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Woman, 31, With Stage 3 Colon Cancer Says Doctors 'brushed Off' 1st Signs
When Kelly Spill was 8 months pregnant, she started experiencing new symptoms, including constipation and blood in her stool. Her doctor assured her it was part of pregnancy.
While pregnant and after delivering her son, Kelly Spill, then 28, experienced worrisome bowel symptoms. Doctors thought she had hemorrhoids but she began suspecting it was more serious. (Courtesy Kelly Spill)
"She pretty much said, 'You're having a baby in about a month, and things are moving around. Things are a little different in your body because you're about to give birth,'" Spill, 31, of Bradley Beach, New Jersey, tells TODAY.Com. "That made sense to me."
The symptoms continued for about eight months and worsened. Doctors kept telling her that her bowel habits had changed because she recently gave birth. Finally, a doctor ordered a colonoscopy, and she learned what was behind her symptoms. Spill, then 28, had stage 3 colorectal cancer.
"I felt very exhausted, and it made me second-guess what I was actually feeling because I was being brushed off," she says. "When you don't have someone listening to you, it's really, really hard to continue to keep going."
Pregnancy and bowel changesWhile Spill's doctor told her the symptoms were likely due to being pregnant, she became worried when they persisted and progressed, especially after she gave birth.
"I still was majorly constipated. I still had blood in my stool, and it was a dark, sticky type of blood, not bright red," she says. "I always feel weird saying this, but I know it's important to say that it had a weird smell to it."
When she visited her doctor for her postpartum checkup, she detailed her symptoms.
"They pretty much said they're 99.9% positive its internal hemorrhoids," she recalls. "That sounded right to me as a new mom."
Her doctor recommended that Spill visit her primary care physician if the symptoms persisted. Spill and her partner were in the middle of moving from California to New Jersey, but she visited her primary care doctor before leaving. He, too, thought it was internal hemorrhoids and ordered blood work, which came back normal.
"I was very stressed about moving back to the East Coast, and I was like, 'You know what? It seems like it's just internal hemorrhoids. I'm just going to put my health aside right now and focus on my child, focus on moving,'" Spill recalls. "That's exactly what I did."
When her son was 5 months old, Spill began experiencing new, worrying symptoms.
"I was experiencing loss of appetite. I'd be really, really hungry, and then I would want something, I would take a bite and I wouldn't be hungry anymore," she says, adding she lost 7 pounds. "That became alarming."
Spill struggled to work because she experienced fatigue and just didn't feel well. One day, when she used the bathroom, she felt stunned by what she saw.
"There was a pool of blood in the toilet," she says. "That's when I was like, 'Something's not right.'"
Spill and her mom went to the emergency room, where a doctor again told her she had internal hemorrhoids.
"He told me to lay off the spicy foods," she says. "(I felt) like I was brushed off."
She got into a new family clinic, and doctors again suspected hemorrhoids. But this time, she met someone who made a huge difference in Spill's search for a diagnosis.
"(The nurse) said to me, 'I just want to say one thing: If you don't find your answer here, keep searching. Keep going. You know your body best,'" Spill says. "That is something that has stuck with me from that day."
Participating in a clinical trial meant that Kelly Spill experienced fewer side-effects from treatment than she would have if she had surgery, chemotherapy and radiation. (Courtesy Kelly Spill)
Spill told friends and family about what she was feeling, and then a friend's mom suggested another primary care doctor. All this time, Spill had been taking photos of what was in the toilet and showed the new doctor.
"She was like, 'Oh, you need to get a colonoscopy, don't you?' And I said, 'Yes, 100% I need a colonoscopy,'" Spill says.
Soon she met with a gastrointestinal doctor and received a colonoscopy the next day.
"I found out that I had a tumor," she says. "It was a very weird feeling because I knew at that point something wasn't right. I knew it wasn't going to be good. But I didn't get upset until I left that room."
She broke down in the parking lot and cried. Soon, she learned it was stage 3 colorectal cancer. Doctors gave her time to preserve her eggs because she and her partner hoped to have another child, and chemotherapy and radiation would likely impact her fertility. At the time, she and her partner were engaged and planning to get married in Switzerland.
"I remember asking the doctor … 'Can I at least go to Switzerland this summer and get married?'" she says. "He basically was like, 'Absolutely not.'"
As she prepared for treatment, a research nurse approached her about a clinical trial. If Spill opted to do it and it shrunk her tumor, she could skip surgery, chemotherapy and radiation. If it didn't work, Spill would have to go through traditional treatment. She opted for the clinical trial for an immunotherapy drug. With cancer, immunotherapy activates the immune system to fight the cancer.
"I didn't know that I was only the fourth person in the country on the drug," she says. "I knew the side effects and knew that it sounded a lot better than chemotherapy, radiation and surgery."
