I’m a colon cancer doctor – six hard truths that might save your life

A leading cancer surgeon has revealed what she would tell people who are either worried about bowel cancer, or have received a diagnosis, in a bid to save their lives.

Dr Karen Zaghiyan, a US-based colorectal surgeon, shared six ‘blunt’ but potentially life saving tips on Instagram, with the hopes that viewers would think twice about red flag warning signs they may have previously dismissed.      

‘I’m glad you feel fine and don’t have a family history [of the disease], but you can still have colorectal cancer,’ she said in a video that has so far been viewed over 410,000 times. 

‘Get a colonoscopy.’ 

In the UK, anyone aged 50-74 is now eligible to receive an at-home test as part of the NHS’ bowel cancer screening programme, after it expanded earlier this year to include 50 to 52-year-olds. 

People at a higher risk of getting bowel cancer—for example those with inherited bowel conditions, ulcerative colitis or Crohn’s disease, polyps in the bowel or a strong family history of the disease—are offered a colonoscopy.

This test looks at the inside of the large bowel using a small camera placed inside a long, thin flexible tube to identify any polyps that are at risk of becoming cancerous or other bowel diseases. 

In the US, people at average risk of bowel cancer will be offered a colonoscopy every 10 years from the age of 45. 

Dr Zaghiyan also recommends always getting a second opinion and advocating for your health if you have any concerns.  

‘If you went to your doctor with rectal bleeding and they told you its hemorrhoids without ever looking down there you need a new doctor,’ she said. 

Common symptoms of bowel cancer may include changes in bowel movements, such as needing to go more often or with more urgency, blood in the stool, rectal bleeding, abdominal pain, bloating, constipation or diarrhoea, fatigue and unexplained weight loss. 

But, in order to diagnose bowel cancer, or rule out less serious conditions doctors will need to perform a number of tests, including a colonoscopy. 

Dr Zaghiyan cautioned however that an at-home stool test will never be better than a colonoscopy.  

This is because these at-home tests—whilst effective at boosting awareness of bowel cancer—can only diagnose around 40 per cent of advanced pre-cancer polyps. 

According to Dr Zaghiyan, colonoscopies are more than 95 per cent accurate at finding and removing these polyps before they become cancerous. 

Whilst health officials say using at home tests could reduce waiting times to enable people on non-urgent referral pathways to be seen more quickly, Dr Zaghiyan says a colonoscopy is always better—especially for people with recurring symptoms that could be a tell-tale sign of cancer. 

 And Dr Zaghiyan didn’t stop there when it comes to hard truths.        

‘Delaying a decision is a decision,’ she told her followers. 

‘I feel so bad for patients who had a chance at a cure, but delayed and deferred until the cancer spread. 

‘Get second opinions. But don’t delay treatment until it’s too late.’ 

Around 90 per cent of patients diagnosed who catch the disease early and are diagnosed at stage one will survive their cancer for five or more years. 

But once the cancer has spread the prognosis is much bleaker, with only 10 per cent of patients diagnosed at stage four surviving at least five years after they are diagnosed. 

And it’s not just about making timely decisions Dr Zaghiyan said. It is also about making informed decisions, guided by qualified cancer specialists. 

‘Cancer diagnoses suck but the random “nutritionist” giving you advice online about curing your cancer with sage and coffee enemas—stop,’ she said. 

Instead, the oncologist recommends seeing a registered cancer dietician who can help patients pair natural remedies with traditional medicine for the best chance of survival. 

Finally, the colorectal surgeon urged her followers not to google their symptoms, and to stay away from extremely niche treatments offered by singular clinics.  

‘Stop with Dr Google. Get 10 opinions if you need them. Go find the world expert and see them. Go with an open mind. But don’t seek out the single clinician doing one single procedure promising cures. 

‘Want something new and novel?’ she asks her 60,000 followers. ‘Enroll in a clinical trial which has rigorous control and oversight.’ 

Bowel cancer is the second biggest cause of cancer deaths in the UK, with 16,8000 people in the UK dying from the disease every year. 

And cases seem to be rising in under 50-year-olds in 27 of 50 nations, including the UK. 

England is averaging a 3.6 per cent rise in younger adults diagnosed with the disease every year—one of the highest increases on record. 

While the disease is linked to obesity, experts have noted that the cancer also seems to be affecting fit and healthy individuals. 

 As such, some experts have blamed environmental factors that young people have been exposed to more than previous generations. 

While no ‘smoking gun’ has been found, there are multiple theories including ultra-processed foods, microplastics, and even exposure to E.coli in food. 

There are around 2,600 new bowel cancer cases in people aged 25-49 people in the UK every year—and around 44,100 new cases among all ages. 

Overall, just over half of bowel cancer patients are expected to be alive 10 years after their diagnosis.