Pregnant Mom Experienced ‘Terrible Pain’ Eight Months Into Her Term. It Turned Out To Be Colon Cancer

Penrice wrote on Facebook, through The Hummingbird Centre, “However, my Bowel Cancer was only just the beginning with an emergency operation to remove my tumour in January 2022, and 2 days later I was fitted with a Stoma.

“Reggie my son was always by my side and I told him I had a naughty ball that needed removing. I’m pleased to say that I’ve now had the stoma reversed and living life.”

A stoma bag, also called a colostomy bag, or a stoma, is a plastic container that attaches to the front of your belly and collects waste through an opening in the abdominal wall.

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The mom of two, who also underwent chemotherapy, is sharing her story to help spread awareness for the disease and also planning to run in an event later this year for Cancer Research UK Race for Life.

Recounting her pregnancy journey in 2021, prior to the birth of her daughter and cancer diagnosis, Penrice told the BBC, “When I was around eight months pregnant, I was in terrible pain, so the John Radcliffe Hospital offered me a scan which highlighted a mass on my bowel.

“During the procedure, the doctor put his hand on my shoulder and said he was sorry, so I knew it wasn’t good news and that it was cancer. My first thought was for my baby as I just wanted to get her here safely. Then I was numb and went into autopilot as I tried to get through each day and each hurdle that we faced.”

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Her doctors induced her on December 21, 2021 and planned to surgically remove the tumor the following month, but on January 2, she endured extreme pain  due to a perforated [punctured] bowel.

However, on 2 January she returned to hospital in severe pain, before her bowel suddenly perforated and she underwent life-saving surgery.

Penrice, who lost her dad do cancer, has learned a lot through her cancer battle and losing her dad. She explained, “My experience and his has taught me that we have to go and enjoy every day and make the most of everything.

“Together, my family and I will think of him as we take part in the Pretty Muddy obstacle course and I know I will overcome all the hurdles, just as I did when I faced cancer.”

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Detecting Cancer During Pregnancy

According to the American Cancer Society, thousands of cancers occur during pregnancies each year in the United States. But, sadly, pregnancy can make these cancers harder to find because sometimes it’s hard to know if changes in your body are from the pregnancy or from cancer. The American Cancer Society notes the following scenarios as examples:

• Changes in hormone levels during pregnancy can cause the breasts to become larger, lumpy and/or tender. This can make it harder for you or your doctor to notice a lump caused by cancer until it gets quite large.
• Bleeding from the rectum could be from benign hemorrhoids, which are common during pregnancy, or from colon or rectal cancer.
• Feeling tired could be from weight gain from the pregnancy or from low red blood cell counts (anemia), which can be seen during pregnancy or with cancers such as leukemias and lymphomas.
• The growth of the fetus and uterus can make it hard to detect ovarian tumors.

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Given these challenges, cancers that develop during a pregnancy are often diagnosed at a more advanced stage than they otherwise would’ve been. It’s important to address any lumps, new pains, or other bodily changes that concern you. Anything suspicious should be promptly checked out by a medical professional.

And if you feel like your concerns are being dismissed, don’t be afraid to seek out multiple opinions. You have every right to push for answers when you feel like something if off.

Colon Cancer in Younger Adults

The average age people are diagnosed with colon cancer is 68 for men and 72 for women, according to the American Cancer Society — but the rate at which younger adults are diagnosed has been on the rise. The U.S. Preventive Services Task Force recommends that adults aged 45 to 75 be screened for colorectal cancer.

The National Cancer Institute reports that since the 1990s, colorectal cancer cases have been rising among adults younger than 50. Research published in CA: A Cancer Journal for Clinicians found that the proportion of cases in people younger than 55 “increased from 11% in 1995 to 20% in 2019.”

Researchers are still trying to determine why younger people are being diagnosed in more significant numbers. Some experts point to risk factors, which include obesity, physical inactivity, and smoking, as a possible explanation for the increase.

“We don’t know for sure why we are seeing earlier onset and death from colon cancer,” Dr. Heather Yeo, a surgical oncologist who specializes in colorectal cancers at Weill Cornell Medicine, told SurvivorNet. “It is likely a combination of factors, including diet and genetics as well as access to care and some environmental factors.”

Understanding Colon Cancer

Colon or colorectal cancer, which is called bowel cancer in the United Kingdom, affects your large intestine (colon) or the end of your intestine (rectum).

The cancer starts when abnormal lumps called polyps grow in the colon or rectum. If you don’t have these polyps removed, they can sometimes change into cancer. It takes up to 10 years for a colon polyp to become full-blown cancer, according to SurvivorNet experts.

Looking for Polyps During Colonoscopy

Most colon cancers can be prevented by regular screening. The screening usually involves a colonoscopy, in which a long, thin tube attached to a camera examines the colon and rectum. If no polyps are discovered, the next screening will not be needed for about 10 years.

“We know that colon cancers can be prevented when polyps are found early,” Dr. Yeo explained. “Lowering the screening age helps somewhat with this, but access to care is a real problem.”

What are Colon Polyps?

A colon polyp is a small group of cells that forms on the colon’s lining.

When you have a colonoscopy, the gastroenterologist looks for polyps inside your intestine. Although polyps can’t be felt, they can be picked up by screening tests before they become cancerous.

Almost all polyps that are removed are precancerous, meaning that they have not yet progressed to cancer.

