Research UK, which was founded by Dame Deborah James, who used her journey with bowel cancer to campaign, fundraise and raise awareness about the disease. These projects include learning more about how bowel cancer spreads within the body; researching how our gut microbiome, or the bacteria living inside our bowel, can influence cancer; and using artificial intelligence to analyse data from blood samples which may help to detect cancer earlier. It’s also not just these projects! in addition, there are many studies and clinical trials already underway, investigating new tests and treatments for bowel cancer.

Colorectal cancer is one of the leading cancers in Scotland which affects many individuals and their families. Research is vital to advance our knowledge about this condition and to enable us to develop better testing and treatment. It is important that we participate in screening when invited and manage our risk factors when we can. If you are interested in finding out more about participating in research, we have lots of information on our website here and you can register your interest to participate in our research studies here.

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