Bowel cancer fear. Again.

[puzzledlass]

Thanks for your reply fallingstar!

I am going to make an appointment with doc, and try my best to be very brave and explain what's going on. Usually I end up crying... Haha

Do you have any advice for tests I can ask for? I've had a fobt (but will request another), had a rectal finger in butt exam. What else can I request?

It doesn't help that where I live (New Zealand) has a RIDICULOUSLY high bowel
Cancer rate. Really high, we are only a country of 4 million people! Sigh.

Any advice/suggestions would be much appreciated.

---------- Post added at 16:47 ---------- Previous post was at 13:51 ----------

I can't do this anymore. I'm going to go and cry in the shower.

[hanshan]

Have you looked at the bowel cancer rate by age in New Zealand?

It may be that New Zealand has a high bowel cancer rate simply because people are so healthy that they live on into their eighties and nineties, when they are much more likely to contract bowel cancer - not at your age.

[puzzledlass]

The mortality rate is pretty high from it too. :(

[hanshan]

The healthier a population gets, and the longer it lives, the more likely its members are to die from diseases of old age - mostly cancers and cardiovascular disease.

This can lead to the odd-sounding conclusion that the healthier people get, the more likely they are to die from heart disease. What this means is that they didn't die of diarrhea from a water based infection when they were five, or malaria when they were 25 but live on into old age.

Western populations are more likely to die from diseases of old age because they live longer.

The bowel cancer rate in Australia is slightly higher than that in New Zealand. We have screening for people over 50, which seems to be a sensible measure.

[puzzledlass]

NZ isn't quite there yet, no regular screening schedule for over 50's - I wish there was.

I know that being younger means less of a chance, however as we all know it doesn't mean no chance. I keep seeing articles about people in their 20's and 30's being diagnosed and get so scared. I don't want that to be me and I worry that if I just assume the symptoms I am experiencing are not serious, it will get worse and then it will be too late.
I feel like I have a responsibility to myself and my family to get all the tests done to ensure I'm ok.. it's hard though when doctors seem to not take me seriously.

In my mind - bleeding means cancer. I just don't really know what to do anymore.

[hanshan]

Based on the statistics, your risk of contracting bowel cancer at age 30 in the next year is about one in twenty thousand general population. Even then, the chance of successful treatment is high.

In contrast, the chance of a mother in a developed country like New Zealand dying in childbirth is about one in five thousand live births. Every pregnant mother-to-be you see is running a risk much greater than your fears of bowel cancer.

[puzzledlass]

I feel like why the blood then? In my mind the only explanation can be bowel cancer!

I would rather it be caught early then me ignoring it until it's too late. Sigh

[hanshan]

Several non-cancer reasons for bleeding:

"Haemorrhoids (piles)
Haemorrhoids are swellings that can occur in the anus and lower rectum. There is a network of small veins (blood vessels) within the inside lining of the anus and lower rectum. These veins sometimes become wider and engorged with more blood than usual. These engorged veins and the overlying tissue may then form into one or more small swellings called haemorrhoids. About half the people in the UK develop one or more haemorrhoids at some stage. Small haemorrhoids are usually painless. The most common symptom is bleeding after going to the toilet. Larger haemorrhoids may cause a mucous discharge, some pain, irritation, and itch. See separate leaflet called Haemorrhoids (Piles) for details.

Anal fissure
An anal fissure is a small tear of the skin of the anus. Although the tear of an anal fissure is usually small (usually less than a centimetre), it can be very painful because the anus is very sensitive. Often an anal fissure will bleed a little. You may notice blood after you pass faeces. The blood is usually bright red and stains the toilet tissue, but soon stops. See separate leaflet called Anal Fissure for details.

Diverticula
A diverticulum is a small pouch with a narrow neck that sticks out from the wall of the gut. Diverticula means more than one diverticulum. They can develop on any part of the gut (intestines), but usually occur in the colon. Several diverticula may develop over time. A diverticulum may occasionally bleed and you may pass some blood via your anus. The bleeding is usually abrupt and painless. The bleeding is due to a burst blood vessel that sometimes occurs in the wall of a diverticulum and so the amount of blood loss can be heavy. See separate leaflet called Diverticula for details.

Ulcerative colitis and other forms of colitis
Ulcerative colitis (UC) is a disease where inflammation develops in the colon and rectum. A common symptom when the disease flares up is diarrhoea mixed with blood. The blood comes from ulcers that develop on the inner wall of the inflamed gut. There are other rare causes of colitis (inflammation of the colon) or proctitis (inflammation of the rectum) that can cause rectal bleeding. See leaflet called Ulcerative Colitis for details."

I get the impression that you have talked to your doctor about it several times, and had at least one fobt. That is not ignoring it.

[puzzledlass]

You are correct. I have had a fobt and mentioned it to doc a couple of times. I know she is a trained medical professional and I should believe her, but there are always THOSE cases you know? Where docs just assume it's ibs or whatever and it's much worse. I feel my age and anxiety don't help me here.

[hanshan]

Your health anxiety has you thinking that being young and healthy is a negative, which is silly.

The great majority of people your age with your symptoms don't have a serious underlying physical condition. There will always be a very small number who do, and doctors are trained to look for those.

Do you have adequate health insurance? You could always ask for a referral to a bowel surgeon, who will at the least take a history and do a rectal examination. The surgeon may also order another fobt and schedule a colonoscopy. However, even if all that comes back clear, it will not be sufficient to dislodge a serious case of HA.