Ballarat's Lisa Butcher's one of rising cases of young people with bowel cancer

The creativity, along with indoor plants and he beloved eclectic bunch of animals offers Lisa a sense of relaxation and comfort.

She is a foster carer for teenagers and has three biological children but other children in the neighbourhood often nickname her Mum. She had thought the increasing tiredness she had been feeling was her chronic health conditions being exacerbated by chasing after children and teenagers.

At 37-years-old Lisa was diagnosed with bowel cancer.

She is just one person in a growing statistic of young Australians with a disease often regarded as an older person's disease.

Australia's free national bowel screening program does not kick in until a person is 50 years old but more than 10 per cent of cases are diagnosed in people aged under 50.

Bowel cancer is Australia's second biggest cancer killer, claiming about 100 lives each week. It is the deadliest cancer for people aged 25 to 44, largely because it is diagnosed too late.

It took Lisa 18 months to get a diagnosis. By then, the colorectal tumour took up three-quarters of her colon.

Lisa said her doctor kept brushing off her stomach cramps with antibiotics. Eventually Lisa sought a second opinion and within a week was undergoing medical scans that revealed her cancer.

"If it wasn't for her, I would probably not still be here," Lisa said. "...Throughout the whole experience, I have wanted to raise awareness. It's so important to follow through on gut instinct."

Ballarat cancer researcher Jason Kelly, who specialises in bowel cancer, said Lisa's story was not rare.

Dr Kelly said it was hard to pin-point why bowel cancer incidence was rising among younger Australians - there were numerous factors "all vague and hard to prove".

He pointed to difficulty in detecting the cancer due to common symptoms without screening - and the best way to treat bowel cancer was with early detection.

Bowel Cancer Australia reports people born in 1990 and onwards have double the risk of colon cancer and quadruple the risk of rectal cancer compared with people born in 1950. The trend is similar worldwide.

Dr Kelly said the treatment for bowel cancer has not changed much the past 20 years and neither had the mortality rate for the disease.

His work with Fiona Elsey Cancer Research Institute is double-pronged: understanding why the immune system fails to recognise normal bacteria in the large intestines and, hence, stops tackling cancer cells; and, to help identify targets that might combat this.

Dr Kelly said the immune system was constantly monitoring for changes and keeping cancers at bay. This could be impacted by immune suppressants, such as for people who undergo organ donations, or with ageing and greater exposure to cancers.

Using immunotherapy has proven an effective way to kill some cancers such as melanoma.

Dr Kelly pointed to Hawthorn footballer Jarryd Roughead who was diagnosed with melanoma that had spread from his lip to his lungs in 2016.

A decade earlier he would likely have been told to put his affairs in order and be pumped with chemicals in a bid to tackle the cancer. Instead Roughead was back playing AFL a year later.

Dr Kelly said this was the "holy grail" of cancer treatment, finding ways to unblock signals for the body's immune system to do what it did best - clearing the body of disease.

"That doesn't work with bowel cancer," Dr Kelly said.

"My work is trying to identify why the immune system can't recognise the stop signals to kill cancer cells."

Dr Kelly said typically the immune system would recognise a small tear in the bowel, which would be painful, or appendicitis.

When bowel cancer starts as a polyp in the cells lining the bowel in time it can create an ulcer or giant hole barrier but people could be walking around undiagnosed.

Bowel screenings, however, do not detect cancer but blood in stools, which can indicate pre-cancerous polyps or early stage cancer.

Dr Kelly said chronic bacteria stimulation was modifying the body's immune response and instead creates a barrier, strong and fast, that was sending the immune system away

He used the metaphor of a beginner gardener whose body might stimulate an inflammatory immune response to blisters on the hands from digging, but overtime stronger barriers on the hands would negate the need for blisters.

His work was in understanding how this was working in bowel cancer and how to reverse this.

Research has been able to identify which cancer cells are making products to block the immune system and which immune cells were switching off. Work was under way to identify targets to unblock this.

Wednesday will mark Lisa's final day of chemotherapy.

Lisa can hardly wait - once more she gets to ring the celebratory bell in Ballarat Regional Integrated Cancer Centre - but she is concerned the chemo effects will linger.

She has been surprised not to lose her hair but has experienced neuropathy, the tingling pins and needles-like sensation, in her nose and ears.

This latest round has been six months' treatment. It has followed initial radiation and oral chemotherapy before Lisa became one of the first patients to undergo robotic surgery in Grampians Health Ballarat Base Hospital in January.

The world-class surgery, under colorectal surgeon Carolyn Vasey, allows for minimal invasion, small incisions and the chance to better access hard-to-reach places for operations.

Lisa was walking the night of her surgery and home within two days.

She will spend the rest of her life with a stoma bag, something that proved unavoidable due to the nature of her cancer.

Life with cancer for Lisa has been a "big adjustment" in how she moves and what she can eat and how she interacts with her children and pets.

Lisa will typically try to rest when her seven-year-old is at school "so he doesn't see me at my worst".

Angel the Persian cat - the kind with the cute squishy faces - has been a constant companion, often purring in Lisa's ear and helping to regulate her own breathing when everything seems too much.

Her family and neighbours have rallied in cooking meals, helping to clean, driving her to appointments and doing school runs.

"I've had to be strong through all of it," Lisa said. "It's really important anyone with a cancer diagnosis to have support from family and neighbours."

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