Understanding Bowel Cancer
- Laila Hudson, of Glasgow, Scotland, was diagnosed with stage 4 bowel cancer at age 27 after doctors dismissed her symptoms for years.
- Her symptoms began in the summer of 2017 when doctors diagnosed her with and treated her for anemia (low red blood count).
- Anemia can be a symptom of bowel cancer if the tumor begins to bleed and leads to blood loss.
- Bowel cancer is a general term for cancer that begins in the large bowel, but generally, we use the term colorectal cancer in the United States.
- Possible symptoms of bowel cancer to look out for include a change in bowel habits, a feeling that you need to have a bowel movement that’s not relieved by having one, rectal bleeding, blood in the stool, cramping, or belly pain, weakness, fatigue and unintended weight loss.
- On average, people who receive a colon cancer diagnosis are in their 60s or 70s. However, Hudson is part of a growing and concerning trend of younger people developing the disease.
Her symptoms began in the summer of 2017 when doctors diagnosed her with anemia (a condition where the body lacks healthy red blood cells), prompting her to take “multiple courses of iron tablets for recurrent anemia.”Read More
It’s true that Hudson is young to get bowel cancer, which people in the U.S. may refer to as colorectal cancer). On average, people who receive a colon cancer diagnosis are in their 60s or 70s, according to the American Cancer Society, However, Hudson is part of a growing and concerning trend of younger people developing the disease (more on that later).
“My more glaring symptoms started in April 2020. My stomach was extremely distended and bloated constantly – I felt like I had a bowling ball in my stomach. I was suffering an intense spasm-y type pain that felt almost like trapped wind. I had lost my appetite and felt full very quickly. I felt like I needed to pee constantly and had a stabbing pain in my bladder when I urinated.”
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After notifying her doctor of her worsening symptoms, she was prescribed antibiotics and irritable bowel syndrome (IBS) medications. Hudson noted that her doctors were hesitant to do any surgery as it was during the Covid-19 pandemic. They even dismissed her symptoms as “stress” when her mom was diagnosed with a brain tumor.
“I then began getting a severe and absolutely debilitating new type of pain that left me unable to move even an inch and the doctor finally agreed to see me,” she continued. “As soon as he palpated my stomach he felt what he described as ‘several masses’. He said it could be an ovarian cyst or a fibroid and I was put on the urgent two-week referral for an ultrasound though he said due to the pandemic it may take a while.”
The ultrasound discovered a “huge mass” on her ovary, leading her to need a CT scan.
Hudson was then told she had an ovarian cyst and needed to get it surgically removed. But then a gynecologist surgeon told her she might have ovarian cancer due to high tumor markers. Following another CT scan, she had surgery to remove the mass, her left ovary, fallopian tube, and her appendix.
A pathology report later stated that her Borderline Ovarian Tumor was removed and “no further treatment” was needed. But her pain returned, this time “spasm-y” and continuing to get worse, prompting her to receive a colonoscopy recommendation.
She was admitted to the hospital again, where doctors likened her pain to her diet and discharged her.
But when her pain became more severe and she suffered from “uncontrollable vomiting,” she knew something was wrong. A CT scan revealed she had a fecal impaction, but after taking suppositories the “blockage” didn’t get better. She was then scheduled for a colonoscopy days later.
However, her pain got worse that night after her CT scan and a second opinion of her CT scan reveal a tumor blocking her bowel that was “most likely cancerous.”
“By this point, my bowel was completely obstructed. They could not perform a colonoscopy due to the risk of perforation so decided to go straight to surgery instead. There was no mention of my ovarian tumor and I had forgotten all about it,” she recounted. The next day she underwent bowel resection (surgery to remove part of the small intestine, large intestine or both. She had three-quarters of her colon removed.
As she tried to recover, her pain worsened and her CRP (C-reactive protein) markers remained high. Another CT scan showed her bowel was leaking, resulting in sepsis. Surgery would be needed to stop the leak and she possibly needed a stoma, she recounted her doctor telling her.
“I woke up in recovery after midnight in intense agony. I felt like I’d been gutted like a fish without any pain relief. For my first two surgeries I’d had opioids injected into my spine prior to being put to sleep but due to the infection, I couldn’t have it done for my third operation. The pain was horrendous and none of the painkillers they were giving me seemed to be doing anything,” she explained, noting the next few days were the “worst” of her life.
She later underwent her third surgery.
“I was informed that the colon tumor was a type of cancer called mucinous adenocarcinoma and they were having a multi-disciplinary team (MDT) meeting to discuss my case. I was still optimistic that they had removed all the cancer and that would be all the treatment I needed,” she added. “There had still been no mention of the ovarian tumor. After the MDT meeting, I was informed they had re-examined the ovarian tumor and it was in fact a metastasis from the bowel tumor.”
She was told she would need aggressive treatment and six months of chemo. And although she was recovering in the hospital for weeks, she was discharged earlier than planned as her mom had become sicker. Thankfully Hudson was able to get home and see her mom before she passed away.
