What is bowel cancer?
The bowel is part of the digestive system and is divided into the small bowel and large bowel. The large bowel is made up of the colon, rectum and anus. The term bowel cancer is normally used to talk about:
Cancer that starts in the colon or rectum is also sometimes called colorectal cancer.
Our information on bowel cancer is also for anyone with either colon cancer or rectal cancer.
Clinical Oncologist Katherine Aitken explains bowel cancer in the video below. She gives an overview of bowel cancer symptoms, diagnosis and treatment.
In the UK, about 44,100 people get cancer in the colon or rectum each year. Bowel cancer is more common in older people. But the number of younger people 50 and under diagnosed with it is increasing.
Cancer can also start in the anus or in the small bowel:
If you are not sure which type you have, ask your GP, cancer doctor or specialist nurse for more information.
Related pages
Symptoms of bowel cancer
Some people may start by seeing their GP because they have symptoms. Symptoms of bowel cancer can include:
- blood in your poo (stools)
- bleeding from the back passage
- a change in your normal bowel habit.
If you are worried about bowel cancer, we have more information about bowel cancer symptoms.
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Causes of bowel cancer
Doctors do not know the exact causes of bowel cancer. But there are risk factors that can increase your chance of developing it.
Different risk factors may increase the chance of being diagnosed with bowel cancer. Find out more about the causes and risk factors for different types of bowel cancer:
Diagnosis of bowel cancer
If you have symptoms, you will usually begin by seeing your GP, who will examine you. If they think that your symptoms could be caused by cancer, they will refer you to a specialist doctor.
The specialist doctor will examine you and you will usually have some tests. These include a rectal examination and a blood test.
You usually also have test called a colonoscopy. A doctor or nurse uses a thin tube with a camera at the end to examine the inside of the whole bowel.
Or you might have a sigmoidoscopy to examine the inside of the rectum and the part of the colon closest to the rectum.
Some people are diagnosed with bowel cancer through the NHS Bowel Screening Programme. We have more information about bowel cancer screening.
We have more information about the tests you may have and how bowel cancer is diagnosed.
Waiting for test results can be a difficult time. We have more information that can help.
Related pages
Staging and grading of bowel cancer
The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging.
A doctor decides the grade of the cancer by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread.
Knowing the stage and grade helps your doctors plan the best treatment for you.
Treatment for bowel cancer
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
Your doctor or cancer specialist or nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions.
Before your treatment starts your cancer team might talk to you about preparing for your treatment. This is sometimes called prehabilitation. It helps you to improve your fitness, health and well-being before treatment. It can also help you recover more quickly. We have more information about preparing for bowel cancer treatment (prehabilitation).
Your treatment will depend on the stage of the cancer and where it is in the bowel. It also depends on your general health and preferences.
Treatments include:
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Surgery
Surgery is often used to remove the part of the bowel where the cancer is. The operation to remove the cancer may be done as open or keyhole surgery through a few small cuts in the tummy. We have more information about surgery for colon cancer and surgery for rectal cancer.
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Chemotherapy
Chemotherapy uses anti-cancer drugs to destroy cancer cells. You may have chemotherapy before or after surgery. It is used to treat colon and rectal cancer..
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Radiotherapy
Radiotherapy uses high-energy rays (radiation) to destroy cancer cells. It is often used to treat rectal cancer. You might have radiotherapy at the same time as chemotherapy. This is called chemoradiation.
Advanced bowel cancer
If you have bowel cancer that has come back or spread to other parts of the body, you may have treatment with a targeted therapy or immunotherapy drug. You usually need tests on the bowel cancer cells to help you and your doctor to make decisions about the best cancer drug treatment for you.
Chemotherapy is also commonly used to treat advanced bowel cancer. Surgery, ablation and different types of radiotherapy can also be used depending on where in the body bowel cancer has spread to.
We have more information about treatment for advanced bowel cancer.
You may have some treatments as part of a clinical trial.
After bowel cancer treatment
Follow-up after treatment for bowel cancer
You will have regular check-ups during and after your treatment. These usually continue up to 5 years. You may have regular blood tests and other tests.
Tell your doctor or specialist nurse as soon as possible if you have any problems or notice new symptoms between appointments.
We have more information about follow-up care after treatment.
Sex life
Bowel cancer and its treatment can affect your sex life. Changes may get better over time, but sometimes they are permanent. If you have any problems or are worried about this, talk to your doctor or nurse. They can explain what to expect and there are often things that can help.
We have more information on your sex life after bowel cancer.
Body image
Fertility
Some cancer treatments can affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.
Support after bowel cancer
People often have many different feelings when they finish bowel cancer treatment. You may feel relieved that treatment has finished, but worried about what will happen in the future.
We have information below about some of the things people ask about after bowel cancer treatment. But you may have other questions or need information about something else.
Macmillan is here to support you. If you would like to talk, you can:
- call the Macmillan Support Line for free on 0808 808 00 00
- chat to our specialists online
- visit our bowel (colon and rectal) cancer forum to talk to people who have been affected by bowel cancer, share your experience, and ask an expert your questions.
Other organisations who offer information and support include:
Well-being and recovery
It can take time to recover after bowel cancer treatment. Some days you may feel better than others.
Looking after yourself can help speed up your recovery. Even small lifestyle changes may improve your well-being and long-term health.
Even if you already have a healthy lifestyle, you may choose to make some positive changes after treatment. We have more information on leading a healthy lifestyle after treatment.
It is important to know where to get support or information if you need it. People often need support even some time after bowel cancer treatment. But sometimes it is difficult to know who to ask for help. To find support:
- ask your GP or someone from your cancer team for advice about support in your area
- search cancercaremap.org to find cancer support services near you
- call us free on 0808 808 00 00 or talk to us talk to us online - our cancer information and support specialists can offer guidance and help you find what you need.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our bowel cancer information. If you would like more information about the sources we use, please contact us at
informationproductionteam@macmillan.org.uk
National Institute for Health and Care Excellent (NICE). Colorectal cancer. NICE guideline [NG151]. Updated December 2021. Available from: www.nice.org.uk/guidance/NG151 [accessed Jan 2023].
Cervantes A, Adam R, Rosello S, et al. Metastatic colorectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Annals of Oncology. 2023 ;34(1):10-32. Available from: www.annalsofoncology.org (accessed Jan 2023).
Dr Paul Ross
Reviewer
Consultant Medical Oncologist
Guy's and St Thomas' NHS Foundation Trust
Date reviewed
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