Three years ago, Samantha and Tony Cook lived a nomadic lifestyle.
The couple worked in the shearing industry and travelled far and wide across the outback to sprawling sheep stations.
But their lives took a drastic turn in late 2019.
"We jumped on the motorcycle to go for a holiday … then one morning Tony got sick [and started vomiting]," Samantha says.
It took a week and two hospitals to discover Tony had stage-four brain cancer.
It was terminal, and he was told he had three months to live.
"I thought I'd been scared at times in my life before, but never anything like that moment," Samantha says.
"Your whole world falls apart, everything you know just stops."
Almost immediately, Tony was taken into surgery and signed up for a strict regimen of chemotherapy and radiation treatment.
Doctors told the couple if they ever wanted to have children, now was their only chance.
"We went to a fertility clinic, but it turns out we didn't need it … because we got pregnant straight away," 36-year-old Samantha says.
The couple were overjoyed, but Tony says he had lingering moments of anxiety and guilt about not being alive to see his son grow up.
"I thought, 'If their diagnosis is true, what have [I] created?' I've left Sam with a baby on her own to fend for herself," he says.
Samantha says people might think the couple are "crazy" for having children, given Tony's diagnosis.
"But nobody is guaranteed that their parents will be around," she adds.
Another curveball
The couple's joy was short-lived when they were thrown yet another curveball during Samantha's 12-week pregnancy scan.
"[The sonographer] did a regular ultrasound, then asked to do a more invasive scan — straight away I thought, 'Oh my goodness,'" Samantha says.
Doctors detected a large mass on her left ovary.
It was early-stage ovarian cancer.
Two weeks later, Samantha was back in hospital — just three months after Tony's diagnosis — to remove the ovary, all while preserving her baby's life.
"Tony, he's my hero in the story," Samantha says.
"If it wasn't for him, the outcome would have been a lot worse. He saved my life."
The surgery was a success and months later, Samantha gave birth to their son, Wyatt.
"It was the most amazing moment," Samantha says.
Tony says he's keenly aware of just how lucky they were to catch Samantha's cancer.
"If we had delayed it for another two more years to have children, that cancer would have spread, and it could have been a death sentence for her," he says.
Silent and deadly
Ovarian cancer is considered the deadliest women's cancer because symptoms can be mistaken for other benign conditions.
The disease is typically associated with women twice Samantha's age and has a survival rate of 49 per cent.
Gynaecological oncologist Nimithri Cabraal from the Mater Hospital in Brisbane operated on Samantha and says ovarian cancer during pregnancy is uncommon.
Dr Cabraal says the disease is extremely difficult to detect.
"The symptoms of ovarian cancer are vague and many women complain of symptoms such as bloating and appetite changes," she says.
"Often women who have early-stage cancer have masses that are confined to the ovary, but masses in the ovary don't necessarily mean you have cancer … and a mass as large as 10 or 15 centimetres doesn't cause a lot of symptoms."
A lack of effective early screening tests means women have little agency in seeking a diagnosis, Dr Cabraal says.
"We also don't have anything preventing ovarian cancer either," she says.
"The only exception is women who have a known genetic cause for ovarian cancer."
Travelling for treatment
Fast forward three years, and the Cook family now live in the small town of Blackall in outback Queensland.
Wyatt is the big brother to four-month-old Aspen.
The family travel back and forth to Brisbane — 10 hours' drive away — for Tony's chemotherapy every three months, which all takes a toll, Samantha says.
"It costs money to be away from home, especially with kids," she says.
At the last count in 2020, there were 107,000 people living with cancer in regional and remote Queensland, according to the Cancer Council.
That figure makes up 39 per cent of all people living with cancer across the state.
While some cancers can be treated through local health services in outback Queensland, the majority of patients need to travel to metro hubs to receive treatment.
"We do often hear issues with people needing to travel … some of the additional impacts can be on employment, financial stresses as well as the health and wellbeing of caregivers," says Cancer Council Queensland's head of service delivery Gemma Lock.
"There is certainly room for improvement to help people access support and information during a cancer diagnosis."
Samantha says she's had no complications as a result of her cancer, and now considers herself cancer free, but that doesn't mean it won't return.
Tony has outlived every prediction made by his doctors, but he's aware his situation is still terminal.
"There's no point sitting around sulking over stuff," Tony says.
"Life goes on."
Remaining positive is what keeps the couple going.
"We've got two little kids that we need to be around for. No-one really knows how much time [we've] got, so we just live every day," Samantha says.
"Not every day is a good day … but we take it as it comes."
