A gynaecologist who discovered her own stage four cancer has said she was only experiencing two mild symptoms at the time.
Dr Lauren Juyia found she had stage four colon cancer after she booked herself in for an ultrasound. The doctor began feeling fatigued in August last year but had initially put it down to just part of life - until it was paired with a sense of "pelvic heaviness", which left her feeling something was wrong. But then the sense of heaviness turned into her feeling a "pelvic mass.
The scan found that she had a larger than normal mass forming by her ovary. Dr Juyia was soon diagnosed with stage four colon cancer.
She told Good Morning America: "Having a background in obstetrics, we describe size by weeks of pregnancy and so I was like, 'Oh my god, I have a 16-week-size mass.' From experience, I could tell that this was my ovary."
The doctor, from Florida, US, consulted with other doctors and sought multiple opinions, and said she knew it wasn't "going to be good" when the mass grew in size from 8cm to 24cm in the space of two weeks. Dr Juyia said she had "never seen anything benign" grow that fast so had suspicions that the masses would be cancerous, but had initially assumed it was ovarian cancer due to the placement of the masses. However, she then found out she had colan cancer.
By September 2022, she was undergoing surgery to have the masses removed after they had spread to her ovaries, uterus, omentum, appendix, and even her abdominal area. The doctor insisted that despite the rapid growth of the masses, she wasn't experiencing any severe symptoms, and aside from the "pelvic heaviness" she could feel, her only other symptom was fatigue.
She explained: "I was a little tired in the afternoon for about two months previous to this and as a mum with two little kids - I had been recently nursing them, they were still waking up in the night, I work full time - I didn't think anything of saying, 'Oh, I think I need a tea in the afternoon.' Whereas maybe someone in their 50s or 60s would be much more tired from stage 4 tumours taking up their energy."
According to the NHS, other symptoms of colon or bowel cancer can include changes to your stool - such as having diarrhoea or constipation that isn't normal for you or having blood in your stool - as well as stomach pains and unexplained weight loss. Dr Juyia was eventually diagnosed with stage 4 colon cancer and began six months of chemotherapy treatments, during which time she kept working in order to take her mind off of her health battle.
She explained that helping her patients was "therapeutic" for her and helped her "forget [she] was ill". In late March, Dr Juyia underwent one more surgery to remove an inactive tumour, and so far, tests have shown she has "no evidence of disease."
And now, the mum-of-two wants to encourage others to be mindful of the early warning signs of the disease such as fatigue and a sense of "pelvic heaviness" - especially for those of a younger age. In the UK, bowel cancer screening is available to anyone aged 60 to 74 and is currently being expanded to also include everyone between 50 and 59.
But Dr Juyia has urged those younger than the screening age - which is 45 in the US - to pay attention to their symptoms, as they may go unnoticed for longer and could pose a risk if not taken seriously.
She said: "People that are younger than the screening age should still be paying attention to our symptoms because we're not eligible for screening usually. We might not have any symptoms because we are young, our bodies are more resilient. We can tolerate more symptoms.
"We just need to be aware if we're not lucky enough to be in the range where we should be screened. And if you are in the range that you should be screened, take advantage of that. Don't squander that opportunity. There's a reason we want to screen you and keep you safe."
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