We have dedicated this whole page to an account by an incredibly brave Lady. Her story is a sort of Moral Tale - one that as Members of CBCSG, we can all equate to, but as individuals we know that we must always be aware of. The story has been edited for 'typos', and 'laid out'. All the words are Patricia's who is pictured here with her husband Philip.
How to Recognise the Symptoms of Bowel Cancer.
How to Avoid a Misdiagnosis, or Late Diagnosis of Bowel, or Colorectal Cancer.
by Patricia J. ( Member of the Cornwall Bowel Cancer Support Group. )
This is a piece written by a woman, diagnosed in the Terminal Stages of Colorectal Cancer, in July 2009, at the age of 57, despite numerous trips to the GP in the 10 months before.
I am here to tell the story. I am still going strong. Please do not let my experience frighten you or make you despondent, because my intention is to support and guide you.
The Common Symptoms of Bowel Cancer can be one, or any combination, of the following symptoms. Similarly, on many occasions, these symptoms can also represent a simple, benign (non life-threatening) condition. The Trick is, to find a GP who is able and willing, to decipher the difference. Unfortunately, misdiagnosis and late diagnosis with Colorectal cancer is extremely common.
Symptoms. Loose, persistent stools, urgent and diarrhoea-like.
Persisting loose stools, alternating with persistent constipation.
Persisting piles (Haemorrhoids), bleeding or not.
Persisting severe abdominal pain.
Anaemia, breathlessness, unexplained persistent fatigue and tiredness.
Blood and or mucous in the poo.
Blood in the toilet pan.
Difficulty evacuating poo, or a feeling of something being left behind.
Lump felt in rectum, or abdomen, especially on the right side.
Abdominal bloating, wind (flatulence).
Loss of appetite, unexplained weight-loss.
Nausea, feeling sick or vomiting.
A patient with Bowel Cancer, may only experience one or two of these symptoms, at the onset of bowel cancer. The most common and significant symptoms, are loose persistent stools/diarrhoea, and or, rectal bleeding. Some may just have abdominal pain and unexplained fatigue or tiredness. Some may experience unusual, persistent constipation and, or piles (haemorrhoids).
Any of the above symptoms, especially if there is loose stools or rectal bleeding, including bleeding piles/haemorrhoids, if they persist for more than 2 to 3 weeks, will require a thorough investigation by a GP, to rule out bowel cancer. It is best to establish the initial time of the symptoms onset. The easiest way to do this, is to write down, jot down, or record the dates and symptoms. It is easy to do if you have a computer and printer, otherwise, hand-write a diary of the dates, symptoms and their frequency per day, in the case of diarrhoea bouts, record the number of times per day, it is extremely useful to illustrate to the GP your ongoing, medical condition. Accuracy, will give the GP a very clear picture of what is happening. It is equally as good, to make a handwritten diary and photocopy it. Keep one for yourself and give your GP the other copy to read, and ask them to place it with your medical records.
When these symptoms are presented to your GP, they should normally ask you questions about your general health and ask how long you have had these symptoms. They should ask you about the possibility of other symptoms from the above list.
The GP should know what your current and recent prescription drugs are, but write them down also, as you may see a different GP or a locum, when presenting with these symptoms. Also write down, non-prescription drugs, which you may be taking. Do not accept a diagnosis where the GP bluntly asserts, that you are too young to have bowel cancer. Cancer Research UK states that bowel cancer in younger people is on the increase.
A patient should give the GP accurate and detailed facts. It is always best to write down clearly your symptoms, indeed everything that is affecting you at present, i.e. possibly unexplained loss of appetite, fatigue, abdominal pain, or experiencing piles, when it is not normal for you, and not having altered your diet or personal habits. Be confident and be direct. Remain persistent. Do not leave the GP`s consulting room, until you feel you have acceptable advice, and “a plan of action” from the GP. Do not think that you are being a nuisance, or making a fuss, and that your symptoms are probably unimportant.
These symptoms are very important, they may well be the common signs of bowel cancer, but remember, they may also be simply an easily treatable condition, which is not life-threatening. Remember, bowel cancer always is. The most important outcome of the consultation, is that you understand clearly what will happen next, be it a straight forward 2 week Urgent Cancer Referral, to see a specialist, or whether you and the GP, have agreed on a “Monitoring Period” of a week or two more, to enable the symptoms to resolve on their own, if that is what they are going to do. Each patients case may follow a different method of diagnosis, but all methods should culminate in the earliest and most beneficial timely diagnosis, if the problems are the result of a malignant tumour or growth.
If you do not feel confident in your GP`s manner, or find difficulty in making yourself listened to, or are in anyway concerned about responses from the GP, ask to see another GP, with whom you can feel confidence in, and feel comfortable with. There is no problem with this, as it is your right to see another if you so wish. You do not have to give a reason for doing so.
A GP should, especially with rectal bleeding and Haemorrhoids, offer to give you a “digital rectal examination” to feel for any unusual lumps, (in a gloved finger), which may be the signs of a growth or tumour. A GP should examine your abdomen externally also. If they do not offer to do these examinations, ask why.
A GP should, especially in cases of extreme fatigue, tiredness and rectal bleeding, arrange for a blood test, to rule out anaemia, but remember, you may not be anaemic but may still have bowel cancer. Similarly, you may have anaemia but not have bowel cancer.
If you experience blood in the stools, the GP may well arrange for a faecal occult test. This is the type of poo test that is now sent out to all patients, when they reach the age of 60, and is used to screen for bowel cancer. It's aim is to recognise whether there is any blood in the stool, which may be minuscule and not evident to the naked eye.
A GP should ask, or if they don't, you must tell them, about any family history of bowel cancer that you are aware of. It may be in your records, but they may have forgotten, or perhaps not be your usual GP.
Your GP should consider carefully all the facts which you have made them aware of, and then make a decision, either to refer you for further investigation, or prescribe topical treatments, i.e. haemorrhoid medication in the instance of piles, and put in place a strict, time-sensitive monitoring regime. This system will mean that you must return to the GP in a certain set, time-period, in order to review the symptoms, as to whether they have resolved or not.
If any of these symptoms continue past the period of 6 weeks, the GP must refer you to a specialist for further investigation. An investigation will normally consist of a procedure known as a colonoscopy, which will investigate for growths or tumours in the rectum or bowel.
The National Institute for Clinical Excellence - NICE, has laid down guide lines for the diagnosis of bowel cancer, which all GPs must follow. There is much information to make you aware of the symptoms of bowel cancer. The www.beatingbowelcancer.org is a main website for questions about bowel cancer symptoms. Another excellent website that was set up by the journalist Lyn Faulds-Wood is www.bowelcancer.tvThis website is very informative and was the original bowel cancer awareness website, set up after her own bowel cancer experience. There are very informative videos on this site, detailing real patients stories. There is also a guide in which you can check whether you have the symptoms of bowel cancer, or not, but never just rely on internet websites for diagnosis, always refer all of your symptoms to a good GP.