"too young to have bowel cancer"

[DrPatient]

In October, I start having bloating, abdominal pain and rectal bleeding. I tried to put up with and from googling just assumed it was haemorrhoids and would resolve itself. Towards the end of November, the pain got excruciating over the course of a day and at about 2am one night I phoned 111. They advised me to go to A&E. I was in hospital for five days and they removed my appendix - but said it wasn't inflamed when they removed it. The pain, bloating and bleeding continued. I had a tonsillitis in February and, because I get it very often (always have and, I assume, always will) the GP wanted to check it wasn't something sinister. The blood test showed I have iron-deficiency anaemia so I'm on tablets for that.
It's obviously now July and I still have bloating, abdominal pain, bizarre squitsy bowel movements (I'm sorry, tmi) and bleeding. My granddad died from bowel cancer before I was born and my dad had it when I was a child.
My GP has said I'm too young to have bowel cancer and that it's "unheard of" at my age so she won't refer me for tests. I've just found a series of blogs on Bowel Cancer UK called "Never Too Young" that have plenty of people my age and younger who were diagnosed with bowel cancer, all have my symptoms and were all told by their GPs that they were too young to have bowel cancer. They're all advising to insist on getting tested but my GP flat-out refuses and is adamant that my symptoms are just stress related.
Has anyone else had these symptoms and it been stress related? Is there anything I can do?

Not sure how old you are op but I lost a dear friend to this dreadful disease and she was only 27. She too had been fobbed by GPs. Hopefully it won’t be anything sinister but you need full checks to check for colitis, crohns etc too. Can you see another GP? Good luck.

I would also ask to see another GP and get another opinion.

I don't think being asked to live with this without any further investigation for several things that it could be as mentioned by PP is right at all.

The NICE guidelines state that your GP should

"Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for colorectal cancer in adults aged under 50 with rectal bleeding and any of the following unexplained symptoms or findings:
abdominal pain
change in bowel habit
weight loss
iron-deficiency anaemia."

pathways.nice.org.uk/pathways/suspected-cancer-recognition-and-referral/suspected-cancer-recognition-and-referral-site-or-type-of-cancer#content=view-node%3Anodes-gastrointestinal-tract-lower-cancers

What age was your dad when he had it and does your gp know he had it as a (presumably) young man? I feel like a parent having it in their 40s or younger is a reason to refer for colonoscopy if you also have symptoms, but I could be wrong there.

I had bloating, soft stools, bowel urgency, minor abdominal pain but regular discomfort, and was told it was just IBS. I then got rectal bleeding and the gp told me it was probably hemorroids. One day I got severe pain accompanied by a fever and got to the gp on an emergency appointment that morning. Purely because of the pain and fever the gp suggested I might have ulcerative colitis. She referred me to a gastro via my work private health care and I got a colonoscopy and endoscopy done. Sure enough I had ulcerative colitis (one of the two diseases that constitute Inflamatory Bowel Disease) and also severe chronic gastritis with a stomach ulcer. I was 29 at the time. If I hadnt gone straight to the doctor whilst still having the fever I doubt they would have caught it.

Having ulcerative colitis and probably the gastritis puts me at a higher risk of stomach or bowel cancer which I worry about fairly regularly. I think I'm meant to have periodic colonoscopies and endoscopies every few years now.

If you're concerned make sure you push to get tested. It sounds like you need a colonoscopy at a minimum although I'm not sure how long you might need to wait for one on the NHS especially in these covid times.

How old was your dad when he was diagnosed and how old are you now? I’m not based in the UK but here regular colonoscopies for screening purposes would be recommended from when you are ten years younger than your relative at diagnosis. i.e. if your dad was diagnosed at 40 you would start having colonoscopies at 30.
I think it’s pretty clear you need a referral for further investigations. If your GP refuses complain to the practice manager and ask for a second opinion. Change surgeries if you need to.

You haven’t said how old you are but my nephew who is 35 is currently receiving treatment for cancer of the colon. You need to insist on a referral.

My friend had bowel cancer age 28. She had chemotherapy and several operations and is now free of cancer. It can happen in younger people.

OP hope you are OK.

Get a second opinion NOW. These are all the symptoms my Husband had and yes both his GP's fobbed him off for a year because he was too young. Finally his GP gave him an internal. Then followed a colonoscopy and he was diagnosed with stage 3 locally advanced cancer. Then chemo, radio and then an operation to remove the cancer and his rectum. He now has a permanent colostomy bag. Please do not wait, go back and get a second opinion NOW. Especially with your family history

Kind of odd that you didn't actually include your age, OP!

Anyway, my sister had it at age 30. Our mother and aunt both had it. If you have a history of bowel cancer in your immediate family, you're at a pretty significantly increased risk.

My cousin also had cancer and had to suffer a lot more than she would have done because the doctors were so slow to diagnose it. Honestly, the NHS at times is not great. They are often reluctant to refer, to test, etc. I would urgently seek second and third opinions.

You are at increased risk due to your family history.
See another Gp immediately as you are not too young to have bowel cancer.

My friend lost her brother last year at 34 as his complaints were dismissed for several years by his gp.