Immunotherapy for colorectal cancerIn some colorectal cancers, the tumor has a genetic mutation called a mismatch repair deficiency, and immunotherapy works well in treating those cancers, Dr. Andrea Cercek, medical oncologist at Memorial Sloan Kettering Cancer Center, says. Researchers wondered if immunotherapy could replace the traditional standard of care — surgery, radiation and chemotherapy — for these types of colorectal cancers up to stage 3.
"We didn't take away any treatment (from these patients), but we started with immunotherapy," Cercek, a Stand Up To Cancer Colorectal Cancer Dream Team investigator, tells TODAY.Com.
For the study, which is ongoing, patients receive the medication, called dostarlimab, via infusion every three weeks for six months. Dostarlimab is already used in stage 4 colorectal cancer and other cancers, so the researchers had prior data on safety and dosing. After a patient completes therapy, doctors perform an MRI of the rectum and an endoscope to see if the tumor has shrunk.
"If the tumor was completely gone by the endoscopy, as well as the MRI, then the patients had what we call a clinical complete response, meaning that there's no sign of the tumor," Cercek says. "We are able to follow them really closely every four months with some evaluation."
Not going through traditional cancer treatment meant that Kelly Spill could get pregnant and carry a baby with the eggs she preserved prior to treatment. (Courtesy Kelly Spill)
The study has enrolled 42 patients. A global study with the same design is also ongoing. If the trials are successful, the treatment could be transformative for colorectal cancer patients with this mutation.
"We can spare patients the toxicity of the radiation and ... Surgery, which is a big deal," Cercek says. "If the patient needs surgery, about a third of them end up needing a permanent colostomy bag, and it can really change people's quality of life."
It's not yet clear how often the immunotherapy drug prevents recurrence of cancer and whether it can be effectively taken more than once, according to Cercek. Any patients in the trial whose cancer returns would receive the traditional treatment, she adds.
'Best day of my life'After Spill's second infusion, she noticed a difference.
"I felt great," she says. "I ended up being able to go to the bathroom. So, it seemed like the tumor was shrinking."
By her fourth treatment, her tumor had shrunk by half.
"By my ninth treatment, the tumor had completely disappeared, which was probably the best day of my life," she says.
Every six months, Spill undergoes screening, including a PET scan, an MRI and a sigmoidoscopy.
"I've been feeling amazing," she says.
What's more, she was able to get pregnant, and she gave birth to a daughter, Maya Grace, on July 14. Thinking about having another child kept her motivated as she struggled to be diagnosed and throughout treatment.
"I had a chance to bring another life into the world, and it's been very humbling," she says. "I feel so grateful for every opportunity that comes my way."
Having cancer caused her to reflect on who she is and what she wants.
"I (joined) a leadership program to learn more about myself," she says. "I've been on a big finding-myself journey for a long time now, and cancer has really pushed it along for me."
She participated in the recent Stand Up To Cancer telecast because she's experienced the power of new cancer research firsthand. Spill hopes her story encourages others to speak up when they don't feel right.
"Go with your gut when you feel something is up with your body," she says. "Really advocate for yourself, continue to push."
This article was originally published on TODAY.Com
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Brand New Mom, 28, Whose Symptoms Were Brushed Off As 'normal Part Of Pregnancy' Is Diagnosed With Stage Three COLON CANCER
A New Jersey woman was diagnosed with stage 3 colon cancer at age 28 after doctors dismissed her symptoms as 'part of pregnancy.'
Kelly Spill, now 31, was eight months pregnant with her first child when she started having constipation and blood in her stool.
Her doctors assured her it was normal, as she was so close to giving birth. But after eight months, her bowel habits continued to worsen. Still, doctors insisted the changes were from having just had a baby.
When doctors finally ordered a colonoscopy, they discovered stage three colorectal cancer, which has exploded into an epidemic in young Americans.
Kelly Spill, now 31, was diagnosed with stage 3 colon cancer at age 28. Doctors had dismissed her symptoms as pregnancy and postpartum-related
Ms Spill experienced constipation, blood in the stool, and a lack of appetite. When she noticed a pool of blood in the toilet one day, she knew something wasn't right
'I felt very exhausted, and it made me second-guess what I was actually feeling because I was being brushed off,' Ms Spill told TODAY.Com.
'When you don't have someone listening to you, it's really, really hard to continue to keep going.'
The blood in her stool, the most common symptom young people with colorectal cancer report, was blamed on pregnancy hemorrhoids, which can affect one in three pregnant women, according to the Cleveland Clinic.
Even after giving birth, doctors assured her it was a normal postpartum symptom. She was still constipated, and the blood in her stool was dark and sticky rather than bright red.
Ms Spill was also in the middle of moving from California to New Jersey at the time, so she thought stress may have been to blame.
