Bowel (Colorectal) Cancer

Mr. Brian Mehigan

Consultant Surgeon

Consultant Image

Bowel cancer refers to cancer of the colon or rectum, two organs which together form the large bowel or large intestine. This section of the bowel starts on your right side, near your appendix, and ends at your anus, or back passage. Bowel cancer is very common, with over 2,000 cases diagnosed every year in Ireland. The number of cases per year is increasing because of a variety of factors, including an aging population and the new bowel screening programme, which will be rolled out over the next few years.

As one of the eight national cancer centres, St. James’s Hospital is a specialist in the management of large bowel cancer, providing 10% of all colorectal cancer care in the country. The unit has three colorectal surgeons who specialize in keyhole surgery for bowel cancer in St. James’s Hospital and two colorectal surgeons who work both here and the AMNCH in Tallaght. They work alongside specialist nursing units in colorectal cancer care, stoma management and colorectal inpatient care and are supported by a specialist dietetic service. Chemotherapy is provided by the Colorectal Oncology Department, led by Professor John Kennedy, and colorectal radiotherapy is provided in the new St. Luke’s Centre on the St. James’s campus, led by Dr. Charles Gilham. All colorectal cancer cases are discussed at a weekly Multidisciplinary Meeting attended by these specialists. As St James’s is a national cancer centre, patients may be referred from another hospital for surgery.

Colorectal cancer treatment is often successful. The outcome is much better the earlier the patient is diagnosed, so anyone with a concern should attend the doctor immediately.

The small and large bowel are part of the digestive system. The large bowel (large intestine) includes the colon, rectum and anus. Cancer in the large bowel (colon) is also known as colorectal cancer and is the second most common diagnosed cancer in Ireland.

We do not know exactly what causes bowel cancer, but age is a factor. Most people develop bowel cancer over the age of 60. Sometimes it can occur because of inherited genes, but in most cases bowel cancer has no specific cause. Most bowel cancers start as a small growth called a polyp. Most polyps are harmless (benign), but some can become cancerous (malignant) over time. Ideally, we can diagnose and remove these polyps before they become cancerous.

The most common symptoms patients experience are a change in their bowel habit or some blood in their bowel motions. The sooner patients go to their GP with their symptoms, the better. Their chances of a cure are higher if the problem is diagnosed early. Patients’ symptoms are investigated with a colonoscopy, a flexible camera that is inserted through the back passage to examine the large bowel. If a growth is found, other tests, including CT or MRI scans, may be necessary.