When Simon Rodgers first started getting symptoms like dizziness, blood in his stool, chronic anemia, fatigue and loss of appetite, he put off getting checked out for over half a year.
The nearly 70-year-old founder of Four Bakery in St Helier said: “Being a typical bloke of course I’d had symptoms for a while but thought ‘it’ll go away, I don’t have a problem with it’ – toxic masculinity and all that.
“But eventually I went to my doctor and they said I need to go to hospital right away. I said ‘I can’t’ but she said ‘I’m not joking. I need you to go to hospital now’.”
They sent him to get a colonoscopy to check for signs of cancer.
Recalling a conversation he had with a taxi driver on the way to the appointment, Mr Rodgers said: “I said ‘I’m going to the hospital’ and he said ‘what for?’ so I told him.
“He said ‘oh god, I’ve been told I should get one of those’ so I said, ‘just do it’. He said ‘yeah but…’ and I said ‘there’s no buts about it. If you’re doctor says you need one, don’t even think about it, just go and get it done’.
“Then he picked me up about a month later and was so grateful that I said ‘just do it, don’t be an idiot’. You leave your dignity on the doorstep, but he got the all clear and it gave him peace of mind.”
However, in Mr Rodgers’s case it turned out he did have cancer.
When he received his diagnosis in 2017, it was caught early enough for it to be removed through a surgery – the first of several as it did go on to spread to other parts of his body.
Now, having been given the all clear about a year ago, Mr Rodgers said he has one clear message: “My advice to any man over the age of whatever, is to go and get checked out.”
Reflecting on his initial reluctance to see a doctor, Mr Rodgers described how when his father had cancer, he did not tell the family, and, even after his diagnosis was known, the ‘C’ word was still not used.
While he does not know when his father first received his diagnosis, recalling a time it became clear something was wrong, Mr Rodgers said: “He collapsed and some type of heavy metal fell on him so he had to go the Hospital. But even then, it was ‘nothing is wrong with me. Something just fell on me’.”
Mr Rodgers explained that his late father was likely influenced by “what some might say is toxic masculinity” being an ex-military man who had a “never admit to any weakness” approach to life.
“I think there is still that idea today,” he said.
Mr Rodgers said his medic sister was able to “put two and two together” and it became “obvious it was something more”.
He added: “We never used the word in front of our father, because at the time, it was just out of respect for him. He didn’t tell anybody besides my step mother and his doctor, so we didn’t discuss it in front of him.”
Keen to show that having your health checked is not a sign of weakness, in the midst of his own treatment during the first Covid lockdown, Mr Rodgers went on to set up his bakery Four.
The entire ethos of the business is to use minimally processed ingredients wherever possible, after Mr Rodgers’s diagnosis caused his to reflect on his diet and see “the rubbish the put in” to everyday foods.
Dr Moses Duku, clinical lead for endoscopy and bowel cancer screening at Jersey General Hospital, similarly highlighted the importance of getting checked out and having open conversations with family members.
He said: “We are increasingly seeing patients in their 40s being diagnosed with bowel cancer and the only real explanation so far that we can see from the data is our lifestyle unfortunately.
“But also the fact that we are not talking about things to our parents and so forth – we’re increasingly seeing patients who are young who have a family history of bowel cancer.
“They have a significant family history, i.e. members of the family who have been diagnosed under the age of 50 in the past. They are supposed to be screened intensively at a very early age.
“So getting information from your family [as to] whether there is any family history of bowel cancer, is really important, and you don’t need to have a conversation with your GP about that.
“If you fit the criteria, where you have a first-degree relative who has had bowel cancer under 50, plus other relatives as well, then you may qualify to have a screen test at a very early age rather than waiting until you are 55.”
However, he added: “The majority of bowel cancers are sporadic, i.e. not genetically associated. There are about 5 to 7% that are due to genes transmitted from parents to children.”
Dr Duku also said many people don’t realise the initial screening test – a faecal immunochemical test – is not invasive like a colonoscopy and can be done from the comfort of their homes.
He added: “They have a little specimen pot with a little brush similar to a mascara one that they put in the sample and send to us in the post. This test shows if there is microscopic blood in the stool.”
It is only if they get a positive result – which does not necessarily mean cancer as it can detect benign polyps that can be removed before they develop into the illness – that individuals are then invited in for a colonoscopy.
It is estimated nearly 50,000 people in the UK – equivalent to more than 130 every day – are diagnosed with the illness which causes more than 17,700 deaths each year. On his own survival, Mr Rodgers said “it’s a lottery”.
The data in Jersey is reviewed on an annual basis, and the latest figures show there was “in the region of about 57 colorectal cancers detected last year”, Dr Duku, who co-led the establishment of the screening programme, said.
He added: “I anticipate that in the coming years we will have a drop in that incidence, especially if we expand our screening programme and we really want to drive this forward as soon as we get the right personnel in place.
“The bowel incident has dropped in men, not so much in the female population, but significantly lower than what we see in the UK. If you are doing better screening, and preventing cancer developing, your numbers will drop.”
This decline is in the older patients Dr Duku sees who have been eligible for, and have benefited from, routine screening that is available to Islanders aged 55 to 65 every two years.
In the UK, the FIT tests are available to those aged 50 to 74, something Dr Duku said Jersey’s Health Department has been looking to expand to once the right IT systems are in place.
However, Jersey is already ahead of England in one particular area – the sensitivity levels in which FIT tests detect cancer in the blood are set at 80 micrograms of blood a gram.
Meanwhile, NHS England only recently announced it would be increasing its sensitivity levels from 120 to 80 to detect more cases of bowel cancer earlier, with the goal of having the new measures established across the country by 2028.
Dr Duku said: “There are other jurisdictions in Europe which have even a lower cut off. If you take the Netherlands, for example, I think it’s 45.
“In the future, once we have expanded, we will be looking at potentially lowering even below 80 to meet jurisdictions elsewhere, because there’s constantly data coming out.”
International research has shown a worrying trend in under 50s developing bowel cancer – with a 50% surge over the past three decades.
Dr Duku said that this was a “trend we have seen here in Jersey”, adding that it is important that GPs refer patients showing signs of the illness even as young as 18 for a FIT test.
“In fact, we got 3,000 last year to have that stool test with potential symptoms, and 17% of them had positive tests and ended up having colonoscopies. Of course, we picked up cancers, and some polyps and removed them,” he said.
Other symptoms include abdominal pain, bloating, a lump in the tummy, losing weight without trying, stool changes or needing to pass stool more or less often.
Often feeling like you need to pass stool despite just having been to the toilet, as well as shortness of breath which can be another sign alongside fatigue of anaemia (that can be caused by bowel cancer), are also warning signs.
Dr Duku added that there are preventative measures that people can take to lower their risk of the illness such as eating less red meat and processed foods, having more fibre, not smoking, and exercising at least 90 minutes a week.
