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Treating 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.

You might have advanced cancer when you are first diagnosed. Or the cancer might come back after previous treatment.

Symptoms of advanced bowel cancer can be hard to cope with. But doctors and nurses can offer support and treatment to help you.

There are treatments available that can help to shrink the cancer and relieve symptoms. These include:

  • chemotherapy
  • radiotherapy
  • targeted cancer drugs (biological therapy)

Other treatments such as stents can treat specific symptoms such as a blockage in the bowel.

Tell your doctor or nurse about any symptoms that you have so they can help you.

Symptoms

You might not feel like eating and may lose weight. It is important to eat as much as you can.

Tips:

  • Eating several small meals and snacks throughout the day can be easier to manage.
  • Ask your doctor to recommend high calorie drinks to sip if you are worried about losing weight.
  • Eat whatever you feel like eating rather than what you think you should eat.
  • Eat plenty of calories when you can to make up for times when you don’t feel like eating.
  • Drink plenty of fluids even if you can't eat.
  • Don't fill your stomach with a large amount of liquid before eating.
  • Try to eat high calorie foods to keep your weight up.
Talk to your dietitian about having high calorie drinks to boost your calorie intake if you need them.

Tiredness is a common symptom of advanced cancer. It can feel a bit overwhelming and as though you don’t have any energy. 

Let your doctor or nurse know if you’re very tired as they might be able to prescribe medicine to help or other treatments. For example, a blood transfusion can give you more energy if you’re tired due to anaemia (low red blood cell levels).

Resting

It’s important to rest a few times throughout the day. Resting regularly can help you feel less tired and more able to cope. You don't have to sleep during these times. Just sitting or lying down will help. 

Exercise

Exercising can be hard when you feel very tired. But research shows that daily light to moderate exercise can give you more energy. Going for a gentle walk is very good. Gentle exercises in bed or standing up can help if you can’t move around easily. 

Your hospital physiotherapist might be able to help you plan an exercise programme that suits your needs.  

Sleeping

You might feel more tired if you have trouble sleeping at night. It can help to change a few things about when and where you sleep.

You might have a swollen tummy (abdomen) if your cancer has spread to the liver. The swelling is due to a build up of fluid called ascites. It can make your clothes feel tighter. Your tummy might feel bloated. You might also find it difficult to sit comfortably or to move around.  

Your doctor can drain off the fluid by putting a small, flexible tube into the abdomen. This helps you to feel more comfortable.

If you get pain, it can often be helped by cancer treatment. For example, an enlarged liver may cause pain in your right side or shoulder. The pain can be reduced by surgery, radiotherapy, chemotherapy or biological therapy that shrinks the cancer. 

If you have pain that is not controlled with cancer treatment, there are many painkillers available. Pain can usually be well controlled. With good pain control, most people should be able to be free of pain when they are lying or sitting. The first step is to tell your doctor or nurse that you have pain so that they can find the right painkillers for you.

Bowel problems such as diarrhoea or constipation can be caused by the cancer. They can also be caused by cancer treatments or medicines. For example, painkillers commonly cause constipation. 

Talk to your doctor or nurse if you have bowel problems. They can help by giving you medicine. And they can refer you to a dietitian for advice on what to eat or drink. 

Treatment for sickness depends on what is causing it. Some painkillers or cancer treatments can cause sickness. You will also feel sick if you are constipated.

It is a good idea to talk this over in detail with a doctor or nurse. Then, you can get the treatment you need.

Some people find that ginger is a good natural remedy for sickness. Try eating stem ginger or crystallised ginger if you like it. Or you can slowly sip ginger beer or ginger ale.

Even when you feel tired you may find it hard to sleep. There are different reasons for this, including anxiety and having a lot on your mind. You may want to ask your doctor for sleeping pills. These can help to break a pattern of poor sleep and get you back into a better routine.

You can also try some other remedies for sleeplessness such as:

  • warm milk drinks before bed
  • natural sleep remedies (for example, homeopathic remedies)
  • a warm bath in the evening
  • a relaxing body massage to relieve muscle tension
  • a little more exercise during the day, if you can manage it

A blockage in the bowel

Sometimes cancer can grow so that it completely blocks the bowel. This is called a bowel obstruction. The waste from the food you have digested can't get past the blockage. This causes quite a few symptoms such as:

  • feeling bloated and full
  • vomiting large amounts
  • feeling sick
  • constipation
  • being unable to pass wind
  • pain

Symptoms from cancer that has spread

You might have other symptoms, depending on where the cancer has spread to.

Help with controlling symptoms

Your doctor or specialist nurse can:

  • give you medicines
  • help you to 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

There are symptom control teams in most cancer units. They can help you to stay as well as possible for as long as possible. 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: 
12 Nov 2018
  • Colorectal cancer: diagnosis and management
    The National Institute for Health and Care Excellence, 2014

  • Metastatic colorectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    E Van Cutsem and others
    Annals of Oncology, 2014. Volume 25, Pages iii1–iii9

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