By Meghan Holohan – TODAY
The fifth pregnancy Yasmine Garjales it was complicated. From the beginning he experienced hyperemesis gravidarum, severe nausea and vomiting. When she was approximately five months pregnant, the woman, who was 30 years old at the time, noticed blood in her stool. Alarmed, she informed her doctors.
“I mentioned it over and over to my gynecologist and primary care doctors, but they both thought it could be hemorrhoids because of my age,” Garjales, 32, who is from Columbus, told TODAY.com. “I had no hemorrhoid symptoms like itching or burning, anything like that. “I only had bleeding and liquid stools.”
This persisted throughout her pregnancy, and then three weeks after giving birth, doctors finally performed a colonoscopy and immediately found a tumor and diagnosed her with stage 3 colon cancer in April 2022.
“They tricked me,” he says. “They seemed to have the same inclination that it would be hemorrhoids, but unfortunately that was not the case.”
As cases of colorectal cancer in young people increase, doctors are also seeing more pregnant women suffering from this type of cancer. Diagnosing it can be complicated because some of the changes that occur during pregnancy, such as hemorrhoids, are similar to the symptoms of colon cancer.
“In the past we said, ‘No, you’re too young (for colon cancer),’” the doctor said. John Marshall, director of the Ruesch Center for the Cure of Gastrointestinal Cancer at Georgetown University. Regarding Garjales’ case, he told TODAY.com: “You have to think about colorectal cancer and, therefore, if you see someone who is pregnant and has had a change in their intestinal habits, you must prove that it is not cancer. colon”.
Changes in pregnancy
Several years ago, Yasmine’s grandmother died of colon cancer, and when she noticed blood in her stool, she worried that she too had the disease. While she continued to tell her doctors about the changes before giving birth, it wasn’t until after she gave birth to her that they performed tests to get to the bottom of her symptoms. The day she had the baby, she experienced what she thought was a “gallbladder attack.”
“I continued to bleed, like every day after giving birth, in my stool,” she explains. After three weeks of bleeding, she returned to the hospital where doctors admitted her and performed a colonoscopy the next day. They discovered a three-centimeter tumor that the doctor determined was cancerous.
“It bothered me a lot because the same specialist just before I went to sleep told me: ‘Don’t worry,’” Grajales remembers. “The first thing I thought about was my children.”
[Esta es la importancia de realizar un ultrasonido durante el embarazo]
She became frustrated because she told her doctors during and after pregnancy about the symptoms she experienced and they dismissed them and, ultimately, she was right.
After the biopsy results came back and she underwent a scan to see if the cancer had spread, she underwent surgery to remove the mass and 42 lymph nodes. Only one was cancerous. She then underwent chemotherapy, which she calls “the worst experience of my life.” Although her grandmother also had colon cancer, test results revealed that there was no genetic link between her cancers.
It is not an isolated case
Alyssa Kelly, who was 38 years old at the time, had lived with Irritable Bowel Syndrome (IBS) since he was 20 years old. While she was pregnant with her child in 2021, she noticed that she looked smaller than other expectant mothers.
“I wasn’t gaining weight during my pregnancy…,” the 41-year-old from Auroa, Illinois, told TODAY.com. She also experienced abdominal pain. At the time, she wondered if they were simply part of having IBS and being pregnant. When she was 28 weeks pregnant she had a routine ultrasound and then a team of eight doctors came into her room. She knew something was wrong.
“They found out I had stage 4 colon cancer,” he says. The doctors discovered that there was a tumor growing in her abdomen. And his growing baby was pressed against him, which likely contributed to the pain he experienced. “They said it was the tumor growing,” he said. “I had no idea.”
Doctors considered Kelly giving birth early, but she saw it through to the end. She started chemotherapy during pregnancy to try to shrink the tumors. Doctors were cautious about performing surgery on Kelly to remove the cancer, but she received a second opinion from doctors in California who believed the tumor was operable. She had the tumor removed, part of her liver and part of her colon resected, a hysterectomy and lymph nodes removed.
