Bowel cancer: ‘People can feel embarrassed to speak about bodily functions, but don’t suffer in silence’

Jennifer McEntee, 34, had struggled with symptoms of irritable bowel syndrome (IBS) for many years – so much so that the bloating, cramping and irregular bowel movements had become part and parcel of her life. Food intolerance tests showed nothing out of the ordinary and as she also suffered from polycystic ovary syndrome (PCOS), she underwent blood tests ever six months, which revealed low levels of iron.

She raised concerns about bloating with her GP on several occasions and was told that it was most likely due to PCOS. So, as a young, healthy woman, she didn’t think that anything serious was wrong until last year when she noticed some blood after going to the toilet and immediately made an appointment to see her doctor.

“In 2021 my symptoms had increased in intensity, with severe bloating every time I ate and I was having to either run to use the toilet or not having a bowel movement for days,” she says. “My iron was very low as always and it was a difficult time as my dad was very sick, so I assumed that the stress and worry was upsetting my stomach. But after he began to recover and came home, my symptoms still persisted and one day, in February, 2022 I noticed a small amount of blood in the toilet. It gave me a bit of a fright as I’d never noticed blood before, so I made an appointment the next day to see my GP.

“She said it was likely to be internal haemorrhoids, but said she would book a sigmoidoscopy (an examination from the rectum to the nearest part of the colon/large intestine, the sigmoid colon) for me. My records showed I’d been to see her with similar symptoms, without bleeding, back in 2017, so I was relieved that it was being investigated further.

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Further tests revealed a mass ‘the size of a large orange’, and although it wasn’t officially confirmed at that stage, she was told that she mostly likely had cancer

“While waiting for the appointment, I began to severely lack energy, to the point that I’d fall asleep at work, get intense pain on my left side when exercising and gurgling in my stomach which would keep me awake at night.”

In April 2022 the primary schoolteacher underwent the sigmoidoscopy and was told that the area was inflamed, that biopsies had been taken and further investigation was needed. But as the “conversation was casual”’, she didn’t feel any concern about her health and was just worried about taking more time off work for the required colonoscopy which would take place the following week.

However, she had much bigger things to worry about as further tests revealed a mass “the size of a large orange”, and although it wasn’t officially confirmed at that stage, she was told that she mostly likely had cancer.

#NoRegrets

April is Bowel Cancer Awareness month, when medical experts aim to highlight the signs of this cancer which is often diagnosed at a later stage as some patients feel embarrassed about discussing intimate details with their doctors. The Marie Keating Foundation is urging people to have #NoRegrets and to seek advice if they notice any of the symptoms associated with bowel cancer.

Symptoms include blood on or in bowel movements, diarrhoea or constipation for no obvious reason which lasts longer than six weeks, unexplained weight loss, pain in abdomen or rectum and a feeling of not having emptied the bowel property after going to the toilet. Although some people have very obvious signs, others may have more vague symptoms – but all, like Jennifer, will need to undergo tests to confirm or rule out cancer.

I can’t remember how I told my parents but I know it absolutely devastated them and they kept saying they wished it was them instead of me

—  Jennifer McEntee

“The days following the colonoscopy were a blur of scanning machines to see if it [the cancer] had spread to other areas, explaining and processing everything with close friends and family, and packing up my classroom,” she says. “This broke my heart as I adored my job and didn’t get to say goodbye to my lovely first class students. In their eyes, Ms McEntee just disappeared. It made it feel so real. I can’t remember how I told my parents but I know it absolutely devastated them and they kept saying they wished it was them instead of me.

[ Bowel cancer: what to do and how to recognise the symptoms ]

“It might seem strange, but guilt is something I felt so strongly throughout my diagnosis and treatment as I was the cause of everyone around me feeling so sad and putting their lives on hold, holding their breath and my hand as I entered a whirlwind of scans and surgery followed by six months of intense chemotherapy.

