It’s often dubbed the ‘taboo cancer‘ such is the level of embarrassment associated with discussing it.
But experts say speaking about rectal cancer, a form of bowel cancer which affects the final few inches of the large intestine, is a vital weapon in the fight to stop people dying from the disease.
Earlier this year, Dawson’s Creek star James Van Der Beek passed away from rectal cancer aged just 48.
Before he died, and in a bid to raise awareness, he revealed in an interview that he had experienced changes to his bowel habits but was unaware this was a tell-tale sign of the cancer.
Along with other cancers that start in the bowel and colon, rectal – also known as colorectal cancer – kills 17,000 people in the UK every year.
It is typically diagnosed at a late stage, when treatment is difficult, because it causes few symptoms early on – which are often mistaken for less serious problems such as irritable bowel syndrome (IBS).
It is a frightening disease – made all the more so by the fact that people are too embarrassed to talk about their symptoms, and doctors still don’t know what’s causing the uptick in cases in young people.
Here the Daily Mail outlines the red-flag warning signs that could be the difference between catching rectal cancer early and delaying treatment until it’s too late.
James Van Der Beek announced his stage 3 colorectal cancer diagnosis in November 2024 when he was 47 years old
Changes in bowel habits: pencil-thin stools
The first warning signs of rectal cancer are often subtle – but one of the most common is a persistent change in bowel habits.
When cancer grows in the colon or rectum, it can block or change the way stool moves through the intestine.
The disease can also interfere with the absorption of nutrients and water which can cause changes in bowel habits.
This can include constipation, diarrhoea, or needing to go to the toilet more often than usual. Some people also feel as though their bowel has not fully emptied after going.
A sudden change to pencil-thin stools might happen if cancer is making the passage smaller.
A small amount of mucus is completely normal but if you are noticing an increased amount of the jelly-like substance, you should contact your GP.
However, there is no hard-and-fast rule for how many times a week you should be going to the toilet. It’s about recognising changes in your normal routine.
Blood in the stool
There are several things that can cause blood in the stool – such as swollen blood vessels, known as hemorrhoids, in the rectum or non-cancerous growths which will often cause bright red blood.
But it can also be caused by cancer.
If the blood is dark red or black in colour, it could be coming from higher up in the bowel.
In some cases the bleeding is very small and not visible to the naked eye – which is why screening tests check for tiny traces of blood.
When stools start to become thinner than usual, are bloody and you are going to the bathroom more often than usual and feeling like you can’t finish, this could be a sign that the cancer has spread.
Severe bloating, stomach pain and constipation
Rectal cancer can also cause ongoing abdominal discomfort, cramping or bloating.
Whilst it is normal to have some of these symptoms, it can also be a tell-tale warning sign that the cancer has spread, causing a build up of fluid.
In some cases, the tumour can partially or completely block the bowel, causing abdominal pain, bloating, nausea and constipation.
A blocked bowel is a medical emergency.
Unexplained weight loss, fatigue and a lump in the rectum
Rectal cancer can lead to chronic bleeding, which may result in iron deficiency anemia.
Symptoms may include persistent fatigue, weakness, pale skin, unexplained weight loss, and shortness of breath. If you experience these symptoms, it is essential to seek medical advice for further evaluation.
A lump in the rectum may also be found in a medical exam.
Why the warning signs matter
Dame Deborah James, nicknamed the ‘bowel babe’ raised more than £11.3mn for Cancer Research and is credited for increasing awareness of the disease, which killed her in 2022 aged 40
Every year, an estimated 44,000 people are diagnosed with bowel cancer in the UK – a number that is only expected to rise.
The first signs are often persistent changes in bowel habits – such as constipation and diarrhoea – as well as blood in the stool, abdominal pain, fatigue and unexplained weight loss.
And because under-50s are not routinely invited for bowel cancer screening, experts say younger people must be aware of the warning signs.
One smoking gun that seems to keep emerging as a major culprit is ultra processed foods.
These foods, including factory-packaged snacks, ready meals, sugary cereals, soft drinks, processed meats and many fast foods, now make up half the average diet in the UK and US.
And research suggests it’s not just becoming an increasing problem in obese people – which is a major risk factor for numerous cancers – with experts speculating that chronic low-grade inflammation and changes in the gut microbiome could be driving the trend.
