Arts administrator Niamh Ferry is upbeat and articulate about her experience of bowel cancer. Keen to break down any stigma attached to bowel cancer screening, home testing kits and colonoscopies, she speaks frankly about her diagnosis, treatment and recovery.
Aged 40, and just about to start another round of fertility treatment, Ferry noticed a change in her bowel habits. “I was on a diet at the time and didn’t connect blood in the toilet bowl with bowel cancer. But, because my mother had been diagnosed four years earlier with bowel cancer, I decided to send off a stool sample. Two days later, I got a call to say that there was a high percentage of blood in my stools, she explains.
With alarm bells ringing, Ferry returned to her GP [who had previously put her and her siblings on a list for bowel cancer screening at 50 — 10 years ahead of the national bowel cancer screening programme] and was referred as a private patient for a colonoscopy one month later. “My husband was invited in with me to get the results so I knew it must be bad news. I immediately thought my mother died from this so how will I survive, but scan results a few days later showed that the cancer hadn’t spread beyond the colorectal region.”
Ferry’s proactive move to order an online home-test kit for bowel cancer was the key to the subsequent discovery of the tumour. It’s important to note that the home test kits can detect blood in the stools that is not visible to the human eye.
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Ferry went on to have five cycles of chemotherapy, followed by 30 days of combined chemotherapy and radiation treatment to reduce the risk of local spread and to shrink the tumour before surgery.
Hysterectomy decision
Sadly, her treatment for bowel cancer put paid to her fertility treatment and she opted to have a full hysterectomy as well as bowel cancer surgery in March, 2022. Both surgeons used keyhole surgery which makes recovery less arduous. “Having a hysterectomy as well was an emotional decision but bowel cancer treatment had already taken away my chances of having a baby,” explains Ferry.
She recovered well following her 10-day hospital stay. “I was feeling great. I was up and moving around within a day of my surgery. I have a temporary stoma which diverts waste … and I’ll have that removed soon,” she explains.
During her treatment, Ferry says that she was particularly inspired by Deborah James, the English journalist, educator and podcast host, who challenged taboos to change the conversation around cancer, following her diagnosis with incurable bowel cancer in 2016. James also raised millions for cancer research before her death in June, 2022. Don’t sit on your symptoms is a popular slogan promoted by James and others to encourage people to get potential symptoms of bowel cancer checked out.
Looking back at her earlier lifestyle, Ferry acknowledges that while she was active in her 20s, she became more sedentary in her 30s and often spent up to 10 hours at her desk. “I lived on fizzy drinks as I didn’t drink tea, coffee or water and I was someone who went on lots of diets.”
Her recovery from surgery has prompted many changes to her lifestyle. “I’m just about to start a new job. My husband and I have moved to live beside the sea and we have a puppy now,” she says.
Following her diagnosis and treatment for bowel cancer, Ferry also made some changes to her diet. “I don’t drink fizzy drinks anymore. I drink water. I don’t eat red meat or processed foods and I dabble in veganism. I try to have an active life but I’m not a perfect person,” she adds.
Prof Reza Kalbassi, consultant colorectal surgeon at the Beacon Hospital in Sandyford, Dublin who was Ferry’s surgeon says that specialists are now seeing more and more cases of bowel cancer in younger people. “We are seeing an increase in cases in people aged between 20 and 49. Young people are living a different life to those in their 50s and 60s. They are going on more holidays and eating all the wrong foods — chips and cheap alcohol — and this is impacting on their bowel health,” says Prof Kalbassi.
He says that many younger people leading busy lives ignore blood in their stools, often dismissing it as a symptom of haemorrhoids. “Older people have more time to think about these things and are more likely to have them checked out,” he adds.
Carrying excess weight and eating a lot of processed foods and drinking too much alcohol are all risk factors for bowel cancer. Unexplained weight loss or fatigue and abdominal pain or discomfort are other potential warning signs. Anyone whose parent died of bowel cancer is also at increased risk of getting this cancer but as with many cancers, early detection is key to successful treatment.
Prof Kalbassi says that all GPs should carry out a thorough rectal examination on any patients presenting with blood in their stools and send patients with a family history of bowel cancer to a consultant even if they don’t have any symptoms.
“With a colonoscopy, we take a biopsy and diagnose as well. If there are benign polyps, we will remove them during the colonoscopy. People are frightened of colonoscopies but you remember very little from the 30-minute procedure as you are under conscious sedation,” he explains.
Every year, more than 3,000 people are referred for colonoscopies through BowelScreen, the national bowel cancer screening programme to have pre-cancerous growths (polyps) removed.
Early detection
In general, Prof Kalbassi — like many of his colleagues — is concerned about the low uptake of BowelScreen.
“The uptake is poor — about 40 per cent — because people are frightened of it but the survival rates for bowel cancer have improved significantly over the last 10 years, especially when it is detected early,” says Prof Kalbassi.
Available free every two years to those aged 60-69, it involves sending a stool sample by post following the receipt of your free home test kit. Those in the specified age group can register online on bowelscreen.ie or 1800-454555.
In many other European countries, bowel cancer screening programmes are available to those aged between 50 and 75. In the United States, bowel cancer screening is available to those aged between 45 and 75. And the HSE is expanding screening gradually with the ultimate aim to offer bowel screening to everyone aged between 55 and 74 as part of the National Cancer Strategy 2017-2026. Efforts are also being made to reach people (for example Travellers and migrants) through new materials and multilingual videos.
About 95 per cent of those who do the home-test kit will get the all-clear, with about 5 per cent referred on for a colonoscopy.
Ferry will continue to have scans and blood tests every six months and an annual colonoscopy to make sure her cancer doesn’t return. “She will be watched carefully for the next five years,” says Prof Kalbassi.
