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Symptoms of advanced bowel cancer

Advanced bowel cancer is cancer that started in either the back passage (rectum) or large bowel (colon) and has spread to another part of the body.

The symptoms of advanced bowel cancer can include the symptoms for bowel cancer that hasn't spread. Other symptoms depend on which part of the body the cancer has spread to.

It might not mean that you have advanced cancer if you have the symptoms described below. They can be caused by other conditions.

Tell your doctor or specialist nurse if you're worried about a symptom or if it continues for more than a few days.

Where bowel cancer spreads

Bowel cancer can spread to the:

  • liver
  • lungs
  • lymph nodes
  • bones
Diagram showing the most common sites for bowel cancer to spread to

General symptoms

  • feeling tired
  • low energy levels
  • feeling under the weather
  • having less appetite

Symptoms if cancer has spread to the liver

You might have any of these symptoms if the cancer has spread to your liver:

  • discomfort or pain on the right side of your abdomen
  • feeling sick 
  • poor appetite and weight loss 
  • swollen abdomen (called ascites) 
  • yellowing of the skin (jaundice) 
  • itchy skin 

Symptoms if cancer has spread to the lungs

You may have any of these symptoms if cancer has spread to your lungs:

  • a cough that doesn’t go away
  • breathlessness
  • ongoing chest infections
  • coughing up blood
  • a build up of fluid between the chest wall and the lung (a pleural effusion)

Symptoms if cancer has spread to your lymph nodes

Lymph nodes are part of a system of tubes and glands in the body that filters body fluid and fights infection.

The most common symptom if cancer has spread to the lymph nodes is that they feel hard or swollen.

Cancer cells can also stop lymph fluid from draining away. This might lead to swelling in the neck or face due to fluid buildup in that area. The swelling is called lymphoedema.

Symptoms if cancer has spread to the bones

You may have any of these symptoms if your cancer has spread to the bones:

  • an ache or pain in the affected bone
  • a weakened bone which is more prone to break or fracture

Sometimes when bones are damaged by advanced cancer, the bones release calcium into the blood. This is called hypercalcaemia and can cause various symptoms such as:

  • tiredness
  • feeling sick (nausea)
  • constipation
  • irritability
  • thirst
  • confusion

Controlling symptoms

Treatments such as radiotherapy or chemotherapy can sometimes shrink the cancer and reduce symptoms.

Your doctor or specialist nurse can:
  • give you medicines
  • get equipment that you need
  • suggest other ways of controlling your symptoms
  • refer you to a symptom control team (a palliative care team)

Symptom control team

Members of the team are experts at controlling symptoms. They can help you to stay as well as possible for as long as possible. There are symptom control teams in most cancer units. They are also in hospices and many general hospitals.

Most symptom control teams have home care services so they can visit you at home.

Last reviewed: 
07 Nov 2018
  • Metastatic Colorectal Cancer: ESMO Clinical Practice Guidelines 
    E Cutsem and others
    Annals of Oncology, 2014. Volume 25, Pages ii1-iii9

Information and help

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