Prevention is better than cure

THE country's second most common cause of cancer deaths, killing 80 people each week, can be treated successfully if caught early, according to landmark Australian research.

The new research provides the first concrete evidence that early detection from bowel cancer screening is critical, as it correlates with an improved prognosis for this perilous yet preventable disease.

Professor of Global Gastrointestinal Health at Flinders University, Adelaide, Graeme Young, who spearheaded the new research and its presentation at Digestive Disease Week in the U.S., says early detection of bowel cancer is critical, as it correlates with an improved prognosis.

"Our research reveals that cancers detected in people who are screened as part of an organised screening program (namely Australia's National Bowel Cancer Screening Program) will be detected earlier than those identified due to other reasons, such as symptoms or family history. Bowel cancers detected at an early stage are highly curable, reducing the chance of death from the disease."

Current guidelines recommend that bowel screening is performed at least once every two years for people aged 50 and over.

Even without symptoms or a family history, all Australians can screen for bowel cancer with tests available from their local pharmacy.

In a bid to curtail the number of Australian deaths from bowel cancer each year, the Pharmacy Guild of Australia together with Bowel Cancer Australia, run BowelScreen Australia® - a pharmacy-based bowel cancer awareness, education and screening program for the community.

According to Kos Sclavos, National President of the Pharmacy Guild of Australia, given that bowel cancer claims more lives each year than breast or prostate cancer, our knowledge of the disease could be vastly improved.

"The aim of screening for bowel cancer is to find any polyps or early stage cancer when it is easier to treat and cure.              

"While bowel cancer is one of the most curable cancers if found early, currently fewer than 40 per cent of bowel cancers are detected in the early stages of the disease.

"So it's imperative that people are much better educated on the disease and how to screen for it," said Mr Sclavos. 

"Pharmacists are positioned at the coal face of community health, as the most accessible healthcare professionals.

"People who do not have any obvious symptoms of bowel cancer can talk to their local pharmacist about bowel health and bowel cancer, and obtain a screening test which they can perform in the privacy of their own home."

As a preface to Bowel Cancer Awareness Week (June 3-9, 2012), Professor Adrian Polglase, specialist colorectal surgeon at  Cabrini Hospital, Emeritus Professor of Surgery at Monash University and Patron of the Let's Beat Bowel Cancer initiative, Melbourne, who has performed more than 5,000 bowel cancer procedures during his career, has a poignant message for the Australian community.

"Don't die from embarrassment. Get tested for bowel cancer."  

According to Professor Polglase, Australia and New Zealand have the highest incidence of bowel cancer per capita worldwide. The reasons for this are unclear.           

"Fourteen thousand Australians are diagnosed with bowel cancer each year, which leads to around 4,000 deaths from the disease per annum and one Australian dying from the disease every two hours. If we can diagnose bowel cancer before symptoms occur, then cure rates for the disease are very high."

Lorraine, 50, a Sydney-based regional sales manager for a multinational, was diagnosed with bowel cancer in January this year after using a screening test for the disease. Now cancer free, the disease has taken a significant toll on Lorraine, who has always led a healthy and active life. She has undergone major surgery which involved a re-section of her bowel and a 12-day hospital stay, and now wears an ileostomy bag. She is preparing for the next stage of her surgical treatment.                                    

"I used a bowel cancer screening test and sent it away, and soon after received a letter from the pathologist stating they had detected blood in my bowel motion. I was advised to have a colonoscopy as soon as possible. 

"The colonoscopy revealed the presence of a four centimetre polyp in my bowel. So I underwent a polypectomy to remove the polyp. It was then sent for testing. When the results came back, I was totally shocked, as the polyp was diagnosed as malignant (cancerous). But fortunately the cancer was detected in the first stage of the disease, which improved my prognosis," said Lorraine.

Lorraine is confident that an early detection of bowel cancer saved her life.

"Bowel cancer screening tests from pharmacies could save your life. Every Australian aged 50 plus should be doing them.

"It's as simple as that."

About bowel cancer
Bowel cancer is a malignant growth that develops inside the large bowel (the colon or rectum). Most bowel cancers are caused by environmental factors such as diet, obesity and lack of exercise.

Inherited factors recognisable from a family history of bowel cancer and certain bowel diseases also contribute to the chance of getting the disease.

There are four stages of bowel cancer that are measured by the extent of the cancer's penetration through the bowel wall, and diagnosis may occur at any one of these stages.9 Stage one bowel cancer has a 90 per cent five year survival rate versus stage 4 bowel cancer which has a 10 per cent five-year survival rate.

The main treatment for bowel cancer is surgery, during which the surgeon removes the affected section of bowel.                           

If the bowel cancer has spread beyond the bowel wall to other organs, surgery might be followed by chemotherapy or radiotherapy. When detected early, it is unusual that reconnection of the bowel is not possible, therefore minimising the need for a bag (an "ostomy").

About screening
Screening for bowel cancer involves testing for small amounts of blood in the bowel motion as polyps or early stage bowel cancers often bleed and the blood is released in the stool.

The Gastroenterological Society of Australia Guidelines recommend testing every one-to-two years with an immunochemical Faecal Occult Blood Test (FOBT) 11 for people aged 50 and over. T

he non-invasive FOBT test available in pharmacy, detects hidden blood, often released from bowel cancers or their precursors (polyps or adenomas) into the bowel motion.

The test is returned through the post and results are provided to the patient and their nominated doctor. If the test is positive, the patient will be referred by their GP for a colonoscopy, which can detect the presence of polyps or early stage cancer. If tumours are present, the patient will undergo surgery to remove the tumour and, if the cancer has spread, chemotherapy or radiotherapy.

The Federal Government's National Bowel Cancer Screening Program provides free bowel cancer screening to people aged 50, 55 and 65. The recent 2012-13 Budget extended the screening program to people aged 60 and 70. The addition of 60 year olds will be implemented in 2013 and the addition of 70 year olds in 2015.13 People who do not qualify for the Federal Government's National Bowel Cancer Screening Program may screen with bowel cancer tests available from pharmacy.

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