“My husband, Dave, and I fell apart together when visitors left. As a young couple planning exciting getaways and home renovations, suddenly we were thrown into incredibly tough conversations about finances, fertility, the possibility of him being my carer during chemotherapy and, sadly, death creeps into those conversations also. We didn’t know what was ahead of us but we knew we would approach everything head-on, as positively as possible, as a team. I know how difficult I found it all but what partners and parents of cancer patients go though is equally devastating.”

Three weeks after the life-changing diagnosis, she underwent surgery to remove the tumour along with 15cm of her bowel and 27 lymph nodes. Further tests revealed that she had stage 3 cancer and would need six months of chemotherapy – something, she wasn’t mentally prepared for.

“Because I had recovered so well and without complications from surgery, I was ready to move on and get back to my normal life, but it wasn’t to be,” she says. “The thoughts of chemotherapy absolutely terrified me and I needed 12 rounds of it. I remember waiting for my infusion in a room waiting with five men of similar age to my dad or older. That was probably one of the hardest-hitting moments. But I also remember thinking that the day oncology ward wasn’t as scary as I expected, as everyone was so lovely and we were all there for one reason – we desperately wanted to live and enjoy life again.

“I had three days of chemotherapy, repeated 12 times over six months, and the side effects were brutal – there were times when I was so unwell that I didn’t see myself being strong enough to make it to the 12th round. My white blood cells were so low that I had to inject myself after each round to stimulate my bone marrow to create more, and the pain caused by those injections alone were awful.

‘Positive mindset’

“But the support I received from my husband, family, friends, colleagues and neighbours was just incredible. From texts of support, voice notes to listen to during chemotherapy, offers of lifts to appointments, endless food and care packages, invites for walks, coffees or lunch on my good days to just listening to my worries, I know my positive mindset throughout was down to the incredible people around me.

“I found having something nice planned after each round of chemotherapy helped and gave me such a boost. There are so many incredible services available to support cancer patients and their families and I also connected with others with a similar diagnosis through social media. This was important to me, as there was such comfort in knowing how I was feeling and the side effects I experienced were normal. Reading survivor stories were invaluable, particularly on tough days.”

[ 'I didn't cry but my parents were upset. I think I was probably in denial' ]

The Kildare woman was lucky that she was diagnosed in time and is now doing well. But she advises others not to ignore symptoms, no matter how young or healthy they may feel. “My latest scan showed no evidence of disease and I’ll be monitored closely for the next five years,” she says. “I have long-lasting side effects from chemotherapy, but it’s a small price to pay for my good health.

For anyone experiencing symptoms of bowel cancer, please speak to your GP. And if you’re not happy with their opinion or if symptoms persist, ask for a second opinion

—  Jennifer McEntee

“I was diagnosed and treated within nine months, which I’m incredibly grateful for, but it was such a whirlwind that I’m still processing it all. The fear of reoccurrence will always be there and cancer has confirmed what I already knew: health is everything, I have the most amazing people around me and I love my life.

“To anyone just diagnosed, I would say that although it’s overwhelming, you are so much stronger than you think. It sounds very simple, but talking helps so much, so don’t keep how you’re feeling to yourself. There is free counselling available for you and your family through the cancer support centres – so let others help and take someone with you to your appointments to take notes, support you emotionally and advocate for you if needed. Connect with others with a similar diagnosis though social media support groups. But mostly, just be kind to yourself and take one day at a time.”

Jennifer says it is also really important not to put off going to the doctor, as early intervention could save your life. “People can feel embarrassed when speaking about bodily functions, but don’t suffer in silence,” she says. “In Ireland, screening for bowel cancer is available for people over 60, yet colorectal cancers are rising at a frightening rate among young people.

“For anyone experiencing symptoms of bowel cancer, please speak to your GP. And if you’re not happy with their opinion or if symptoms persist, ask for a second opinion. You know your own body best, so trust your instincts because unfortunately, you are never too young.”