Meet the Yorkshire woman who has spurred supermarkets to include bowel cancer symptoms on toilet roll packaging in fight against the disease

Cara Hoofe was diagnosed with bowel cancer six years ago and has now sparked a movement to get symptoms on toilet roll packaging. Laura Reid reports.

Cara Hoofe was 32 when she was diagnosed with bowel cancer back in 2016.

“My dad had bowel cancer when he was in his forties and he’d always talked openly about that experience with me,” she says. “I was aware of some of the symptoms - maybe not all of them - but he’d always been an advocate for if anything changes, get it checked out.”

The 38-year-old from Huddersfield did just that. Experiencing more tiredness and a change in bowel habits, she turned to her GP. Ten months later, a stool sample showed hidden blood in her poo and a colonoscopy examination of the bowel revealed the cancer.

Cara Hoofe, who had bowel cancer, has worked to get symptoms listed on toilet roll packaging. Photo: Oliver Dixon/M&S

Now, Cara is behind an initiative to raise awareness of bowel cancer symptoms.

After pitching an idea to her workplace, Marks and Spencer, the retailer will print the symptoms on its toilet roll packaging from next month and has already rolled out signage about bowel cancer in its stores - and their toilets - for both customers and staff.

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“There’s often a lot of conversation in the bowel cancer community about what we can do in terms of getting messages about bowel cancer out there,” Cara says. “The toilet roll idea is bandied about by a lot of people.

“What Deborah James did in terms of being vulnerable with her story, getting that message out there and creating a platform, has opened up avenues.

“When she announced that she was moving to hospice care, it’s upsetting to see another young person be in that position and I wanted to do something. I realised I was sat in a company that should really be able to make it happen to get symptoms on toilet rolls.”

Cara submitted the idea to M&S’ newly launched Straight to Stuart colleague suggestion scheme. Introduced by CEO Stuart Machin, it encourages colleagues to share ideas and views.

The retailer, which has 30 million customers, partnered with Bowel Cancer UK and the charity’s logo and symptoms information will appear on M&S’ toilet roll range from next month. A QR code will also redirect customers to the charity website to find out more.

M&S has also pledged a £50,000 donation to the charity, which, following the partnership, launched the #GetOnARoll campaign in June, calling on supermarkets across the country to put bowel cancer symptoms on their own brand loo roll – where it says people need to see them most. Andrex, Aldi, Morrisons, Waitrose, Asda, Sainsbury’s and Coop have since joined the campaign.

Cara says: “It means that hopefully the majority of people that are buying loo roll are going to see that message at some point. It’s the first step - people being aware of the symptoms and putting aside any embarrassment might get them through the doors of the GP.

“Then from there it’s about ensuring those primary care providers aren’t just dismissing people because they’re too young...There’s work going on in that space but more to be done.”

After chemotherapy and surgery to tackle her bowel cancer, Cara found out it had spread to her liver and underwent further treatment before being told there was no longer any sign of the disease in March 2018. Last year, however, she was diagnosed with a second cancer - that of the womb - and has had a total hysterectomy to eradicate the disease. It’s been a difficult and emotional few years.

“The most difficult thing for me was that my dad had died six months previous to me starting to have bowel cancer symptoms - not of cancer, he survived his cancer and went on to live a full life, which is something that’s helped me to get through I think.

“Cancer affects every part of your life. It affects work, as you’re juggling your treatment with work. It affects your friendships, in the way that you’re going through something that none of them have experienced and puts you at a different stage of your life I suppose.

“All you can do is take each step at a time. It can knock you quite badly and I’ve tried to be kind to myself in terms of rebuilding and re-visioning what my life looks like going forward.”

Though Cara was aware of some of the symptoms of bowel cancer as a result of her father, almost half of UK adults cannot name a single symptom, despite it being the fourth most common cancer. The aim of the toilet roll packaging is to encourage people to know and act upon the signs so that bowel cancer can be detected and diagnosed earlier.

“There are many factors that contribute to people being able to get early diagnosis and one of those is being aware of the symptoms and changes in your own body,” Cara says. “It’s really important to reach people where it’s easy for them to see and consume information and that’s where the loo roll comes in because everybody buys it.”

She adds: “What’s been created through Deborah James’ platform is the opportunity to talk about bowel cancer and build that awareness beyond our community. She did a fantastic job and I think it’s up to us now as a community to keep that drumbeat going.

“Not everybody is a Deborah James and wants to talk about their diagnosis but there are so many people helping to do things to move this forward to help people to be diagnosed at an earlier stage, whether that’s through fundraising efforts, research or supporting other people in the community. It’s all really important.”

* Bleeding from the bottom, or blood in poo

* A persistent and unexplained change in bowel habit

* Unexplained weight loss

* Extreme tiredness and anaemia

* Pain or a lump in the stomach area or back passage

* A blocked bowel

The charity says: “Knowing the symptoms, and acting on them, means that bowel cancer can be diagnosed earlier when it is more treatable and curable. Fewer than 40 per cent of people are diagnosed at the earliest stages. We can change this and ultimately save more lives.”

Visit bowelcanceruk.org.uk to find out more.