The specialist told me I just had piles… why didn’t he realise it was colon cancer?

by Symptom Advice on January 23, 2011

Just over a year ago, Nancy Elvin was enjoying life as a busy mother looking after her three small children, one of whom was newly born.

Today, the 28-year-old is in recovery from the bowel cancer that spread through her abdomen to her liver and right lung. she has endured two major operations — one lasted ten-and-a-half hours — as well as two ?debilitating cycles of chemotherapy.

‘I look back over the past year and, despite the scars across my stomach, I sometimes have trouble believing what has happened to me,’ says Nancy, mother to Poppy, five, ?Brianna, three, and baby Rosie, now one.

Precious time: Nancy Elvin with her husband Chris and their children Poppy, Brianna and Rosie

‘it has been such a traumatic time. Instead of enjoying being a mum to my lovely ?daughters, I have been left with the pain of not knowing if I will live to see them grow up.’

Nancy’s agony has been compounded by the knowledge her cancer was misdiagnosed as haemorrhoids by a gastric surgeon a vital four months before the cancer was finally discovered in December 2009.

‘Losing those four months might have cost me my life,’ she says. ‘it probably gave the ?cancer enough time to spread from my bowel to my liver, which in turn means my prognosis is not as good as it would have been. Of ?everything that’s happened, that ?misdiagnosis is the one thing that makes me angry.’

It was near the end of her third pregnancy when she noticed the first worrying symptoms.

‘I began passing blood from my bowels,’ explains Nancy, a pharmacy assistant who lives on the Isle of Man with her husband Chris, 30, a pharmacist. ‘it happened ?suddenly and carried on for a few days. Chris and I are both well aware that any blood in your stools should be investigated, so I went straight to my GP.’

A blood test showed her iron ?levels were very low, so she was admitted to hospital for a blood transfusion. ‘while I was there, a gastric ?surgeon was also called to ?investigate my rectal bleeding.’

Although her mother had ?developed bowel ?cancer at 41, Nancy didn’t realise that someone her age could get the disease, so didn’t mention the family link. it also seems the family link was not passed on by her GP, either.

In any case, the surgeon decided not to carry out a colonoscopy — an internal investigation involving a tiny camera being inserted into the large bowel and up into the small intestine, which sits below the stomach.

But instead, Nancy was given a ?sigmoidoscopy, a much less ?invasive — but less thorough — ?procedure, where just a section of the large intestine was examined.

‘Almost immediately, he announced that he had found some haemorrhoids,’ says Nancy. ‘he removed them and told me I could go home.

‘Losing those four months might have cost me my life. Of ?everything that’s happened, that ?misdiagnosis is the one thing that makes me angry’

‘I still had some nagging ?concerns, as I didn’t feel myself. But I assumed my incredible tiredness and haemorrhoids were down to the pregnancy. and the bleeding did stop, so it made sense that this was the cause.’

But by two weeks before her due date, Nancy was so exhausted her obstetrician agreed to give her a Caesarean and Rosie was ?delivered on September 19. Nancy ?continued to feel unwell for weeks afterwards.

‘I had constant flu-like ?symptoms, such as fatigue and night sweats. I soldiered on until one night in early December, when I discovered I was haemorrhaging from my bottom. Chris drove me to A & E the next morning.’

Doctors suspected she had ulcerative colitis, where the lining of the bowel becomes inflamed and ulcerated.

‘this time they carried out a full colonoscopy,’ recalls Nancy. ‘I remember watching on the screen as the scope went up. I saw a black bulging mass and the ?doctors started taking biopsies from it. my heart just sank. I knew I was in trouble.’

Shortly afterwards, a consultant broke the news that it was cancer. Worse, a CT scan revealed it had spread to her liver, causing two large tumours.

‘I was in total shock, completely numb. I think I was crying but I do remember saying: “That’s it then, I’ve had it.”

‘my first thought was one of total devastation that my children, still so young, probably wouldn’t even remember me in a few years’ time.

‘Poor Chris couldn’t listen to any more and had to leave the room. I think the doctor, too, was shocked at how young I was and how far the cancer had spread.

Through the worst: Nancy had to have an operation and two rounds of chemotherapy

‘I was also angry that the first consultant had not been thorough enough. once he had found the piles, he thought that was the answer, even though I had very low iron levels which indicated quite significant bleeding. The blood was also dark red, which doesn’t occur with haemorrhoids.

‘The consultant clearly thought I was too young to get bowel ?cancer, but doctors should assume the worst case scenario to be on the safe side.’

Indeed, bowel cancer is mainly a problem for the over-50s. ?However, about 2,000 younger people are diagnosed with the condition every year, making it a relatively ?common cancer for that age group.

But according to Mark ?Flannagan, chief executive of the charity Beating Bowel Cancer, many ?doctors simply do not ?consider bowel cancer when they are dealing with young people.

‘Just because a person is younger than the average bowel cancer victim does not mean that it should be discounted as a ?diagnosis,’ says mr Flannagan. ‘it is very rare for men to get breast cancer, but they do.

‘if someone presents to a ?clinician with the symptoms of bowel cancer then they should be investigated for bowel cancer: age should not be a factor.

‘The tragedy is that if bowel ?cancer is caught in the early stages, it is extremely treatable and you have a 90 per cent chance of living past five years. But by the time it has spread outside the bowel that rate drops to 47 per cent.

‘Just over half of all patients ?currently diagnosed are at this stage, which is why bowel cancer is the second biggest cancer killer in the UK. this is simply not good enough.

‘My message to GPs and ?hospital clinicians is that they have bowel cancer on their radar when they are treating anyone with bowel problems.

‘In return, the public should not be embarrassed to get their ?symptoms checked out.’

Two weeks before Christmas 2009, Nancy underwent a five-hour operation to remove a third of her small intestine. afterwards, she was in a great deal of pain.

‘If you suspect there is something wrong with your bowels please go and get them checked — and then get them checked again’

‘But I made every effort to get up and around as quickly as possible — I was determined to get home to my family for Christmas,’ she says.

‘a few days before I was ?discharged, my best friend Trish brought Rosie in. I hadn’t been able to see her for 12 days and it was so wonderful to hold her, I just burst into tears. she looked at me as if to say: “Who on earth are you?”

‘I wasn’t too upset by that, only relieved that she wasn’t ?desperately missing me!’

Christmas was ‘an incredibly emotional time’, says Nancy. ‘I just wanted to hug the children for ever.’

Last February, Nancy began six sessions of chemotherapy for one day every two weeks, with awful side-effects — her skin became extremely irritated and painful. But it shrank the liver and lung tumours, which were removed in June in the ?ten-and-a-half-hour operation. she then underwent a second round of chemotherapy.

‘if it hadn’t been for friends and our church helping out, I have no idea how we would have coped,’ she says.

But despite her dreadful year, Nancy remains upbeat.

‘For now, all the tests and scans indicate that there is no sign of cancer anywhere in my body. and the doctors seem determined to keep fighting for me.

‘however, I really want others to learn from what happened to me. if you suspect there is something wrong with your bowels please go and get them checked — and then get them checked again.’

‘be persistent,’ agrees mr ?Flannagan. ‘if you don’t feel right about being told you have piles or IBS then go back and back again.

‘Better to be thought pushy than to have your cancer missed.’

Beating Bowel Cancer’s be Loud, be Clear awareness week runs from January 24 to 30. bowel123.co.uk For information about the disease, go to beatingbowelcancer.org

 

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