While on holiday in Israel six years ago, sports professional Gideon Josephs was suddenly unable to sleep due to the chronic pains he was experiencing in his stomach. Tests back home in London revealed that the father-of-three from Borehamwood had stage 2 bowel cancer aged 39.
At the time, his eldest child was nine and his twins just seven. “It was a very big shock because none of my family or my wife’s family had experienced any cancer when I was diagnosed,” he says. “It was a very stressful, difficult time.”
Gideon, who has fortunately been in remission for six years, is reflecting on his ordeal in the light of Bowel Cancer Awareness Month this April. He is grateful that his cancer was caught early enough for it not to have spread to his lymph nodes.
“We were very happy that we caught it as early as we had and that I was able to go into full remission,” he says, adding: "We have been lucky enough to have celebrated our sons bat mitzvah two years ago and our twins’ bnei mitzvah seven weeks ago. Without an early diagnosis I may not have been here to see these special events.”
For this reason, Gideon welcomed the news in February that the NHS would be giving regular preventative checks to thousands of people with Lynch syndrome, a genetic condition that significantly raises their risk of developing colorectal cancer, and others, at a younger age. The aim is to detect bowel cancer early to give more chance of full recovery and to save lives.
Gideon Josephs, who has been in remission from bowel cancer for six years
While Gideon does not have the condition himself, Lynch syndrome causes about 1,100 cases of bowel cancer each year in England – and it is more prevalent among Ashkenazi Jews. It affects about 175,000 people in England – that’s one in 400 – but only 5 per cent of those with the inherited condition know they have it. And it’s easily identified by a blood test, which is now available to all those diagnosed with bowel and endometrial cancer, and their relatives. Anyone identified with the condition is entitled to a colonoscopy every two years.
What’s more, the Ashkenazi Jewish population has among the highest rates of colorectal cancer of any ethnic group, experiencing up to treble the risk of the general population, says The Norton and Elaine Sarnoff Centre for Jewish Genetics in Chicago. About 10 per cent of colorectal cancer is hereditary and Lynch accounts for a significant proportion of that, causing approximately 5 per cent of colorectal cancer cases.
Gideon urges the community to take up any screening that is offered to them. “You never know what could be around the corner. People should be screened more regularly; it makes you feel more comfortable knowing that you’re being regularly looked after and screened for any cancerous cells that might be growing in your body.”
During his treatment and recovery, Gideon was supported by Chai Cancer Care, and to thank them, a few years ago, he took part in a football match against a team made up of former Arsenal legends and celebrities to raise funds for the charity. In addition, because of his own experience, he has now qualified as a cancer rehab specialist to help patients who may have had cancer or who undergoing cancer treatment.
“I wanted to give back to Chai, with all the help that they gave us as a family and myself,” he says. “I wanted to give back what I could through my experience to other people who are going through or recovering from cancer, and to show them that you can come through it. That if you’re recovering from it, with exercise, things can improve. Exercise is really important when it comes to your recovery and remission.”
Dr Steve Mann, consultant gastroenterologist at the Royal Free Hospital, says that during the 30 years he has been doing colonoscopy and bowel cancer screenings, the overall trend has been towards a reduction in bowel cancer incidence, which he attributes to improved technology, better quality training and endoscopy competencies and the high take-up of the National Bowel Cancer Screening Programme. However, he has observed an increased incidence of bowel cancer in the under 40s, which was previously considered to be very rare.
Dr Steve Mann, consultant gastroenterologist
Dr Mann said: “There does appear to be a higher risk of bowel cancer in Ashkenazi Jews attributed to certain genetic mutations. That would require extra vigilance regarding awareness of family history of various cancers and paying attention to symptoms that develop.”
Since Lynch syndrome leads to increased risks for certain cancers – mainly bowel, endometrial and pancreatic – Dr Mann says that for those in a family affected, regular colonoscopy screening is recommended from a young age of 25 to 35 years.
He advises that all members of the community should adhere to the UK NHS bowel cancer screening guidelines. “For example, the FIT test for hidden blood in the stool done every two years from the age of about 55 can reduce mortality from bowel cancer by 30 per cent. A negative screening colonoscopy at about 55 years without any family history would also be reassuring and indicate a low risk of developing bowel cancer.
“Be alert to symptoms such as rectal bleeding, increased bowel frequency, looser stools, abnormal rectal sensations, as well as abdominal pain, bloating and weight loss that are unusual for you. Patients may ignore their bowel symptoms for too long through fear, denial or not recognising that something serious may be happening. Ongoing symptoms that are out of character should prompt further evaluation. It can be easy to attribute such symptoms to haemorrhoids or IBS, but go and get checked.”
As the Jewish community’s dedicated cancer support organisation, Chai Cancer Care provides specialised support and expert care to anyone affected by a bowel cancer diagnosis, including counselling, support groups, complementary therapies, nutritional and dietary advice and pelvic health physiotherapy.
Lisa Steele, CEO of Chai Cancer Care
Chai’s chief executive, Lisa Steele, says: “The symptoms of bowel cancer can be extremely vague, particularly in its early stages. The sooner cancer is detected, the more likely it is to be treated successfully. Bowel Cancer Awareness Month is an opportunity to raise awareness of one of the most common cancers in the UK.
“If you notice any physical changes or have any cancer related concerns, please contact your GP as soon as possible.”
Genevieve Edwards, chief executive at Bowel Cancer UK, says: “For anyone of Ashkenazi Jewish heritage, it may be worrying to hear that there’s a greater risk of having Lynch syndrome, a genetic condition which puts people at a high risk of developing bowel cancer as well as other cancers.
“If you have bowel cancer or a close relative has been diagnosed with Lynch syndrome and you have not been offered testing, we urge you to contact your GP to request a referral to genetic services.
“If you do test positive for Lynch syndrome, you should get regular surveillance colonoscopies. This means that any bowel cancers can be detected earlier, when it is more treatable.”
Chai Cancer Care helpline: 0808 808 4567
chaicancercare.org
bowelcanceruk.org.uk