However, when her son was five months old, her symptoms became even more concerning. She lost her appetite, becoming full after just one bite, and lost seven pounds.
Then, one day, there was 'a pool of blood' in the toilet. That's when she realized something was wrong.
At the emergency room, doctors told Ms Spill to lay off the spicy foods.
After seeing another primary care doctor and a gastroenterologist, she finally had a colonoscopy and was diagnosed with stage 3 colon cancer.
In the parking lot, she broke down crying.
Data from JAMA Surgery shows that colon cancer is expected to rise by 90 percent in people ages 20 to 34
The same data shows that rectal cancer will rise by 124 percent in the youngest age group
Colorectal cancer rates are on the rise worldwide, especially in people who are young.
Rates are expected to double in under-50s in the US by 2030, and colorectal cancer is also expected to become the leading cause of cancer deaths in Americans under 50 by the end of the decade.
This is based on data from JAMA Surgery, which found that between 2010 and 2030, colon cancer will have increased by 90 percent in people ages 20 to 34. Rectal cancer will have spiked by 124 percent in the same age group.
Cancers of the colon and rectum are the third most common type in the US and the third leading cause of death in both men and women.
The American Cancer Society (ACS) estimates about 153,000 colorectal cancer cases will be detected this year, including 19,500 among those under 50 years old.
Some 52,550 people are expected to die from the disease.
Experts are still working to unravel the cause of this devastating epidemic.
They have commonly blamed unhealthy diets, alcohol consumption, and sedentary lifestyles on this shift.
A study from the Cleveland Clinic suggested that eating red meat and sugar could lead to a higher chance of young people developing colorectal cancer.
However, some research suggests otherwise.
A 2021 study, for example, found that early-onset cancer patients were less likely to be obese or be smokers than their older counterparts.
A study published in April examined how being born via C-section influenced the chance of developing early-onset colorectal cancer. The researchers found that females born via C-section were more likely to develop colorectal cancer earlier in life than those born vaginally. There was no association among males.
Additionally, antibiotic use has been shown to impact this risk. One study in the journal Gut found that prolonged antibiotic use increased the risk of early-onset colon cancer. However, it was also associated with a lower risk of rectal cancer.
And one study showed that the fungus Cladosporium sp. Was more common in the tumors of young patients than in older individuals.
It's still unclear how Cladosporium sp. Could lead to this increase in cases, but the researchers think it could damage cell DNA. This could turn them into cancerous cells.
These environmental factors have a lasting impact on the gut microbiome, which experts think could increase the risk of colorectal cancer, even when exposure is limited to early life.
Ms Spill started experiencing symptoms when she was eight months pregnant with her first child. After diagnosis, she froze her eggs and has since given birth again to a daughter
Ms Spill wasn't able to get married in Switzerland like she planned after diagnosis, though she and her partner did eventually wed in Washington state
At the time of her diagnosis, doctors told Ms Spill it was time to preserve her eggs before chemotherapy and radiation so she could have another child later. She and her partner were also planning on getting married in Switzerland. When she asked the doctor if she could still do that, he said 'absolutely not.'
As she prepared for treatment, a nurse asked her if she would be willing to participate in a clinical trial for an immunotherapy drug. If it shrunk the tumor, she could skip chemo and radiation.
The trial is still ongoing and has enrolled 42 patients so far. It involves patients receiving the medication dostarlimab via an infusion every three weeks for six months.
Ms Spill noticed a difference after her second infusion and 'felt great.'
After four treatments, her tumor had been slashed in half.
By the ninth treatment, the tumor was completely gone. She said it was 'probably the best day of my life.'
Ms Spill is far from the only young patient who has had their symptoms dismissed by doctors.
Part of what makes colorectal cancer difficult to diagnose is its symptoms, which can often be attributed to other conditions. However, some stand out more than others.
A study published earlier this year in the Journal of the National Cancer Institute found that the most reported symptoms were abdominal pain, blood in the stool, diarrhea, and iron-deficiency anemia.
Additionally, in a 2020 survey by Colorectal Cancer Alliance, 68 percent of participants said they experienced blood in their stool. The average participant age was 42.
The same survey also found that many patients with colorectal cancer symptoms were initially misdiagnosed or dismissed.
Spending longer amounts of time without a diagnosis could allow colorectal cancer to advance to later stages, making it more difficult to treat.
Ms Spill has since gotten married and had her second child, a daughter named Maya Grace. She also encourages others to speak up when they feel something isn't right.
'Go with your gut when you feel something is up with your body,' she said. 'Really advocate for yourself, continue to push.'
What To Know About Stage 3 Melanoma
Stage 3 melanoma is a skin cancer that has spread to the lymph nodes and areas of skin near the primary tumor. Depending on the tumor's thickness, doctors may treat stage 3 melanoma with surgery and other treatments.
