Bowel and Colon Cancer Prognosis and Survival Rates
Bowel cancer and Colon cancer have a relatively good prognosis compared with most other solid cancers. Between 50 and 60 per cent of people with colorectal cancer survive for five years, after which a return of the cancer is uncommon. If the disease is caught at a time when the tumour has not spread through the bowel wall (so-called Dukes grade A), then the cure rate is over 90 per cent.
Colonoscopy carries a perforation rate of about 1 per 300 procedures, and a death rate of 1 per 5000. Perforation may be the result of polypectomy (polyp removal), particularly in the right colon where the bowel wall is thinner and where polyps more commonly have a flat base.
- Significant bleeding requiring blood transfusion occurs in about 1 per 100 cases after polypectomy and is usually due to bleeding from an incompletely clotted artery in the remaining polyp stalk.
- The rectal balloon catheter used for barium enema can very rarely cause perforation.
- The laxatives used as bowel preparation for colonoscopy or barium enema can occasionally cause a significant fall in blood pressure and fainting. Considerable changes in body fluids and in salts such as sodium and potassium can also occur.
- Significant problems rarely happen in individuals who are otherwise in good health, but particular care is needed in people with kidney disease or with heart problems. If these other conditions are significant, the bowel preparation might have to be performed in hospital.
About 5 in every 100 patients will die by 30 days after an operation to remove bowel cancer. Possible complications after surgery include:
- Leakage from the repaired bowel that can sometimes require a second operation at the same site.
- Paralysis of the intestines (ileus), which is usually temporary and recovers spontaneously after a few days.
- The complications of any operation under general anaesthesia, including deep vein thrombosis, pulmonary embolism and pneumonia.
Patients are routinely given antibiotics to prevent infection from any minor leakage of the repaired bowel, and preventive anticoagulation (blood thinning treatment) with heparin to protect against possible deep vein thrombosis.