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A Colonoscopy Explained

A colonoscopy is a procedure doctors use to screen for colon cancer by looking inside your colon.

This procedure requires your colon to be “cleaned out.” To clear out your colon, your doctor will prescribe a “bowel prep,” a liquid you drink the night before the procedure. The prep acts as a laxative that causes you to have multiple loose stools before your procedure.

Once your colon is cleared, the gastroenterologist performing the procedure can have a clear look to evaluate if any polyps or masses are present. Depending on the size and number of polyps found, it may be recommended that patients undergo a repeat colonoscopy within three to five years.

Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center, previously explained the colonoscopy procedure to SurvivorNet.

“When we see a polyp, we actually physically take the polyp out through the colonoscope,” he explained. “What does that mean? That means we basically put a wire through with a little bit of a flange at the end, and we pull the polyp out. Now, note there is no pain with that. Inside the colon, there are no pain fibers. So there’s no pain,” Dr. Murrell added.

The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on colonoscopy before they develop or when the polyps are small enough to be removed without surgery.

What Increases Your Risk for Colon Cancer?

For some people, certain factors can increase their risk of getting colon cancer.

They include the following:

• Age. About 90% of cases are in people aged 50 or older, according to the U.S. Centers for Disease Control & Prevention (CDC). Yet it is possible to get this cancer earlier in life.
• Inflammatory bowel disease. Crohn’s disease or ulcerative colitis can, over time, cause cells in your intestines to turn cancerous.
• A family history of this cancer. Just under one-third of people who get colon cancer have family members with the disease.
• A genetic mutation. About 5% of colorectal cancers are caused by an inherited genetic mutation that causes syndromes such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (Lynch syndrome).
• Lack of exercise. Staying active can lower your risk.
• A diet that’s high in meat. Regularly eating red meats like burgers and steaks, and processed meats such as hot dogs and bacon might put you at higher risk.  Eating more fruits, vegetables, and whole grains instead might lower your risk.
• Being overweight or obese. Having too much weight increases your risk of both getting colon cancer and dying from it.
• Alcohol use.  Limiting alcohol to one drink daily for women and two drinks daily for men could help lower your risk.
• Tobacco use. Long-term smokers are more likely to get this cancer than nonsmokers.

Which Treatments are Best for You?

It’s important to understand that your doctor has many ways to treat colon cancer, depending on what stage the cancer is, including:

• Surgery
• Radiation therapy
• Chemotherapy
• Targeted therapy
• Immunotherapy

Surgery

Surgery is the main treatment for most early-stage colon cancers, according to the doctors SurvivorNet spoke with. The surgeon will remove the part of the colon or rectum where there is cancer, along with a small area of healthy tissue around it. Taking out as much of the cancer as possible is important for improving your outcome.

The surgery may be performed through small incisions (laparoscopy), or through a larger incision. Some people may need to wear a special bag (ostomy) to collect wastes after surgery.

Radiation Therapy

This treatment aims high-energy x-rays at the cancer to destroy the abnormal cells. The radiation can come from a machine outside your body, or be placed directly inside your body. Sometimes people get radiation before surgery, to shrink the tumor and make it easier for the surgeon to remove. This is called neoadjuvant radiation.

Chemotherapy

This treatment uses strong medicine to stop cancer cells from dividing, no matter where they are in your body. You may get a combination of chemotherapy drugs as your first treatment. Chemotherapy has been very well studied for colorectal cancer, and it is known to improve survival.

The most common therapy is a combination of chemo drugs called FOLFOX:

• FOL = leucovorin calcium (folinic acid)
• F = fluorouracil
• OX = oxaliplatin

Your doctor may add medications like irinotecan (FOLFIRI) or cetuximab, depending on how well your tumor shrinks with treatment and other specifics about your particular cancer. For FOLFOX, the medications are given through the vein and require regular doctor visits.

To determine exactly which chemotherapy regimen you get, your doctor will consider your age and how well you might tolerate the side effects of chemotherapy. Gene mutations (for example, BRAF and KRAS) and the location of the primary colon tumor also factor into the decision.

You can also get chemotherapy before colon cancer surgery, which is called neoadjuvant chemotherapy. Getting chemo first helps to shrink the tumor, which can make both the surgery and recovery easier, according to SurvivorNet’s experts. Chemo is also a treatment for cancer that returns after therapy.

Targeted Therapy

This treatment targets substances like proteins or genes that the cancer needs to grow. This makes targeted therapy more precise than chemotherapy, and less likely to damage healthy cells. One example of targeted therapy is bevacizumab (Avastin), which stops the growth of new blood vessels that feed tumors. Another group of targeted therapies are called epidermal growth factor receptor (EGFR) inhibitors, which block the cancer from growing.

Immunotherapy

This treatment makes your own immune system a more efficient cancer fighter. A group of drugs called checkpoint inhibitors, which includes pembrolizumab (Keytruda) and nivolumab (Opdivo), work by preventing cancer cells from hiding from your immune system. Checkpoint inhibitors may extend the amount of time before the cancer spreads.

Dr. Paul Oberstein, on which treatments doctors use to turn stage 4 colon cancer into a chronic but manageable disease

Questions to Ask Your Doctor

If you are facing a colon cancer diagnosis, here are some questions you may ask your doctor.

• What are my treatment options based on my diagnosis?
• If I’m worried about managing the costs of cancer care, who can help me?
• What support services are available to me? To my family?

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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