Definitely push for testing. As @Antipodeancousin says if a parent had bowel cancer you should have a colonoscopy aged 10 years before their diagnosis anyway (so at 25 if they were 35). I had bowel cancer diagnosed at 39 and my kids will need to be tested from 25 (stage 3 so consultant reckons it had been growing a few years). I was fobbed off with 'it's just piles, you're too young' from gp for over a year. Hope it isn't but you are definitely not too young. A few people in the mumsnet cancer thread were in the same boat.

Your GP's attitude is shocking - surely they know your family history? I think I would be looking for a new GP. It may turn out to be something minor, but definitely needs checking out. Keep pushing and don't be fobbed off with such rubbish.

I know someone who was recently diagnosed with bowel cancer, early 30s. It's end stage so not sure how long she has had it before diagnosis.

I hope it's something less sinister but go back and don't leave until you have been referred for more tests.

Did the GP ask for a stool sample to check for faecal calprotectin levels?
My DD has been passing blood when going to the toilet, her stool sample showed high levels of faecal calprotectin and she’s now being referred to a specialist as she most likely has IBD. The GP moved really quickly, it sounds as if she was lucky.

My OH had stage 3 colorectal cancer by the time he was diagnosed after being fobbed off for 10 years by various Doctors with exactly the same symptoms. He was in his early 30's when it probably started growing and nearly died due to the tumour blocking his bowel. Your Dr needs removing from the profession. Please demand an urgent referral x

A friend came back from the Far East and was told their weight loss was down to foreign food. It continued back the the UK and was finally investigated and found to be bowel cancer. He was 27 and it was diagnosed too late. Please go back to the GP.

Insist that your GP refers you. My family are screened due to a family history and screening began when we were under 30.

I had some worrying symptoms a few years ago and my consultant took it very seriously even though I was way below the average age.

Hi,
How old old are you ?

My husbands mother died from bowel cancer, she was diagnosed at 43 and unfortunate after going in to remission, it started to show up in other places and she died at 48.

My husband was 38 when he was diagnosed.

Thankfully we caught it early and he has been in remission for nearly 4 years now.

Following his surgery we had my husband tested for Lynch syndrome, due to his mother having bowel cancer too, and thankfully it came back negative.
Lynch testing tells you if it's hereditary or if it's just your pot luck but given that your grandfather and father have both had it, it would be worth asking

On another note Cancer research guidelines ( which I'm sure nhs follow advice wise) is that you should be tested at whatever age your dad was minus 10 years, what I mean is that my daughter will need to be tested for bowel cancer when she is 28 as her dad was 38 when he got it, he should have been tested at 33 but the guidelines weren't there at the time.
So if your 10 years younger than the age your dad was when he got it you should be able to request the bowel screening test.

Your never too young for Bowel Cancer.
If you have Instagram please look up kickasskel a lovely lady who was 28 and has just passed away from bowel cancer. She had stage 4.

I would go and see another gp and insist on more tests.

I'm so sorry you're going through this OP. It's completely unacceptable that you have been ignored by your GP. I have a medical background and those symptoms, along with the anaemia and your strong family history would certainly make me worry about something potentially sinister. I'm appalled at your GP, they are providing a worrying level of care if they are refusing to refer you.

Can you request a second opinion from a different GP at the practice? Failing that can you find out about a private endoscopy, I know it's an unnecessary expense when we all pay into the NHS but it may be worth it for the peace of mind/fast diagnosis?

You need a different GP. Or a private colonoscopy. I live overseas and the guidelines here are similar to those above for people with a family member who has had bowel cancer, but if you have symptoms, like you do, then you have a colonoscopy regardless of how old your relative was at diagnosis (for example, my dad was diagnosed with bowel cancer at 58; my sister and I all started being screened from 40 and it was done through the public health system). Your symptoms could be Crohn’s disease or Coeliac disease or bowel cancer or IBD or something else, but they sounds like they need investigating. If you can’t move GPs or see another at your practice, I would save up for a private colonoscopy.

Hi everyone,
Thank you for your responses. I'm 25 - which I do understand is young but based upon some of the responses here, it doesn't appear to be "too young".
I phoned my GP this morning for an appointment but they said no - they said they aren't doing any appointments because of Covid but I think they might just be sick of me. I'll look into private stuff but I'm not really in a position to pay much.
I'm sorry for the many losses that have been mentioned on this page.

You phone them back and tell them you need an urgent appointment and if you don’t get one today you will be making a complaint. Ask for the practice managers details and PALS and the contact details of the CCG. Hopefully that will scare them into giving you one. You don’t even need a physical apt but you should be able to talk over the phone.

Explain you have become aware of the nice guidelines that warrant an urgent referral and that you meet the criteria. If this isn’t done you will be taking this further as well as making an official complaint. You could also mention contacting the GMC as the gp is not following guidelines. Good luck!

OP, you say yoû were in hospital for 5 days; surely they would have done tests then? I don't know if you've read through the NHS guide so I've linked it here.
www.nhs.uk/conditions/bowel-cancer/symptoms/

I'd suggest you contact your gp again, and ask for a telephone consultation. Even if you've not got anything seriously wrong with you, you're clearly showing signs of anxiety, which your gp can support you with.