I ignored warning signs because I ran 10ks – but then doctors found a 5cm tumour in my lower colon
When I messaged my friend Simon to tell him I’d been diagnosed with bowel cancer, his reaction surprised me. ‘Bet you wish you’d eaten more bacon sandwiches,’ he texted back.
Simon is a rugby-playing bon viveur who has little time for ‘wusses’ like me who do Pilates, go running, eat salad three times a week and only drink alcohol on weekends. In his own clumsy way, it was the irony he was alluding to. Of all his friends, I was probably the most health-conscious, yet I was the one with a 5cm tumour in his lower colon.
Deep down, I agreed with him. It wasn’t fair. I didn’t deserve this.
I was diagnosed the day before ‘Freedom Day’ – Monday 19 July 2021, when the majority of the remaining lockdown restrictions were lifted. I was 52, living in south-east London with my partner Bethan and our daughters Ava and Georgia, then 14 and 10.
My job as a freelance writer and editor meant I was deskbound but I had an active lifestyle. On both the Friday and Saturday before my Sunday-morning colonoscopy, for example, I’d played 90 minutes of competitive 11-a-side football.
At the time of my diagnosis, I didn’t feel tired, I had no pain; I was the picture of health. But about seven months previously, at the end of 2020, I’d noticed blood in my stool. To begin with, it came and went. Whenever it stopped, I said to myself, ‘Great, I’m better.’ But then a few weeks later it would happen again.
When I eventually told Bethan what was going on, she rolled her eyes. ‘Don’t be a bloke about this,’ she said. ‘Just call your GP.’
I promised I would. Instead, I put it on the back burner and hoped it would go away. There were plenty of distractions: we were trying to keep our girls sane through the grim days of lockdown, and we’d just bought a puppy. And anyway, I felt fine.
So I delayed my diagnosis for much longer than I should have done – vital weeks that could have changed the nature of my treatment radically – because I simply couldn’t believe I was ill. My rational brain told me: ‘You need to get this checked out.’ My irrational brain said: ‘You can’t be seriously ill – you just ran a 10k.’ And so I put it down to internal haemorrhoids.
Things came to a head one day in May 2021. I’d been for a long run and afterwards, when I went to the toilet, there was a lot of blood – more than ever before. I couldn’t ignore it any longer. The problem was, we were about to set off for a half-term break, so I resolved to call my GP on our return – but then we all tested positive for Covid. Cue another month’s delay.
With hindsight, I was living in a state of denial, but it was easy to put things off. When I finally secured a phone appointment with a GP, she reassured me it was ‘probably just piles’ and arranged an appointment with the nurse at a local health centre 10 days later.
The nurse didn’t pull any punches. As I sat down, she looked up from her notes and said, ‘Why are you here?’ I began explaining my symptoms. She raised a palm. ‘No. I mean, what are you doing here? You should be in the hospital right now having a colonoscopy. Everything about this says cancer.’
It was like a bucket of freezing-cold water in the face. I immediately called my GP surgery and was booked in for a colonoscopy at King’s College Hospital the following Sunday.
The most surprising thing about a colonoscopy is that you can see the screen while it’s happening. So, after 20 seconds, when the camera suddenly encountered what doctors call a ‘mass’, my stomach lurched. To compound my dread, a tiny metal arm resembling Alien’s secondary jaw then shot out from below the camera and took a bite out of the lump for analysis.
After the procedure, while everyone else in the recovery room was being given a biscuit and sent home, I was told to phone my partner and wait in a separate room. Still, the voice in my head said, ‘It might not be cancer.’
As soon as Bethan arrived, the surgeon came in. He got straight to it. ‘We won’t have confirmation until the biopsy results come back, but it is my professional opinion that you have cancer,’ he said.
The first emotion I experienced was a kind of grudging acceptance that I was going to die. The word ‘cancer’ is so freighted with dread, hearing it feels like a death sentence. I started to cry, but I was strangely calm. I remember thinking: ‘But my life hasn’t even properly started yet.’
The second emotion was a wave of self-loathing. Deep down, I’d known I was ill months before. Anyone with blood in their stool and access to Google had to have an inkling something was up – and Deborah James’s game-changing campaign around bowel cancer had raised even more awareness of it, and of the fact that it kills more than 16,800 people each year in this country. Yet I’d ignored it. Now, I was convinced I was going to leave my children fatherless.
Thankfully the surgeon was upbeat – he told me he’d had bowel cancer the previous year and he’d played football with his son that morning. Bowel cancer, he said, was very common – and very treatable. This was just what I needed to hear. I told myself that I had some hideous months ahead, but I would be fine.
