Remembering Bobby Moore and Understanding Bowel (Colorectal) Cancer

What the record shows

The Football Association marked the anniversary plainly. "It was on 24 February 1993 that England's World Cup-winning captain Bobby Moore sadly died of bowel cancer." The FA also noted that he survived for 20 months after diagnosis.

His widow, Stephanie Moore MBE, set up the Bobby Moore Fund for Cancer Research UK. The FA reports that since the fund began, bowel cancer mortality rates have fallen by more than 30 percent.

Nothing further about his care is on the public record, and this article does not invent any. What is worth explaining is what a bowel cancer diagnosis involves, and in particular what happens when it has already spread by the time it is found.

What bowel cancer is

Bowel cancer is the British term for colorectal cancer, meaning cancer of the colon or rectum. Most cases begin as a polyp, a growth on the inner lining of the bowel. Most polyps are harmless. Certain types can turn into cancer over a period of years.

That slow timeline is the reason screening works here. A polyp found and removed never becomes a tumor.

For 2026 the American Cancer Society projects 158,850 new colorectal cancers and 55,230 deaths in the United States, and the federal SEER program carries that projection. SEER's own trend analysis puts incidence falling about 0.5 percent a year and death rates falling about 1.3 percent a year. That is what a working screening program looks like in the data.

When it reaches the liver

The bowel drains its blood into the liver, which is why the liver is where colorectal cancer most often turns up first when it spreads.

NCI is blunt about how common that is. Roughly 50 percent of people with colon cancer will be found to have liver metastases, either when they are first diagnosed or later as a recurrence.

That does not automatically close off surgery. NCI lists the conditions that make liver deposits removable. There must be a limited number of them, in positions a surgeon can reach. Major blood vessels must be clear. Disease outside the liver must be absent or limited. And enough healthy liver must remain to function afterward.

Where those conditions are met, the results can be substantial. NCI reports five-year survival of 25 to 40 percent after surgery that removes the deposits with clear margins. That evidence comes mostly from non-randomized studies. NCI also cites a five-year cure rate above 20 percent for removing single or multiple deposits.

Only a small share of patients qualify. For everyone else, NCI describes ablation, which destroys deposits with heat or cold. It also describes chemotherapy given before or after surgery, chemotherapy delivered into the artery feeding the liver, and systemic drug treatment.

Symptoms that get explained away

The problem with bowel cancer symptoms is that each has a dozen innocent explanations. Fit, busy people are especially good at finding them. NCI lists:

• Blood in the stool, either bright red or very dark.
• Diarrhea, constipation, or a feeling that the bowel does not empty completely.
• Stools that are narrower or a different shape than usual.
• Frequent gas pains, bloating, fullness, or cramps.
• Weight loss for no known reason.
• Fatigue, or vomiting.

When to get checked

Britain's NHS gives a clean threshold: see a doctor if you have had any bowel cancer symptom for three weeks or more. Applied to the list above, that means:

• Any visible blood, at any age, without waiting three weeks. Do not assume hemorrhoids.
• A change in bowel habit lasting three weeks, whether looser or more constipated than is normal for you.
• Abdominal pain, bloating, or a lump in the abdomen that persists.
• Unexplained weight loss, or fatigue and breathlessness that could reflect slow blood loss.

Some findings need faster action. The NHS advises urgent contact for stool that is black or dark red, or for bloody diarrhea. It says to call 999 or go to A&E if bleeding from your bottom will not stop, or if there is a lot of blood — for example the toilet water turns red or you pass large clots. The NHS adds that you should not drive yourself.

Family history changes the calculation. A parent, sibling, or child with colorectal cancer raises risk, as do inherited conditions such as Lynch syndrome and familial adenomatous polyposis. Mention it before symptoms appear, not after.

Screening starts earlier than most people expect

The US Preventive Services Task Force gives a grade A recommendation for screening every adult aged 50 to 75, and a grade B recommendation for adults aged 45 to 49. For ages 76 to 85 it advises offering screening selectively, based on overall health.

Several tests qualify. A stool test for hidden blood, either FIT or high-sensitivity gFOBT, is done yearly. A stool DNA-FIT test runs every one to three years. CT colonography and flexible sigmoidoscopy are every five years. Colonoscopy is every ten. The test a person will actually complete is the right one.

Screening is for people without symptoms. Symptoms need their own appointment, whatever the calendar says. This matters because SEER records 5.3 percent of new colorectal cancers in people aged 35 to 44 and 2.1 percent in people aged 20 to 34, all of them below the screening age.

Treatment for advanced disease has changed

When Bobby Moore was ill, fluorouracil was essentially the only active chemotherapy drug for this cancer, and NCI records median survival around 12 months in trials from that era.

The picture now is different. NCI reports that adding irinotecan or oxaliplatin to fluorouracil improved response rates, progression-free survival, and overall survival in three randomized studies. Capecitabine, taken as a tablet, proved equivalent to intravenous fluorouracil regimens.

Targeted drugs followed, chosen by what the tumor's genes show. NCI lists cetuximab, panitumumab, ziv-aflibercept, ramucirumab, regorafenib, fruquintinib, and trifluridine-tipiracil. It also lists two gene-matched pairings: encorafenib with cetuximab for tumors carrying a BRAF V600E change, and sotorasib with panitumumab for those with a KRAS G12C change.

Immunotherapy applies to a small, identifiable group. NCI states that about 4 percent of stage IV colorectal cancers are mismatch repair deficient or microsatellite unstable, a pattern linked to Lynch syndrome. The FDA approved pembrolizumab for previously untreated metastatic disease of that type in 2020.

What the numbers say

For people diagnosed between 2016 and 2022, SEER reports five-year relative survival of 91.3 percent for localized colorectal cancer, 75.2 percent for regional spread, and 16.9 percent for distant disease, with an overall figure of 65.4 percent. About 34 percent of cases are localized when found, and 23 percent have already spread far.

Those are group figures drawn from tens of thousands of people over many years. They describe populations rather than individuals. What they do capture is the change the Bobby Moore Fund was built to pursue, and which the FA points to: bowel cancer death rates that keep falling.

Sources

• https://www.cancer.gov/types/colorectal/hp/colon-treatment-pdq
• https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq
• https://seer.cancer.gov/statfacts/html/colorect.html
• https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
• https://www.nhs.uk/conditions/bowel-cancer/symptoms/
• https://www.thefa.com/news/2018/feb/23/bobby-moore-25-years-on-240218