Regular user
Male 40 y.o.

My (now) fiancé was diagnosed with Bowel cancer in July 2019. Being only 31, it took some time for various GPs to take her symptoms seriously (this is despite Bowel cancer being prevalent in at least the last 3 generations of her family, and often under the age of 50).

The original CT scan showed stage 4 disease with a large (c10cm) tumour in her sigmoid colon, a suspected ovary met and deposit on her peritoneum. It's been a long journey since then! She commenced in 4 cycles of Folfox before a re-staging CT scan showed a good response. She then suffered a bowel perforation and was rushed to St Mark's overnight where they managed to clear the area and undertake a loop ileostomy while doing a staging laparoscopy. We then had great news that the laparoscopy showed no visible peritoneal disease but her amazing surgeon (Mr Antoniou) decided to proceed with HIPEC anyway given the risk the perforation created.

An MRI scan was undertaken to help plan the operation, which showed that the tumor was pressing against her iliac vein. The planned operation was then postponed pending vascular review - the week or so that followed was horrific. The vascular surgery team were then consulted and undertook a FemFem crossover operation in late October (bypassing her iliac artery and vein to make way for the main operation). This ended up being a c5 hour procedure. She then remained at St Mark's for a week before having the main CRS HIPEC surgery (c10 hours, which included resection of her sigmoid colon a total mesorectal excision, an element small bowel resection, peritonectomy, total hysterectomy and the removal of both ovaries (by a county mile the longest day of my life). This was followed by 5 days in intensive care and a further 10 days recovering on the ward. All in all, it was pretty radical stuff. I spent almost a month at the premier Inn in Harrow, and our poor cat must have wondered what was going on!

After a few weeks we got amazing news, R0 resection, the cancer was pathologically staged as T4a+b, N0,M0 - it was stage 2, with no metastases and all 42 lymph nodes removed being clear, albeit with high risk factors of EMVI and perineural invasion. For this reason 8 cycles of adjuvant FolFox was completed (making up the total to 12 cycles) with her wonderful oncologist (Dr Krell) at the Royal Free. We got engaged over Christmas and the end of treatment scan showed an all clear in May. We are now on the standard surveillance pathway.

St Mark's are also looking after her at the Family Cancer Clinic given they suspect that she has lynch syndrome. The tumour showed PMS2 mutation and initial bloods showed deficiency of the MLH1 gene of unknown significance, more tests pending but given all of this and the family history it seems pretty certain.