A study looking at the symptoms that show bowel cancer is coming back after surgery

Cancer type:

Bowel (colorectal) cancer
Colon cancer
Rectal cancer





This study looked at symptoms people might have that show bowel cancer is coming back after surgery.

More about this trial

Doctors often treat bowel cancer (colorectal cancer) with surgery to try and cure it. But sometimes the cancer comes back. Researchers think recognising early symptoms Open a glossary item of cancer coming back may help people to get the treatment they need sooner.

The aim of this study was to see if it was possible to identify

  • The pattern of symptoms people have
  • Factors affecting how people manage their symptoms including when they decide to see a doctor
  • If people at high risk of their cancer coming back had any differences in their symptoms and the way they used the health care services

Summary of results

The study team found it was difficult to do a detailed analysis of symptoms or identify specific symptoms that were most likely to show that bowel cancer had come back (recurred). The researchers say this is due to a lack of research on which to base recommendations for recognising symptoms for both patients and doctors.

The researchers looked for any previous research that described the symptoms people have when their bowel cancer has come back and also looked for information about this in the national guidelines for bowel cancer.

The study team then asked a small number of expert cancer doctors and nurses about the symptoms they think are important signs of bowel cancer coming back. They used this to develop a symptom checklist.

30 people who had surgery for bowel cancer took part in this small study. Some people had cancer that had come back and some didn’t.

The researchers looked at everybody’s hospital notes to see what tests, treatments and symptoms they had. The researchers also interviewed everyone. They asked about

  • Treatment and care people had
  • Symptoms people had since  diagnosis and how they managed them
  • Which symptoms prompted them to seek medical advice

The main findings were that

  • Few studies have reported the symptoms people have when their cancer has come back
  • Current national guidelines promote early detection of cancer that has come back but fail to provide advice on what the symptoms are
  • Patients with or without cancer that has come back report a number of symptoms that include tummy pain or bloating, breathlessness, tiredness, back pain, joint pain or pain elsewhere in the body
  • Most patients think the symptoms are due to treatment, getting older or other causes but not a sign of cancer coming back
  • Most patients choose to manage their own symptoms rather than tell their doctors. Only a few symptoms reported in the interview were recorded in the patient’s medical notes

The researchers concluded that there isn’t enough research into recognising symptoms of cancer coming back. They recommend that future research looks into this in more detail.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Nicola Gray

Supported by

Chief Scientist Office (CSO)
NIHR Clinical Research Network: Cancer
University of Aberdeen

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Charlie took part in a trial to try new treatments

A picture of Charlie

“I think it’s really important that people keep signing up to these type of trials to push research forward.”

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