Nearly three years later, Kelly has undergone 52 rounds of chemotherapy and had two more surgeries, including an ileostomy, a surgical opening in the abdomen to allow waste to leave the body if the colon or rectum is not functioning normally.
Undergoing chemotherapy during pregnancy was “the hardest thing,” she says. Kelly will most likely always have cancer. Right now, she is taking a break from chemotherapy, but if her tests show that the cancer has spread, she will have to start again. “They really pay attention to a lot of things,” she said.
Colorectal cancer and pregnancy.
Doctors have noticed that over the past 15 years the type of people who develop colon cancer has changed, John Marshall said. More people in their 30s and 40s are now being diagnosed with the disease, according to previous TODAY.com reports.
“The trend is increasing,” Marshall explained. “The belief was that bad habits like not having a proper diet, not having the right weight, having some kind of genetic correlation, caused it. But honestly, as we’ve seen this evolve, it doesn’t jive with that.”
The specialist explains that often young patients are fit, active and eat healthy foods and avoid processed and fast foods and have no family history. While their habits may not be contributing to the rise in colon cancer, experts have noted that younger patients have tumors that appear in “a similar location.” Marshall explains that the colon is shaped like a question mark and historically colon cancers could appear anywhere in the colon. This differs in younger people.
“Almost all of these cancers, 90% arise at the bottom of the question mark of that last little curve,” he explains. “They are in what is called the rectosigmoid area, so it is clearly a unique phenomenon.”
While there are theories as to why it occurs more in these groups, experts are still investigating this trend. More cases of colon cancer in young people means that it is also appearing in pregnant people.
“There are two things that can overlap. You have a group of young people in their 30s and 40s who get pregnant, a time of joy, but also of changes in health,” says Marshall. “There are changing symptoms that occur due to pregnancy that can overlap with something much rarer like colon cancer.” Pregnancy can cause hemorrhoids and intestinal changes in many people.
Colon cancer symptoms include:
- Changes in intestinal habits.
- Changes in stool quality, such as being thinner.
- Rectal bleeding
- Fatigue
- Anemia
John Marshall says pregnant people should report any intestinal changes to their doctors, as Garjales and Kelly did.
“Don’t be ashamed to talk about it. There are still many doubts when talking to the doctor about the intestines or about the blood,” she says. “Part of it is personal embarrassment, but make sure they know so they can give you proper attention.” Doctors can often perform an exam to see if someone has hemorrhoids.
Marshall highlights the importance of “raising everyone’s awareness and putting that in the doctor’s mind.” If he feels that his doctors do not take him seriously or ignore his symptoms, he may ask if his diagnosis is differential: if his symptoms match more than one condition.
Life today
Dealing with incurable cancer is sometimes difficult for Kelly. She accepts all surgeries and chemotherapies to “move forward and stay alive.” “I’ve had my good days and bad days,” she says, “I just have to be patient with myself to take it one step at a time.”
He enjoys time with his son, Colin, who will turn 3 in August. She credits her husband, Chris, and her family for helping her get through cancer treatment and raising a baby. Kelly is focused on “being very happy to have a child and have my husband.”
[Esta es la importancia de cuidar tus dientes durante el embarazo]
Grajales is currently cancer-free and is being followed up, which seems like a challenge.
“The anxiety that comes with these scans, the PTSD, the depression, is being drowned out,” he says. “You would think that after finishing chemotherapy and hearing ‘sure’, life would go back to normal. But it is absolutely heartbreaking and very scary.”
Although it is difficult to cope with the mental health difficulties of surviving cancer, she also embraces life in a way she did not before cancer. He likes to take his kids to the water park or Disney or just spend the day with them.
“I need to value life and appreciate the life that I have been given,” he says. “God gave me a second chance and I must take advantage of it and spread my story to help so many other people.”
Both women hope to raise awareness about colon cancer with the Colorectal Cancer Alliance. For her part, Grajales encourages others to speak up if they notice new symptoms or health problems. “Don’t stop,” she assures. “He keeps telling the doctors that something is wrong. Get the test you need.”
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