A fortnight after I received my diagnosis, Bethan and I took a call from my specialist cancer nurse with the results of my first CT scan. We hid away in our shed to answer it because we hadn’t yet informed our daughters, but midway through the conversation Ava knocked on the door demanding to know what we were doing. ‘Talking to a mortgage advisor,’ we lied. She beat a hasty retreat.
My cancer, the nurse said, was stage three, which meant I would need chemotherapy, radiotherapy, an operation, followed by more chemo. After my op, I would also have a loop ileostomy, or stoma, for a year, to allow my insides to heal.
That sounded bad enough, but she added that there was also reason to believe the cancer had spread to my liver, which meant my treatment would last two and a half years. I don’t remember the rest of what she said. All I could think was: ‘I’m going to die.’ Even if I made it, I imagined myself as being prematurely elderly.
I lived under that cloud for a week, until the hospital performed a close-up scan and the nurse rang with good news: the mark on my liver was not cancer. Compared with what I’d confronted previously, now my treatment sounded like a breeze: only 18 months.
We told Ava and Georgia shortly after. They cried, but seemed to bounce back. Within an hour they were asking what was for dinner. Perhaps they were relieved we weren’t separating, which is what you assume when your parents assemble you on the sofa for ‘news’.
I felt reassured that they were robust enough to deal with my illness, to take it in their stride. They did, up to a point, but their trauma revealed itself in different ways. Even now, Georgia is so anxious about death, she refuses to attend religious studies lessons at school.
During my first meeting with my oncologist, in August 2021, she told me that people like me (52, physically fit, no relevant family history) rarely used to get bowel cancer, but there had been a huge spike in the number of ‘young’ people being diagnosed. My next question, naturally, was: ‘Why?’ She shrugged. ‘We don’t have the data.’
There is now a study underway, though it is a five-year project. But you don’t need to be a scientist to make the connection between a tumour in your digestive system and the food you put into your body each day.
In those early days, I kept asking myself if I was to blame for my cancer. I mentally divided my lifestyle into ‘good’ and ‘bad’ lists. Before my diagnosis I did exercise most days: 5k or 10k runs, weights in the gym, Pilates, football. I ate oily fish and a large salad of lettuce, peppers and tomatoes three nights a week. I consumed very little red meat (Bethan is vegetarian). As for the bacon sandwiches, I probably ate one a year.
Admittedly, I had my vices – a weakness for crisps, for example, and alcohol, which had been a near-daily occurrence for most of my 30s and early 40s. A decade earlier I’d resolved never to drink during the week. Over the weekend, however, I tended to binge 20 to 25 units – a drop in the ocean compared with most of my friends.
Even some of my healthy habits turned out to be questionable. Shortly after my diagnosis I opened a newspaper and was confronted with a list of the worst fruits and vegetables for pesticides. I became convinced that these had contributed to my cancer; I’ve since read that there isn’t necessarily a link, but at the time it just fuelled my emotional turmoil. Many things I ate all the time were up there: lettuce, oranges, grapes, carrots. I washed things, of course – but sometimes, in a rush, a quick dunk under the tap seems to suffice.
My oncologist was adamant that there is no way of knowing what makes an individual’s cells mutate. Genes, lifestyle, environmental exposures and diet are all factors, but unlike lung cancers – of which 85 per cent of cases are believed to be caused by smoking worldwide – with bowel cancer it’s impossible to pinpoint what caused your illness.
Nonetheless, the more I found out about the rise in bowel cancer cases among younger people, the angrier I got. I lurched between guilt (‘I did this to myself’) and rage (‘Big Food did this to me’). In the end, guilt won. In darker moments, when I asked myself, ‘What have I done to deserve this?’ I thought knew the answer.
I had always eaten too much sugar. I mentally scrolled back to my 1970s childhood, when I drank orange squash almost exclusively. Later, throughout most of the 1990s, I smoked cigarettes – only giving up aged 30 – and drank too many cocktails. Could I really expect to avoid cancer just because I’d become a model of clean living in my late 40s?
The truth is that I felt embarrassment – yes, embarrassment – telling people that I had a life-threatening illness that is linked to poor diet. And the more I thought about it, the more the true meaning of my friend Simon’s comment revealed itself to me: ‘Everyone’s going to assume you ate a lot of bacon sandwiches… so you might as well have eaten them.’
Of course, the idea of one person being more ‘deserving’ of a major illness than another person is obscene. And yet it was hard to avoid a sense of shame. And once I’d convinced myself that I was to blame, that’s when the self-loathing really kicked in.
