Some Facts on the early Detection of Cancer of the Bowel

Cancer of the large intestine and rectum, known as ColoRectal Cancer (CRC), is the most frequent cancer of the digestive system in Eastern Europe and in North America, and here in Argentina it was estimated that it was second only to breast cancer, and more frequent than lung cancer, with approximately 10.300 new cases in the year 2000.

These numbers have determined that it is good medical practice, not only to investigate those persons who have symptoms, but also to screen healthy adults over the age of 50, and over 40 for all who have had close relatives who had cancer or polyps of the bowel.

No screening method is infallible, though colonoscopy has the highest chance of success. 

  • The search for minute microscopic quantities of blood in the stools can be done. If negative, it has to be repeated systematically, and if positive, a colonoscopy must be performed.
  • An old method is looking into the last part of the intestine, what is known as fiberoptic rectosigmoidoscopy, the problem being that only the left side of the bowel is seen.
  • An x-ray of the bowel, called barium enema, is not routinely used as a screening method, but it may be used if the colonoscopy has not reached far enough into the right side of the bowel.
  • The same made be said of a new technique developed with the appearance of very fast rotating tomographs, which is known as ‘virtual colonoscopy’.
  • Fiberoptic Colonoscopy requires adequate preparation so that the specialist can have a good look into the bowel.  It is performed under light general anaesthesia by specially trained doctors, who can also remove small polyps or adenomas, which are then analyzed by the pathologist, and thus very early lesions are identified. If a tumour is seen, a small part is removed (biopsied) for its correct identification. The possible complications of this procedure are seldom seen, mainly bleeding and perforation, and the specialists are ever alert to treat these complications immediately.
  • If the colonoscopy was normal, most experts agree that it should be repeated 10 years later.  If polyps have been removed, or if there is a family history of cancer of the bowel, the specialist will determine according to each case, how frequently it should be repeated.

It is also useful to know what symptoms might be related to the unsuspected presence of CRC: the presence of blood in the bowel movement, a change in the daily rhythm of these, a slow onset of anaemia with no other known cause, or a gradual loss of weight. If any of these are present, you should consult your physician.  Unfortunately, sometimes the first symptom is the complete blockage of the intestine, which constitutes a medical emergency, and needs immediate Hospital treatment.

The British Hospital has just finished refurbishing an area in the Out Patient Department, where the Gastroenterology Service led by Dr. Luis Colombato, and the Proctology Service led by Dr. Mario Salomón, will be performing upper and lower endoscopic gastrointestinal studies. There are 4 separate small rooms for post anaesthetic recovery, supervised by Hospital nurses.