Doctors classify melanoma according to stages that relate to whether the tumor has spread.
After staging the cancer, they can recommend a suitable treatment plan.
This article discusses stage 3 melanoma. It looks at its symptoms, causes, treatment options, and more.
Melanoma is a type of skin cancer that occurs when the cells that give the skin its color (melanocytes) grow out of control.
The American Cancer Society (ACS) states that the staging system that doctors use to classify melanoma derives from three key pieces of information:
Stages 3A to 3D involve the tumor being between 2 millimeters (mm) and 4 mm thick. Stage 3 means the cancer has spread to at least one lymph node and small areas of nearby skin. However, in stage 3 melanoma, the cancer has not spread to distant parts of the body.
In comparison, stages 0–2 mean that the tumor may be more than 4 mm thick but has not spread to lymph nodes or other parts of the body. In stage 4 melanoma, the tumor may be any thickness, may be ulcerated, and has spread to distant lymph nodes or organs such as the lungs, liver, or brain.
Learn more about melanoma stages.
New spots or moles on the skin or ones that change size, color, or shape are important warning signs of melanoma. The ABCDE approach is a visual guide to melanoma signs:
Learn more about the ABCDEs of skin cancer.
Not all melanomas fit these characteristics. Other signs include:
Additionally, melanoma can start in places other than the skin, such as under nails, inside the mouth, or in the eye's iris.
Furthermore, a person with stage 3 melanoma may have additional signs and symptoms if the cancer has spread to other body parts. It is important to inform a doctor about every symptom a person may be experiencing.
Learn more about melanoma symptoms.
Scientists don't know exactly why some moles turn into melanoma. However, researchers have found that gene changes inside mole cells may cause melanomas to develop.
A person may acquire gene changes during their lifetime or inherit them. Acquired gene changes may be due to the effects of ultraviolet (UV) rays that damage cells.
Learn about the risk factors of skin cancer.
If a doctor suspects melanoma, they may refer a person to a dermatologist for further investigation. A dermatologist is a doctor who specializes in skin conditions. They may use a technique known as dermoscopy to look at spots and take an image of the affected area.
Various tests can help with diagnosing and staging melanoma. A skin biopsy involves removing a sample of the affected area for analysis under a microscope.
A doctor may also order imaging tests to see whether or how far the cancer has spread. These include:
A person's doctor will be able to advise on the tests they order and what they involve.
Learn about screening for skin cancer.
There are two main types of surgical treatments that doctors may recommend for stage 3 melanoma: Wide excision of the primary tumor and lymph node dissection.
Wide excision of the primary tumorWide excision of the primary tumor is a fairly minor operation that may be suitable for most thin melanomas.
Doctors inject a local anesthetic into the area to numb it before cutting out the tumor site along with a small margin of skin around the edges.
Medical professionals view the sample under a microscope to ensure that there are no cancer cells left at the edge of the area.
Lymph node dissectionLymph node dissection involves removing all of the lymph nodes near the primary tumor.
The ACS notes that it is unclear if lymph node dissection can cure cancer that has spread to these areas, but some doctors believe that it may prolong a person's life and ease the pain of cancer growing in the lymph nodes.
Complete lymph node dissection may cause long-term side effects, including lymphedema, in which fluid builds up, causing swelling and an increased risk of infection.
A person's doctor can advise on ways to reduce the risks of long-term side effects and how to manage any that develop.
Learn more about lymph node dissection.
Other treatmentsOther treatments that doctors may recommend for stage 3 melanoma include:
Here are some frequently asked questions about stage 3 melanoma.
Is stage 3 melanoma curable?The ACS notes that wide excision of the primary tumor will cure most thin melanomas. However, it also states that current treatments may not cure some people with stage 3 melanoma.
It is best for a person to speak with their doctor about their treatment options and outlook.
What is the survival rate of stage 3 melanoma?According to the ACS, survival rates derive from the Surveillance, Epidemiology, and End Results (SEER) database, which groups cancer by factors other than stages. The five-year relative survival rate for regional melanoma that has spread to lymph nodes is 71%.
Is stage 3 melanoma considered advanced?Stage 3 melanoma is an advanced type of melanoma. It is more advanced than stages 0–2 but less advanced than stage 4 melanoma.
Stage 3 melanoma is a cancer that starts in the cells that produce skin color. It spreads to nearby areas of the skin and lymph nodes, but at this stage, it is not present in other organs. Symptoms can include an irregular, new, or growing mole or spot.
Skin biopsies and imaging tests can help doctors to diagnose and stage cancer. Doctors can treat stage 3 melanoma with surgery and other therapies such as radiation therapy and chemotherapy.
It is best to contact a doctor for advice as soon as a person has concerns about melanoma.
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