Listening for Bowel Cancer

In a recent Johns Hopkins Health Alertthe signs and symptoms of colorectal cancer are discussed. Some of the symptoms of colorectal cancer include a change in bowel status such as diarrhea, constipation,or narrow stools that last for a few weeks. Bloating, cramping, a feeling of incomplete emptying of the rectum, or inability to pass stool for a week can also be the first signs of cancer. Unfortunately for pelvic rehabilitation providers, the above symptoms can describe many of our patients who we are treating for bowel dysfunction.

To better screen for concerning symptoms, you can ask if the patient has had bright red blood in the stools or a black stool, abdominal tenderness that does not improve, loss of appetite, loss of weight, vomiting, and/or persistent fatigue. Hopefully some of above symptoms are included on your medical conditions intake form. I am always amazed that we meet patients who are dealing with bloody stools for months, or unexplained weight changes, who do not find these changes compelling enough to share with a medical provider.

A couple of great textbooks to keep on hand for medical screening purposes are Goodman and Snyder's Differential Diagnosis in Physical Therapyor William Boissonnault's Primary Care for the Physical Therapist.

We must continually challenge ourselves to be alert to changes in the patient's health status. Keeping in mind that a patient who is in the early stages of having colorectal cancer may have primary complaints of changes in bowel habits, the medical providers who trust our care may be quick to refer for pelvic rehabilitation. Develop the habit of constantly asking questions and if you are not sure what questions to ask, acquire one or both of the above mentioned texts which are designed to lay out useful questions.