What is advanced colorectal cancer?
This is when the cancer has spread from the colon itself to other sites in the body. This may have already happened when the cancer is first diagnosed or may occur at a later date. The most common site for the cancer to spread is to the liver. Chemotherapy in this situation can be effective in controlling symptoms and prolonging life. Chemotherapy does not cure the disease and treatment is selected to provide a balance between the side effects and the benefits gained from treatment.

Are there any implications for my family?
If a person is young (40–50 years of age) when bowel cancer is diagnosed or if cancer is very common in the family, it may be that there is an inherited genetic abnormality. In such circumstances, brothers, sisters, and children may be referred to a specialist for advice. If the risk of inherited disease is high enough, some relatives may be advised to undergo a regular colonoscopy. There are uncommon and inherited conditions including familial adenomatous polyposis (FAP) in which numerous polyps develop throughout the bowel and the cancer risk is greatly increased. The family of these patients has to be carefully screened.

Is there any screening for colorectal cancer?
Mass screening of the population for bowel cancer is not yet available but clinical trials are in progress. Because polyps may bleed, one of the screening methods involves testing the stools chemically for traces of blood, then carrying out further investigations of the bowel if the test is positive. Another technique of screening is to examine the lower part of the bowel with a flexible sigmoidoscope in people between the ages of 55 and 65. Trials of using these techniques on individuals who have no bowel symptoms have shown that more early cancers are being diagnosed and that early detection improves your chance of survival. The government will introduce mass screening within the next few years.

Further information
National Cancer Institute: www.cancer.gov/cancertopics/types/colon-and-rectal

Last Reviewed: May 2013