Dame Julie Walters reveals bowel cancer battle – what are the symptoms and treatment?

Dame Julie Walters has revealed she overcame stage-three bowel cancer.

Speaking on the BBC’s flagship Victoria Derbyshire programme, the Billy Elliot actress initially thought doctors “must have made a mistake” when she was diagnosed 18 months ago.

Dame Walters, 69, has since been given the “all clear” after undergoing chemotherapy.

She warns her next film The Secret Garden may be her last, with the ordeal changing her perspective towards acting.

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The BAFTA-winning actress claims she initially went to her doctor with indigestion and “slight discomfort”.

She later went back complaining of abdominal pain, heartburn and vomiting.

After being referred to a gastric surgeon, a CT scan revealed it was cancer.

“I was still thinking, 'That's ridiculous, he must have made a mistake',” said Dame Walters.

The Educating Rita actress later had “30cm [11.8 inches] taken out of her colon”.

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Stage three cancer is defined as a “larger” tumour that “may have started to spread into surrounding tissues”, as well as “cancer cells in the lymph nodes in the area”.

Dame Walters reportedly had malignant tissue close to her lymph nodes, with two “primary tumours” in her large intestine.

She reluctantly had chemotherapy, which was “fine”, causing no hair loss.

Smiling, the actress added: “I've just had a scan and I know [I'm] clear”.

What is bowel cancer? And what are its symptoms?

Bowel cancer, also known as colon or rectal cancer, is a general term for tumours that begin in the large bowel.

The fourth most common form of the disease in the UK, about 42,000 new cases arise every year.

In the US, 104,610 people are expected to be told they have bowel cancer in 2020.

More than 90% of patients experience one of three sets of symptoms.

The first is blood in the faeces for no obvious reason.

A persistent change in bowel habits is another warning sign, with some producing more faeces than normal, which may be runny.

Pain, bloating or discomfort in the lower abdomen should also raise alarm bells. This may occur alongside a loss of appetite or losing weight without trying.

Most of the time, blood in the faeces is caused by haemorrhoids, while a change in bowel habits may come down to something you have eaten.

If you experience one or more of the above, or if just one symptom lasts over four weeks, see a GP.

Colon cancer can also trigger bowel obstruction, when a tumour stops waste passing through the digestive system.

This triggers severe abdominal pain, always brought on by eating.

Another symptom of obstruction is the midsection “constantly” being swollen.

Diagnosis usually involves an examination of the backside, which puts many suspected patients off.

Dame Walters is keen to combat this stigma, stressing “doctors are used to bottoms”.

What causes bowel cancer?

The exact cause of bowel cancer is unknown, however, there are defined risk factors.

Almost nine in 10 cases occur in people aged 60 or over.

A diet high in red and processed meat, and low in fibre, is another risk.

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Bowel cancer is more common in those who are overweight, inactive and drink excessively.

Smoking may also raise the risk.

Some risk factors cannot be altered, like a family history of bowel cancer or another colon condition, such as Crohn’s disease or ulcerative colitis.

Is bowel cancer screened for?

The NHS offers two types of screenings for bowel cancer.

An at-home kit is offered to men and women aged 60-to-74 every two years.

Patients collect one sample of faeces in a small plastic bottle, which they post back to a laboratory for testing.

If blood is found, a thin tube called a colonoscopy is inserted into the patient’s anus to look for other signs of bowel cancer.

A new test called the bowel scope screening is being offered to people aged 55.

This involves a thin, flexible tube with a camera on the end looking inside the bowel for small growths called polyps, which can become cancerous.

The one-off test is being rolled out across England.

How is bowel cancer treated?

Treatment depends on where the tumour is in the bowel and if it has spread.

Surgery is usually the go-to treatment, removing the cancerous section of the colon.

According to the NHS, “it's the most effective way of curing bowel cancer and in many cases is all you need”.

In more severe cases, chemo or radiotherapy may be required to kill malignant cells.

A newer group of treatments called targeted therapies can increase the effectiveness of chemotherapy and prevent the disease spreading.

These may target “growth factors” on the surface of some cancer cells.

If spotted early enough, bowel cancer can be “cured”.

In England and Wales, 57% of patients are still alive 10 or more years after diagnosis.

The five-year survival rate in the US is 65%.

In advanced cases, “a cure is highly unlikely”.

Treatment then focuses on controlling symptoms and slowing the cancer’s spread.