Shame old story

IT was a year or so after the birth of her son Michael that June Armstrong first began to get abdominal pains. They weren't that bad - except when Michael, as toddlers do, climbed on her stomach to play - and she didn't at first think much of it.

"It was a stabbing feeling, low down in my stomach, nearly like appendicitis but not quite in that area," says June, 41, from Rawcliffe. "I did have the runs a bit, but never anything like bleeding and I didn't think anything dramatic was wrong."

Her GP at first put it down to stress, anxiety or irritable bowel syndrome. It was only when the symptoms persisted and a blood test showed something was not quite right that she was referred to York District Hospital for a colonoscopy - a 'camera up the bum', as June cheerfully calls it.

That was in December, 1999 - just a few weeks before Christmas. Her specialist told her straight away, within an hour of the procedure, that it was cancer of the colon. He even showed her a polaroid photograph. The tumour looked, she says, like a 'big, raw ulcer.'

Her first reaction wasn't what you might expect - though typical of June. "I was very blas about it," she admits. "I didn't think 'Oh, God, I'm going to die. What's Michael going to do?' I thought 'Oh God, I've got all the Christmas shopping to do and the cards to write!' My surgeon told me to 'b***** Christmas!'"

She was admitted to hospital straight away, and within a couple of days had undergone surgery to remove the tumour. It all went very smoothly - except that soon after the operation she foolishly ate a bowl of pineapple chunks. "It was absolutely horrendous!" she says spiritedly. "The pain nearly killed me! I should have been on gravy and mashed potato." She won't say who advised her to try the pineapple, but stresses it wasn't any of the hospital's medical or nursing staff.

She spent a week in hospital, was home in time for Christmas, then in January began a 12-week course of chemotherapy to help ensure the disease didn't recur. She'd have to go in to hospital as a day patient a couple of days a week every other week - and there would meet up with a 'gang' of friends undergoing similar treatment. They had, she says, a scream. "It was hysterical," says June. "People used to come to see what all the laughing was about."

The chemotherapy left her immune system weakened, so she picked up a lot of the infections Michael, now five, brought back from school. And she still suffers from occasional diarrhoea. "My surgeon said it would take a while for my bowel to get used to food again," she says. "I always had to make sure I planned my journeys around where there was a loo."

Apart from that, though, the only permanent legacy of her illness is the operation scar. "But what's a scar when you've got your life?" she says.

This is what makes her angry with people who run scared of confronting cancer. With bowel cancer, as with most other cancers, early diagnosis is vital. If you have symptoms you don't understand, especially if you have a family history of the disease, she says, it is vital to get it checked out.

"I have a schoolfriend whose husband goes for check-ups every year. His dad had bowel cancer. But his sister won't go because she says it's too embarrassing. I'd go straight away! Even if you feel you're being a nuisance, at least you've had it checked out."

That's a message the Imperial Cancer Research Fund is keen to ram home in its new campaign Breaking The Last Taboo to mark the beginning of National Bowel Cancer Month today.

Bowel cancer is the third most common form of the disease in Britain - but the second biggest cause of cancer deaths. More than 17,000 people in the UK died from the disease in 1998.

Part of the reason so many people die, the charity says, is that our embarrassment over everything to do with our bowels prevents us spotting the symptoms or seeking help early.

"Despite a traditional British fondness for toilet humour, we still avoid actually talking about bowels - an attitude which could have potentially serious consequences," a spokesman says.

"A lot of patients say even though they suspected something was not right, they were still reluctant to see their GP. But there's nothing to be embarrassed about - and once they have gone they say they wished they had gone sooner."

The charity is keen to encourage a habit that could help people spot warning signs of bowel cancer early, enabling earlier diagnosis and treatment - simply looking into the loo bowl before flushing it. Because one of the tell-tale symptoms is bleeding from the back passage.

If it is bright red, fresh blood, it probably means you've got nothing more serious than haemorrhoids - though it's still worth getting it checked out by your GP, says Nicola Sullivan, colorectal cancer specialist nurse at York District Hospital.

But if it is older, darker blood that's mixed in with the stool, then it could be something more serious and you should definitely see your GP - especially if it is accompanied by other symptoms.

These include persistent abdominal pain, diarrhoea and unexplained anaemia (which leaves you looking pale and feeling washed out) - all classified as 'higher risk' symptoms of bowel cancer.

Some forms of bowel cancer can also be hereditary, Nicola points out - so if you have a family history of the disease (a parent or grandparent who contracted it, say) it will pay to be particularly vigilant. Your GP may even be able to arrange for you to be screened.

Not all bowel cancer patients display these symptoms - and if you do have some of them, it doesn't necessarily mean you've got cancer.

If you're not sure whether you're just being silly or whether you really do have a problem, Nicola says, it is worth watching and waiting for four to six weeks.

"Then, if the symptoms are still persisting, go to your GP and get it checked out," she advises.

Consultant surgeon Steve Leveson, one of two specialists at York District Hospital who operates for bowel cancer, agrees.

He and his colleague are particularly keen to be able to tackle bowel problems early, even before they become cancerous, he says - so any unusual symptoms should be checked out.

"People can be very apologetic," he says. "But don't be embarrassed and don't worry that you're putting someone to trouble. This is what we are here to sort out."

u The Imperial Cancer Research Fund runs a cancer information service you can turn to for advice - call 0207 269 3142. The same charity's website - www.imperialcancer.co.uk - is also a useful source of information and suggests questions to ask your GP if you're going for a consultation. Alternatively, call the charity's northern appeals office in Leeds on 0113 231 9828 for a leaflet.