Colon Cancer During Pregnancy
- Kathy Peter was 29 when she was pregnant and having cramping, constipation, bloody stools and extreme pain. Doctors told her it was related to the pregnancy.
- Eventually, she was diagnosed with stage four colon cancer.
- The American Cancer Society says cancers can be harder to find when you're pregnant. It can sometimes be difficult to know if bodily changes are from pregnancy or cancer.
- A recently published report found that more young people are being diagnosed with colorectal cancer (cancer that starts in the colon or rectum). The report also notes that patients younger than 50 are more likely to be women and present with rectal bleeding.
- Make sure you prioritize recommended screenings, pay attention to any changes to your health and advocate for yourself if you feel like something is wrong.
Peter’s colon cancer journey began long before her diagnosis. At the age of 29, she was pregnant with her first child and started feeling “much worse than [she] expected” during her second trimester.
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Still, her doctor didn’t properly address her concerns and insisted that pregnancy was "uncomfortable." Her visits always felt rushed, and even her husband joining her appointments didn’t help. When it was time for Peter to give birth at 38 weeks, she finally felt relief thanks to an epidural.
“For the first time in so many weeks, I had relief from the pain,” she said. “I had a smooth delivery and welcomed my son, Oliver, into the world, knowing that I would love him with all my being for the rest of my life.”
Sadly, motherhood began with a traumatic trip to the emergency room just five days after Oliver was born when she left the shower feeling really cold and shaking. Her temperature was 99 degrees, so her a nurse over the phone said she was likely panicking and needing to take some deep breaths. But before she knew it, Peter was drenched in sweat.
“Miraculously, my husband managed to get me and our newborn into the car and to the ER. Just 30 minutes after calling my doctor, my temperature had spiked to 104 degrees, and I was delirious,” Peter explained. “It was soon discovered that I had developed sepsis. I was pumped full of antibiotics and admitted to the hospital, where I remained for 10 days.”
Sepsis is the body’s extreme response to an infection, and, in the case of Peter, hers was caused by an abscess in her lower left abdomen where she felt the pain during her final trimester. She was discharged after the abscess was drained, but a later scan revealed that there was “a possible connection between the abscess and [her] colon.”
A follow-up colonoscopy revealed colon cancer.
“I was shocked and had a lot of questions. How long had the cancer been brewing inside me? How far along was it? But there was also some relief at finally knowing a cause for my horrible pain, and I felt confident I could beat it,” she said. “When I talked to an oncologist, I learned that I had a large tumor in my colon and that my colon was perforated, which is what caused the abscess. This meant I needed the tumor and a part of my colon removed immediately, a surgery that I had less than three weeks later.
“I also learned that the cancer had already spread to my liver and my lungs. Stage 4. I didn't know much about cancer then, but I knew that stage 4 was very bad.”
For treatment, the now 31-year-old mother has undergone two major surgeries and 20 rounds of chemotherapy. And though her prognosis is not great, she’s determined to fight her cancer with everything she’s got.
“I'm confident that 2023 will be the year that I get most of the rest of this cancer out of me,” Peter said. “It's hopeful thinking, which is exactly what my family and I need.
“If we don't believe I will get well, how can I be present for Oliver and give him what he needs in the here and now? How else can I enjoy the time I have with him, without worrying about how much time there will be?”
Thinking of the "what ifs" has been a struggle for Peter, but she hopes her story can encourage other women to advocate for their health when they know something is wrong.
“All I know is that if just one other woman hears my story and speaks up for herself because of it, I won't have gone through this in vain,” she said.
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.
Be Pushy, Be Your Own Advocate… Don't Settle
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, like in the case above, 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.
More Younger People Are Getting Colon Cancer
Kathy Peter’s story makes another case for the importance of advocating for your health, but it also serves as an example of the shifting colon cancer patient population.
According to the American Cancer Society, the average age at the time of diagnosis for colon cancer is 68 for men and 72 for women. For rectal cancer, it is age 63 for both men and women. But lately we’re seeing a concerning trend of more and more younger people being diagnosed colorectal cancer a term used to describe both colon cancer and rectal cancer.
"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," said Rebecca Siegel, lead author of a recently published report in CA: A Cancer Journal for Clinicians that outlines up-to-date- colorectal cancer statistics.
According to the data in the report, rates of colorectal cancer have been increasing in adults aged 2039 years since the mid-1980s and in those aged 4054 years since the mid-1990s. With "one in five new cases" now occurring in people in their early 50s or younger, we have to address the shifting patient population.
"Early-onset colorectal cancers seem to be more aggressive, and found at later stages in younger adults, but they are not necessarily more fatal if they are caught early," Dr. Heather Yeo, a surgical oncologist who specializes in colorectal cancers at Weill Cornell Medicine, previously told SurvivorNet.
According to the recently published report, patients younger than 50 years are more likely to be women. Younger patients are also more likely to present with hematochezia (rectal bleeding) and abdominal pain at least in part because of the predominance of left-sided tumors.
Treating Stage Four Colon Cancer
In addition, as Dr. Yeo previously stated, early-onset colorectal cancers are more often diagnosed with advanced disease. In fact, the rising rate of early-onset colorectal cancer is confined to advanced diagnoses because rates increased by about 3% per year for regional-stage and distant-stage disease versus a decline of 1% per year for localized-stage disease from 2010 to 2019.
So, that’s why it’s ever-important people are prioritizing annual screenings. Given the shift in the colorectal cancer landscape, the United States Preventive Services Task Force recently updated its colorectal cancer screening recommendations to begin at age 45 instead of 50.
"We know that colon cancers can be prevented when polyps are found early," Dr. Yeo said. "Lowering the screening age helps somewhat with this. But access to care is a real problem."
If you are not yet 45 but have concerns about your risk, talk to your doctor. Ask about your individual risk based on your lifestyle and family history and find out when screenings would be right for you.
Additionally, make sure you listen to their body and seek medical attention when concerning changes to their health occur. Possible colorectal cancer symptoms to look out for include:
- 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
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