Colorectal cancer; or bowel cancer as it is more commonly known, is Wales’ second leading cause of cancer death, with around 900 lives lost to the disease every year. Latest data from the Welsh Cancer Intelligence and Surveillance Unit reveal that rates of bowel cancer in Wales have risen steadily over the last ten years – up by about a quarter for men and almost a fifth for women, as of 2013-2015.
As with all cancers, early detection is vital if patients are to be offered the best chance of a complete cure and the fact that almost 50% of all cases of bowel cancer recur at a later stage means that Wales, like the rest of the UK, has a lot of work to do in this area. In an attempt to arrest some of these trends, Cancer Research Wales supports a number of exciting projects at the forefront of bowel cancer research, especially in the areas of early diagnosis and better treatments.
Bowel Cancer cell
Some of the symptoms of bowel cancer, like a change in bowel habits, rectal bleeding and indigestion, occur in other less serious but still debilitating conditions such as ulcerative colitis, Crohns disease and irritable bowel syndrome. Other symptoms may be very vague and not represent a typical ‘red-flag’ symptom that requires urgent attention. These factors, amongst others represent a challenge to the early diagnosis of bowel cancer. The reasons for the late detection of bowel cancers are multi-factorial and involve patient and GP behaviour and issues arising in secondary care, following the necessary referral from primary care.
Cancer Research Wales has supported a fundamental study linked to the International Cancer Benchmarking Project which will help us understand exactly where in the Welsh Healthcare System delays in the diagnosis and treatment of bowel cancer patients takes place. The study will also reveal what other countries are doing more effectively, with the possibility that similar strategies can be implemented in Wales to improve matters. This exciting study is due to report its final results this summer. So please stay tuned!
Currently, Wales has the lowest uptake of the fecal blood test in the UK, well below the desired 60% target. Reasons vary and include a reluctance to handle and store fecal matter and a perception that if a person is feeling well there is no need for them to participate. Cancer Research Wales scientists based in Swansea are helping to overcome some of these barriers with the development of a less-invasive blood test that can be easily undertaken in GP surgeries. Although in its early stages, this award-winning research is shown to have an accuracy of over 85%, which offers the chance of an accurate, quick and simple test for bowel cancer that can be undertaken in GP practices.
Professor Andrew Godkin
Better and more effective treatments for advanced Bowel Cancer are urgently needed. As seen with other cancer types, immunotherapy, where the patient’s own immune system is stimulated to recognise and kill cancer cells offers an exciting and promising approach. TaTiCC, an immunotherapy clinical trial sponsored by Cancer Research Wales, seeks to reset the immune system of patients with inoperable secondary bowel cancer. Professor Andrew Godkin who designed and led the trial, recently travelled to America for one of the year’s major cancer conferences to present the final trial results to some of the world’s leading cancer clinicians. These results, soon to be published in full, shows how effective targeting of the immune system can lead to dramatic improvements for some patients with little or no side-effects.
Although research is leading to improvements in both the early diagnosis and treatment of bowel cancer, neither is a substitute for prevention. Bowel Cancer is largely a preventable disease, with a diet rich in fruit and vegetables, regular exercise, healthy body weight, cessation of smoking and a reduction in alcohol intake, all significant factors that can make a real difference. It is alos important to participate in national screening programmes, which seek to detect possible tumours and pre-malignant polyps even before symptoms have occurred.