It was general fatigue that made Sandrine, 35, start thinking something wasn't quite right with her health.
She had stopped working out at the gym, which she loved, because she was just too tired all the time. Then she started losing weight.
When she finally noticed that her bowel habits were changing without reason, and that at times her rectum was bleeding, she went to see her general practitioner.
"I was sure her diagnosis of haemorrhoids, caused by stress and overwork – without any direct examination – wasn't right because of my age," Sandrine explains, who was just 31 at the time. "I was given suppositories to soothe the pain, but these had no effect, so for the next year I just carried on with my life."
Within a year, Sandrine had lost enough weight to drop two dress sizes. Eating was increasingly difficult, as she was frightened of the effect it would have on her bowels. Finally, a bout of food poisoning made her return to the doctor.
"This time, I saw a different GP who recognised my symptoms and referred me to the local hospital to be tested for bowel cancer," she says. "I was devastated to receive the diagnosis as I was so young and had always taken care of myself."
Sandrine is just one of many diagnosed with bowel cancer every year.
More than 37,500 men and women are diagnosed annually in the United Kingdom alone, according to charity Beating Bowel Cancer, making it the third most-common cancer behind breast and lung cancer.
Bowel cancer affects the large bowel, made up of the colon and rectum, and is also known as colorectal or colon cancer. Nearly all diagnoses (97 per cent) are in people above the age of 50, so Sandrine's case is a particularly rare one.
While bowel cancer is currently the second largest cause of cancer deaths, killing more than 16,000 people a year, 90 per cent of cases could be successfully treated if caught early enough, according to Beating Bowel Cancer.
Sandrine's symptoms are common, but they are not the only ones indicating trouble in the colorectal region, says nurse advisor Mary Heynes of Beating Bowel Cancer.
"There are several different symptoms that could indicate bowel cancer," she explains. "These include bleeding from the rectum, mucous or blood in the stools, abdominal pain, a change in bowel habits (such as constipation or diarrhoea lasting more than two weeks), unexplained weight loss, tiredness, or, perhaps, a lump in the abdomen."
People who feel that they present with symptoms associated with bowel cancer should visit their general practitioner, who can refer them to a gastroenterologist or colorectal surgeon.
The exact cause of bowel cancer remains unknown, says Ian Beaumont of charity Bowel Cancer UK, although it tends to affect older people. "Eight out of 10 cases occur in people over the age of 60, but we don't know why exactly," he says.
Diet, lifestyle and family history are considered the three strongest factors in determining a person's susceptibility to bowel cancer.
Those at high risk are people with a family history of the disease, or those who suffer from inflammatory bowel diseases (such as Crohn's disease or ulcerative colitis).
But a poor diet, sedentary lifestyle, smoking and excessive drinking are all considered risk factors too.
"The amount of red and processed meats such as sausage consumed should also be limited, as they can take longer to process in the bowel," says Beaumont.
According to a World Cancer Research Fund (WCRF) report, which linked a high consumption of red and processed meat with an increased risk of bowel cancer, such meat should be limited to only 80g per day, as it is believed to produce toxic metabolites in the bowel.
Excessive liquor consumption is considered another risk factor, as research from WCRF suggests that people who drink more than three drinks per day may increase their risk of bowel cancer.
Exercise and fibre
Regular exercise – plus a diet rich in fibre, including fresh fruit and vegetables – is also considered a good method of reducing your risk of bowel cancer, says Heynes.
"Regular exercise moves food through your system much more quickly than if you're sedentary all day, as the food doesn't stagnate in your system," says Beaumont. "But even people who eat lots of fibre and exercise can still sometimes get bowel cancer; eating well and taking exercise just lessen your chances of getting the disease."
Sandrine, who says she received her diagnosis in time, is urging anyone with similar symptoms to see their doctor as soon as they can. Today, after bouts of chemotherapy, radiotherapy and surgery, she is now in the all-clear.
"If your diagnosis doesn't feel right, then keep pursuing medical help," she says.
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