Symptoms of advanced bowel cancer

Advanced bowel cancer is cancer that started in either the back passage (rectum) or large bowel (colon) and has spread to another part of the body.

The symptoms of advanced bowel cancer can be similar to bowel cancer that hasn't spread. Other symptoms depend on which part of the body the cancer has spread to.

It might not mean that you have advanced cancer if you have the symptoms described below. They can be caused by other conditions.

Tell your doctor or specialist nurse if you're worried about a symptom or if it continues for more than a few days.

General symptoms of advanced bowel cancer can include:

  • feeling tired
  • low energy levels
  • having less appetite 

Symptoms if cancer has spread to the liver

You might have any of these symptoms if the cancer has spread to your liver:

  • discomfort or pain on the right side of your abdomen
  • feeling sick 
  • poor appetite and weight loss 
  • swollen abdomen (called ascites) 
  • yellowing of the skin (jaundice) 
  • itchy skin 

Symptoms if cancer has spread to the lungs

You may have any of these symptoms if cancer has spread to your lungs:

  • a cough that doesn’t go away
  • breathlessness
  • coughing up blood
  • a build up of fluid between the chest wall and the lung (a pleural effusion)

Symptoms if cancer has spread to the bones

You may have any of these symptoms if your cancer has spread to the bones:

  • an ache or pain in the affected bone
  • a weakened bone which is more prone to break or fracture

Sometimes when bones are damaged by advanced cancer, the bones release calcium into the blood. This is called hypercalcaemia and can cause various symptoms such as:

  • tiredness
  • feeling sick (nausea)
  • constipation
  • irritability
  • thirst
  • confusion

Controlling symptoms

Treatments such as radiotherapy or chemotherapy can sometimes shrink the cancer and reduce symptoms.

Your doctor or specialist nurse (key worker) can:

  • give you medicines
  • help you to get the equipment that you need
  • suggest other ways of controlling your symptoms
  • refer you to a symptom control team (a palliative care team)

Symptom control team

There are symptom control teams in most cancer units. They can help you to stay as well as possible for as long as possible. They are also in hospices and many general hospitals.

Most symptom control teams have home care services so they can visit you at home.

  • Metastatic Colorectal Cancer: ESMO Clinical Practice Guidelines 
    E Cutsem and others
    Annals of Oncology, 2014. Volume 25, Pages ii1-iii9

  • Principles and practice of oncology (11th edition)
    VT De Vita, S Hellman and SA Rosenberg
    Wolters Kluwer, 2019

  • Colorectal cancer 
    The National Institute for Health and Care Excellence (NICE), 2020. Updated December 2021

Last reviewed: 
04 Mar 2022
Next review due: 
04 Mar 2025

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