GP partner and educator Dr Anish Kotecha provides an overview of bowel cancer prevention, diagnosis and management in general practice, and the role of nurses at each stage
Over 40,000 people are diagnosed with bowel cancer every year in the United Kingdom, making it the fourth most common cancer. It mainly affects people over the age of 50, and the large bowel is more commonly affected than the small bowel.
This module will provide an understanding of the risks, signs and symptoms of bowel cancer and how nurses can be involved in supporting patients after diagnosis and treatment.
Changes to a person’s lifestyle can help prevent bowel cancer such as avoidance of smoking, being physically active and maintaining a healthy weight, eating wholegrain foods and fruits and vegetables and reducing alcohol intake.
Nurses in all settings can be involved with the care of a person with bowel cancer or suspected bowel cancer and Advanced Nurse Practitioners (APNs) may find themselves dealing with the first presentation of bowel cancer. An understanding of the possible warning signs of bowel cancer is essential, as well as where to go to seek further help.
Practice nurses may also be the first to hear about worrying symptoms from elderly patients coming into the practice for flu jabs or to receive post-operative wound care, who may mention symptoms of bowel cancer in passing.
Possible symptoms of bowel cancer to look out for include a change in bowel habit (either diarrhoea or constipation), bleeding from the back passage, a lump in the abdomen or in the back passage, a feeling of needing to evacuate the bowels, abdominal or rectal (back passage) pain, unintentional weight loss and lack of appetite.
- Bowel cancer is relatively common
- The practice nurse often plays a vital role, in assessing patients with signs and symptoms, promoting screening programmes and supporting post-diagnosis patient care
- It is important to recognise the symptoms quickly and refer to specialists promptly
- Encouraging people to live healthy lifestyles is key and reminding them about the screening programme is important
- Treatment depends on many factors but the person should always be at the centre of the conversation
The prognosis of bowel cancer can be reasonable depending how early it is caught; the 5-year survival rate is around 60%. Sometimes when the cancer is not curable, the focus turns to keeping people comfortable. This allows a palliative approach, establishing the person’s biggest priorities and working to achieve them.
Dr Anish Kotecha is a GP partner in a surgery in South Wales. Dr Kotecha is also a Royal College of GPs (RCGP) South East Wales Faculty Education Lead and Aneurin Bevan University Health Board Cardiff University Communication Skills tutor and examiner.
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