Bowel Cancer: How It Can Be Diagnosed By Doctors?

Posted on Oct 11, 2008 under Bowel Cancer |

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The doctor might sense a cancer of the rectum by supplementing a gloved finger into the rectum. The diagnosis generally established by biopsy in which a small (2mm diameter) sample of tissue is taken painlessly with forceps supplemented through a small tube that is a proctoscope or sigmoidoscope.

In order to notice cancers further along the colon, the doctor will use either a flexible sigmoidoscope or a colonoscope to see the whole colon, including the part on the right side of the abdomen.

Colonoscopy is generally executed by using intravenous sedation and it takes 30 minutes. Flexible sigmoidoscopy takes 10 minutes and generally performed without sedation.

Alternatively, a barium enema examination may be used to see the whole colon. Generally a small balloon is then inflated in the rectum to pump in a small amount of air. This gives ‘double contrast’ to illustrate the lining of the bowel in good detail. The procedure takes 30 minutes.

For both procedures, the colon needs to be cleaned by vigorous purgation, which many patients find the most unlikable part of the procedure.

There are merits and demerits of each approach:

Colonoscopy permits biopsy and therefore the presence of cancer can be confirmed under the microscope. But, even by capable hands, the whole colon is seen in only about 90 per cent of procedures.
The barium enema is generally more relaxed, but it is executed without sedation. It nearly always shows up the whole colon, but with fewer feature than colonoscopy so very small polyps can be missed.

Screening is now advised in the USA for all individuals over the age of 50. It is done by a combination of an annual test for non-visible blood in the faeces, plus some form of endoscopy, flexible sigmoidoscopy or colonoscopy, every three to five years. Experts have not yet firmly developed whether this approach can extend life, and screening has not yet been introduced routinely in the UK.

The requirement for screening is different if you have a strong family history of bowel cancer. People who have a first-degree relative e.g. a parent, brother, sister or child who established colorectal cancer before the age of 45, the life-time risk for colorectal cancer is 1 in 10.

It is suggested that such people should be accessed screening, likely by full colonoscopy, every five years, and beginning 5 to 10 years younger than the age at which the relative was diagnosed. People who have two first-degree relatives with colorectal cancer have a one in six life-time danger and should be likewise offered screening.