Bowel cancer tests

Holly - kind donor of poo bags.

Warning - this post is not for the squeamish!

It's a slightly sobering thought that once you're past 60, the NHS starts to lose confidence in your longevity.

They leave you alone for years and years, but after 60 you start to get letters dropping through your door inviting you to take a test for this and check you for that ...

It's all sensible stuff, of course, and certainly driven by statistics (which is a genuine reason to be worried).

Bowel cancer is the latest nasty illness to get a higher profile and also a screening programme to try to identify people in the early stages, when it's more easily treated (and when the survival rates are better).

It's been in the news a great deal, with a mounting campaign by a cancer pressure group to make people aware of the warning signs and to encourage them to visit their doctor if there are any concerns. We 60+ types don't need to visit our doctor with any concerns; the NHS is concerned enough to send us a home test kit to see if we have any symptoms.

I've been very lucky to have been born just a few years after the foundation of the National Health Service and I've been on the receiving end of much public health campaigning.

We were the first generation to be vaccinated for polio and (I think) diphtheria. I have an early memory of being taken to the old fire station in Northwich, which was being used as a mass immunisation centre. The fire engines had been taken out and people were queuing in a long line, snaking up and down inside the building, until you came to a set of screens and it was your turn. This type of treatment is inconceivable these days, it was like a news report on disease control in some Third World country, but I guess we had no regular system for mass immunisation and this did the job. I knew nothing about polio, but I was worried - my mum had noticed that the Dudleys (a notoriously unwashed family) were a few in front of us and she was working out how often they changed the needle in the syringe. She was keen that we didn't get the same needle as the dirty Dudleys.

In the 1950s, it was not uncommon to see children fitted with leg irons due to polio distorting their limbs and the ultimate horror was to have it affect your chest muscles so you were unable to breathe on your own and had to live in an iron lung - a machine that allowed you to breathe by sucking up your chest and pushing it down.

Subsequent booster jabs were done at the doctor's or at school and my final polio inoculation was dripped onto a sugar cube and taken orally (no worries about the dirty Dudleys then). The vaccination programme was so successful that polio wasn't a disease that threatened my children; it had gone from the UK within a generation.

I did catch the other common childhood diseases - measles, mumps and chickenpox. My sister also added whooping cough to her CV.

But here I am at 60 and the NHS is still looking out for me. That's nice - but when my bowel cancer home test kit dropped through my door that wasn't my first thought. The test involves collecting your own faeces and sending them away for analysis, which didn't greatly appeal. What's more, it had to be done over a period of several days.

I was still working when the kit arrived and it wasn't really practical to take the test as my daily "cycle" generally involved a trip to the loo (for a No 2) at work. So I left the kit buried among a pile of other letters awaiting attention on my desk at home - another job for retirement.

Some time before Christmas, Margaret informed me that she had been given the bowel cancer all-clear and so I resolved that one of my first jobs after leaving work would be to do the test. Now bowel cancer is not a nice disease and it's on the increase probably because of less fibre in modern diets and perhaps because we're all living a bit longer and not dying from other nasty things.

The cure/treatment would probably involve part of your bowel being cut away and would mean you having a temporary or permanent colostomy (depending on the severity).

So I got the kit and read the instructions more carefully. Basically, the test is for blood in your faeces. This can mean you're in the early stages of bowel cancer, or it could mean you have something worse (or something not quite as bad). Anyway, blood traces would mean further tests ... and a probe!

I'm not normally at all squeamish, but the mechanical process of this test concerned me greatly. You have to acquire some fresh poo, which must be free from water and urine; you then have to scrape a tiny sample from different parts of the turd and deposit the sample into special recesses in the kit, seal that section up and wait for another couple of days before you do the next one.

How do you get hold of fresh poo? Normally, that's the last thing you want to do!

I asked Margaret, who is never backward when it comes to complaining and yet she'd done the test without even telling me. Apparently she'd used a bowl, which sounds like a good idea, but has rather put me off Christmas pudding for the foreseeable future (I don't care how often it's been through the dishwasher).

I needed a couple of days to mentally prepare and to think the process through. I decided against a bowl and instead went for kitchen towel and a poo bag (kindly donated by Holly, the English Springer Spaniel). I’ve picked up plenty of warm dog poo in my time, but it is a whole new sensation holding your own warm poo.

The process requires you to sit on the toilet, poo bag covering your right hand which is hovering under your bottom waiting for the turd to drop. You then have to extract your hand, place the poo bag (and poo) on the paper towel on the toilet floor, finish your business, do up your pants and then take your sample. I found it smelly and humiliating. I was also rather generous with the sample and struggled to get that day’s window closed properly.

This has to be repeated over a number of days in order to sample a period of bowel function. Cancer polyps can bleed intermittently and so this catches the occasional bleeder.

Constipation and irregularity isn’t normally an issue, but I was dreading my next sample day and that seemed to throw out my digestive process, or rather bring it to a standstill. Sample No 2 was a day late and took some effort; rather more effort than I would have liked sitting above my outstretched hand in the downstairs loo.

I was so happy when the process was over. This really did freak me out, almost to the point where I’d decided not to bother with it. Having sealed my last window, I put the sample in the post with a sympathetic thought for the person whose job it is to open thousands of these things. The covering letter that comes with the kit warns that the test may be clear (which doesn’t mean you don’t have cancer), or it may be inconclusive and require further tests.

Mine was clear, thank goodness, but I have this to look forward to again in another five years. I don’t know why, but this really did bother me.