When Paul Swift started suffering from digestive problems and noticing blood in the toilet, he admits he ‘put it to one side’.
At the time, the father-of-one was training for a marathon and believed the intermittent episodes were simply down to his intense fitness regime.
For days at a time he would suffer from loose, bloody bowel movements, but then it would clear up.
Feeling otherwise ‘fit as a fiddle’, Paul, then 39, says he just carried on with life.
It was only after a year, in July 2023, when his symptoms worsened and became more frequent, that he told his wife Jess about them.
She urged him to visit a doctor and, just weeks before a big race, Paul was told he had rectal cancer, a form of bowel cancer.
Recalling that moment, he says: ‘I just thought my life was over. My daughter was only three at the time, and I wondered whether I would see her grow up.
Paul Swift on his wedding day to Jess, who urged him to visit a doctor after noticing blood in the toilet
Just weeks before a big race, Paul – a marathon runner – was told he had rectal cancer, a form of bowel cancer
‘It was a complete shock because I was fit as a fiddle and I felt completely fine.’
Now he wants to warn others of the common symptom he overlooked.
Thankfully, despite the delay in seeking help, Paul was diagnosed before the cancer had spread.
He was initially told surgery was his best option, but it would mean he’d live the rest of his life with a stoma – a pouch that collects bodily waste via a small opening in the abdomen.
So when he was invited to be part of a groundbreaking trial, backed by Cancer Research UK, of a treatment that spares colorectal cancer patients from this invasive procedure, he jumped at the chance.
Rather than surgery, researchers at The Christie NHS Foundation Trust in Manchester have been offering some rectal cancer patients daily high-dose radiotherapy alongside a twice-daily chemotherapy tablet, called capecitabine.
Experts believe the five-week treatment has proved so effective it could be widely used in the NHS by the end of next year.
Paul, an engineer, says that during the treatment it had little impact on his day-to-day life – he was even able to keep working – and he got married just weeks afterwards. ‘I feel incredibly fortunate,’ he adds. ‘The treatment has allowed me to remain active, which I never thought would be possible when I was diagnosed.
‘I was lucky that I managed to catch the cancer before it had spread, but I really should not have put it to one side for so long.’
Later this month he is running the Manchester marathon and next year is attempting an ultra-marathon in aid of The Christie.
For Paul, the side effects of the treatment have also been minimal. A month after he suffered a burning sensation in his bowels, but it has since returned to normal.
To be eligible for the treatment, the disease needs to be caught early – and experts are urging the public to be vigilant of the common symptoms.
In England, the NHS offers a free at-home test for bowel cancer every two years for those aged between 50-74.
However, there has been a sharp rise in cases such as Paul’s, with many being diagnosed below the age of screening.
Every year in the UK there are about 44,100 new colorectal cases – bowel cancers that develop in the colon or rectum – of which about 2,600 affected 25- to 49-year-olds. Research shows those born in 1990 are nearly two-and-a-half times more likely to get bowel cancer than someone born in 1950.
Dr Claire Arthur, consultant oncologist at The Christie, said that, alongside bleeding, people need to look for changes in bowel habits – such as going to the toilet more regularly or looser stools. Other symptoms include abdominal pain or cramping and weight loss.
‘We often see people who have completely ignored blood in the toilet,’ she adds.
‘It’s usually nothing sinister, but bleeding is often an early symptom of bowel cancer and it should always be investigated by a GP.’
The cancer specialist explains, however, that the symptom will not necessarily mean red blood left on toilet paper and that it can be hard to spot.
Paul Swift was training for a marathon when he first started to notice digestive problems
She says: ‘Blood in the stool is a spectrum, from appearing on the surface or mixed in with red streaks to a change in overall colour, which is not so easy to identify if the bleeding is coming from higher up in the bowel.
‘It is so important to get tested if you are experiencing symptoms, particularly if you are below the age of screening as we have seen a massive rise in young people being diagnosed, and often people still associate the disease with old age.’
Currently, only a third of patients with an early diagnosis of rectal cancer will be successful with a course of five-week radiotherapy. The rest are likely to need surgery, which leaves them with a stoma bag.
‘Patients such as Paul are keen to avoid the prospect of a stoma bag if possible,’ says Dr Arthur.
‘While many people continue to lead active lives with a stoma, it can significantly impact an individual’s quality of life. That is why advancements such as this are so important.
‘This is a really exciting time to be treating bowel cancer, with many developments, and it is likely we will see more patients offered radiotherapy over surgery in the next year or two.’