Hudson was ultimately diagnosed with stage 4 bowel cancer, dubbed T4N1M1. Stage T4 (meaning the cancer has invaded adjacent organs), N1 (meaning the cancer has spread to a regional lymph node), or M1 (meaning the cancer has spread to another part of the body).
Treating a Bowel Obstruction Caused by Colon Cancer
Hudson was initially scheduled to do 12 rounds of chemotherapy, however, there were complications amid her treatment. She explained, “My first PICC line got infected so I had another one inserted which gave me a blood clot. They tried to get a third one in but my veins were too damaged so I had a Hickman line inserted. Unfortunately, this went on to give me a rare infection called Nocardia which caused an abscess in my brain.”
That prompted her treatment to stop and her to get IV antibiotics in the hospital. “Nocardia infections require 6-12 months of antibiotic treatment so my oncologist decided it would be safest to stop my chemo after eight cycles,” Hudson said.
“All I can do is live in hope that I will remain No Evidence of Disease,” Hudson, who admitted she’s scared of her cancer coming back. “I am hoping to have my stoma reversed this year. I have an end ileostomy which unfortunately means I will require another open surgery to reverse it but I’m very grateful that they are giving it a bash.”
She concluded, “Getting diagnosed with cancer in a pandemic is extremely isolating. I have had all my appointments, operations and treatments by myself. Long stints in hospital with no visitors is tough and has a big impact on your mental health and recovery. However, I have the most amazing group of friends and family who have supported me from afar every step of the way and for that I am very thankful. Now I can’t wait to get out and start living my life – this last year has made me realize how so very precious it is.
Understanding Bowel Cancer
Bowel cancer is a general term for cancer that begins in the large bowel, but we usually use the term colorectal cancer – or colon cancer or rectal cancer depending on the location of the cancer – in the United States.
Bowel cancer, like all cancers, presents its own set of challenges for patients on the road to recovery. But Dr. Heather Yeo, a surgical oncologist and colorectal surgeon at New York Presbyterian Weill Cornell Medical Center, wants to remind people how far the treatment of this disease has come.
Understanding Your Options With Stage Four Colon Cancer
Dr. Yeo says in an earlier interview with SurvivorNet, “One of the most exciting things about my job is that we’ve made a lot of progress on treatment options. However, patients are still — while they’re living longer, they are still living with colon cancer, and so I think it’s really important that we talk about how some of the things in your life affect you.”
Colon Cancer Becoming More Common in Young People
The average age at which people receive a colon cancer diagnosis is 68 for men and 72 for women, according to the American Cancer Society, but people significantly younger are increasingly being diagnosed, researchers say.
“We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population,” cancer epidemiologist for the American Cancer Society Rebecca Siegel said in an earlier interview.
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The National Cancer Institute reports that since the 1990s colorectal cancer cases have been rising among adults younger than 50. The research, published in CA: A Cancer Journal for Clinicians, found the proportion of cases in people younger than 55 years old “increased from 11% in 1995 to 20% in 2019.”
Researchers are still trying to figure out why more younger people are being diagnosed. Some experts are suggesting risk factors, which include obesity, physical inactivity, and smoking, as possible reasons for the continued rise in cases.
“Some of those [risk factors] have become more common over the last 45 years, along with this rise in early-onset cases,” National Cancer Institute program director Phil Daschner said, the National Cancer Institute reports.
Dr. Heather Yeo previously told SurvivorNet, “We don’t know for sure why we are seeing earlier onset and death from colon cancer. It is likely a combination of factors, including diet and genetics as well as access to care and some environmental factors.”
Symptoms of Colorectal Cancer
Colorectal (bowel) cancer might not immediately cause symptoms, but these are possible symptoms to look out for:
- A change in bowel habits, such as diarrhea, constipation or narrowing of the stool that lasts for more than a few days
- A feeling that you need to have a bowel movement that’s not relieved by having one
- Rectal bleeding with bright red blood
- Blood in the stool, which might make the stool look dark brown or black
- Cramping or abdominal (belly) pain
- Weakness and fatigue
- Unintended weight loss
RELATED: Why Do So Few Black Men Get Colon Cancer Screenings?
It is important to remember, however, that showing some of these symptoms does not mean you have colorectal cancer. You could also have colon cancer and none of these symptoms could be displayed. Regardless, it is important to bring up any symptoms to your doctor should they arise.
Stage 4 Colon Cancer Options
Stage four colon cancer means that the cancer has spread from the colon to other organs. The most common sites for colon cancer to metastasize to is the liver, lungs and peritoneum (the lining in your abdomen). Each case is very different, and therefore, the treatment options are different for each patient.
RELATED: All Americans Should Begin Colorectal Cancer Screening at Age 45, According to New Guidelines; Previous Age Was 50
Chemotherapy, surgery or a combination of therapies may be recommended, but individual recommendations depend on where the metastases are located and how widespread the disease is. Some patients with limited metastases in only one organ may be recommended to undergo surgery, whereas chemotherapy may be indicated in patients who have many metastases or disease at different sites.
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Contributing: SurvivorNet Staff
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