If you bin your BowelScreen, you’re throwing away your chance of getting lucky like I did
Jim Ahern was diagnosed with bowel cancer in 2024 through the BowelScreen national screening programme. Photo: Dylan Vaughan
“I got back a letter, and I’ll never forget the phrase: They had found traces of blood imperceptible to the eye.”
The letter to which Jim Ahern, 66, is referring had come from BowelScreen, the free national bowel screening programme.
It was the Cork man’s third time participating since he became eligible in 2020 (Bowelscreen is offered to everyone aged between 58 and 70). On the previous two occasions, there had been “no issues”. This time, the faecal immunochemical test (FIT) he’d submitted had detected the presence of blood. He’d had no symptoms and his bowels were, he says, “like clockwork”.
“The whole purpose of BowelScreen is to pick up bowel cancer in the setting of no symptoms,” says Prof Derek Power, consultant oncologist at Mercy University Hospital, Cork, and Cork University Hospital.
Where symptoms are present, the main ones are a change in bowel habits (such as constipation or diarrhoea), pain on passing a bowel motion, and bleeding in the stool or bleeding from the back passage. Non-specific symptoms include abdominal pain or fatigue, Power says, noting that “it is relatively common to have no symptoms at all”.
In response to his BowelScreen result, Ahern, a retired teacher who lives in Kilkenny with his wife, Catherine, was referred for a colonoscopy: The bowel is examined via a small camera on the end of a thin tube.
Several years previously, he’d had a minor colorectal procedure. Prior to the colonoscopy, he assumed “this was this back again”, and on November 29, 2024, he brought along the relevant medical notes to share with the surgeon.
Following the colonoscopy, with Catherine at his bedside, Ahern’s surgeon broke the news that while he could find no evidence of the previous issue, “hiding in the top right-hand corner” of Ahern’s colon was cancer. “He showed me a picture of it,” Ahern says, “and said it was contained. Here’s where my luck began.”
Hearing he had cancer was “like a slap in the face”, but the news that it was a slow, non-aggressive type, and was contained, slightly softened the impact.
The following Monday, Ahern was contacted by the Beacon hospital in Dublin, and, shortly afterwards, attended for “a barrage of scans”, one of which showed “calcification” on a heart artery. He calls this discovery “the other bit of luck”.
“The way he spoke gave me confidence. He knew exactly what he was going to do, exactly how he was going to do it, and exactly the outcome that he wanted,” says Ahern, who was advised to lose weight, and so shed six kilos through “no sugar, no alcohol. I cut out biscuits. My nemesis was biscuits.”
A keen golfer — he’s club captain — he had an active lifestyle, and had no previous health issues, nor any family history of bowel cancer. He’d retired in 2018, having put in 38 years teaching maths and French, and had been “going grand” since.
“A significant number of bowel cancers diagnosed have no discernible risk factors,” says Power, while also pointing out that an estimated 60% are caused by known risk factors.
These risks include smoking, excessive use of alcohol, a high body mass, a nutrient-poor diet (one high in refined carbohydrates, fried, fatty, or processed foods; excessive red meat), and addressing these issues will reduce a person’s chance of developing the disease.
Family history is also a determinant, he says, “so it’s very important to ascertain if there’s a history of bowel cancer, especially younger-onset bowel cancer, in the family”. (Bowel cancer in those under the age of 50 without a family history was previously rare, but now represents 10% of patients, Power says. While there are many theories, ultimately, “we don’t know why this is happening”.)
Ahern’s surgery was scheduled for mid-January, and having attended a cardiologist, he underwent a cardiac MRI two days prior, out of “an abundance of caution”.
In light of those results, three options were on the table, one of which was to postpone the operation. “In my own mind, I had crossed the bridge. I was ready,” Ahern says.
It was decided to proceed with an angiogram that afternoon and, if safe to do so, the bowel surgery that evening. (The angiogram showed Ahern had a 50% blockage in one artery and would require a stent. He had it inserted in July.)
At seven o’clock he walked into theatre and “woke up three and a half hours later… feeling good”. The surgeon had excised the diseased section, along with some lymph nodes, and rerouted Ahern’s digestive system by attaching the end of the small intestine to the remaining colon.
Physios got Ahern up and walking early the next morning and while he had some discomfort, on a scale of one to 10 he puts it at a “four, maybe”. He didn’t require a stoma, even temporarily, which he says was his “third bit of luck”.
Power says: “The bulk of bowel cancers don’t require permanent stomas. It’s usually temporary, if at all,” says Power. The location of the cancer dictates whether a stoma is required, and it can often be reversed at a later date.
Ahern had his surgery on a Thursday and on Monday morning he got the green light that all was well and Catherine was able to take him home. Since his diagnosis, she and his two sons, David, 40, and James, 37, have been “100%” supportive, he says.
Once he got home, he “walked and walked”, initially around the house, then further afield. At his six-week check-up, he recalls his consultant saying, “I have good news, and I have good news.” The first bit of good news was the lymph nodes that had been removed showed no trace of cancer, and being told he had a “95% chance” the cancer wouldn’t return was the second.
“Here’s the next golden phrase that stands out my in my mind. He said, ‘There’s no further treatment required,’” Ahern says. “That was a surprise.”
Chemo would be part of the treatment for stages three and four. Stage three, where lymph nodes are involved, comprises 30% of all bowel cancers, while 20% are stage four.
But even when bowel cancer is at an advanced stage and has spread to other organs, most commonly the liver, “there is a very significant chance of a 10-year survival, which is defined as cure”, says Power.
“I don’t know how lucky you can get, but whatever bit of luck was going, I got it,” Ahern says.
But he made his own luck by being proactive. Currently, only 25% of men take up the initial invitation to participate in BowelScreen.
“Based on my experience, you have nothing to lose, and you have everything to gain,” Ahern says. “Let’s put it like this. If a person gets the BowelScreen and throws it in the bin, they’re throwing away their chance of getting lucky.”
“Bowel cancer screening works,” says Power.
“It helps pick up bowel cancers that have no symptoms and [very likely] at an earlier stage, like stage 3, stage 2, or stage 1. We see a lot of bowel cancers picked up earlier for this reason, and treated with surgery [with no need for] chemotherapy after, and a very good prognosis.
“So, the take-home message is, please do this. It is well studied all around the world that bowel screening works.”
- For more information on bowel cancer, cancer.ie
- See exa.mn/HSE-BowelScreen
- Changes in bowel habits — diarrhoea, runny bowel movements, constipation, needing to poo more or less often than usual.
- Blood in your poo, which may look red or black.
- Abdominal issues — cramps, general abdominal pain, bloating that doesn’t go away.
- Weight loss when you’re not trying to lose weight.
- Tiredness and lack of energy when you’ve had enough rest.
- Any unusual change you know isn’t right for you.
- If you experience one or more of these symptoms, you should make an appointment to see your GP.
- For information on bowel cancer screening and using home test kits, see: hse.ie/conditions/bowel-screening
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