At this point, some people might have attempted to learn everything they could about bowel cancer – poring over each new study, interrogating their consultant surgeon. I was the opposite. I didn’t really want to know and was bizarrely uninterested in finding out any more than was strictly necessary.
I’m not sure if this was denial, or simply pragmatism. Serious illness infantilises you. Things are done to you – by people who, you assume, know what they’re doing. It felt easier to go along with it all and not ask too many questions. The only time I wished I’d done more research was when I was asked to sign documents confirming that I understood the possible consequences of my treatment: incontinence, erectile dysfunction, permanent neuralgia, sterility.
The last was unavoidable. My oncologist explained that if I was planning to have more children, I’d need to freeze sperm – four rounds of chemotherapy and a week of radiotherapy would take its toll.
Surprisingly, none of the medical professionals I encountered on my cancer ‘journey’ (oh, how I grew to hate that word) showed any interest in why I was sitting in front of them. Throughout what ended up being nearly two years of treatment, I was never asked about my lifestyle. Privately, though, I continued to find it hard to banish these questions. And inevitably, I ended up comparing myself with others. ‘But what about X? He’s on first-name terms with his Deliveroo driver. What about Y? She opens a bottle of albariño every night.’
This kind of thinking is futile, of course: cancer is random. Yes, there are things you can do to reduce the risk, but if your number comes up, there’s nothing to be gained from trying to work out why. What’s more, my oncologist insisted on the importance of staying upbeat. So I tried to be optimistic.
It wasn’t always easy. I had an operation to remove the cancerous part of my bowel, but a few days afterwards there were complications; my temperature and heart rate spiked, and my lips turned a weird colour. Bethan left the hospital in tears thinking she might never see me alive again. I was transferred to the intensive care unit that night.
Afterwards, back on the ward, I had a short period of psychosis during which I began to see pointillist faces in the fabric of the curtains and confidently announced to Bethan that the patient in the bed opposite was someone I’d played football with. (Not true.)
A scan revealed that I’d sprung an internal leak. I was whisked back into surgery. After my second operation I woke with three surgical drains emerging from my abdomen, a stoma bag, a catheter, a drip, oxygen in my nostrils and a tube running from my nose down my throat to prevent me from choking on my own bile. Doctors would admonish me for not walking around enough (‘It’s the only way you’ll get better’) but getting out of bed with all of that was exhausting.
I ate nothing for weeks, fed intravenously with a milky solution in a silver bag. I didn’t sleep for more than an hour or two at a time. The only positive moment was when a doctor told me I would not need more chemotherapy.
I was in hospital for more than three weeks: post-Covid regulations meant I was permitted one visitor, Bethan. Ava and Georgia were allowed to visit me only once, towards the end of my stay.
When they arrived, I could see they were shocked. I’d lost two stone and my face was drained of colour. The nurses found me a wheelchair and we trundled off to one of the hospital cafés. Georgia got a little tearful while Ava, mired in her awkward teen years, seemed embarrassed. She didn’t know how she was supposed to behave.
Back home, as the months passed, I slowly began to feel physically better. I was working, I’d started running again – with the help of a neoprene corset to hold my stoma pouch in position – but the persistent throb of anxiety remained. I was convinced my cancer would return and I’d have to go through it all again. I ruminated on whether death would be preferable.
But then I imagined what that would do to Bethan. Our relationship had, if anything, been strengthened by my illness. Having been together, unmarried, for 20 years, we became civil partners six weeks after my diagnosis. We did it for pragmatic reasons – death and taxes – but it was still a joyful celebration and one that might never have happened if I hadn’t got cancer. Now I was on the road to recovery, I couldn’t stop thinking about how close I’d come to destroying the life we’d created together.
These thoughts continued to plague me until I was put in contact with a family friend of a friend – a world-renowned colorectal surgeon, now retired, who agreed to have a chat on the phone.
He touched on the fact that I had responded extremely well to radiotherapy: my tumour disappeared after five days of treatment. (The decision to persevere with the operation was ‘belt and braces’).
‘Did they tell you what this means – the headline news?’ the surgeon said. ‘It means that statistically the chances of your cancer recurring are very low.’
I sat in confused silence, struggling to take this in.
‘What I’m saying,’ he continued, ‘is that you will see your grandchildren.’
‘Not too soon, I hope,’ I joked. But as soon as the call ended, I burst into tears of relief.
My stoma was reversed in 2023 and I have since made a full recovery. Well, more or less. My stomach is scarred and my digestion will never be what it was, but it’s a small price to pay for being alive.
My brush with mortality hasn’t changed my philosophy on life, exactly. Some people who survive a serious illness make dramatic changes to their lives; I’m muddling along pretty much as before, but with a greater focus on diet.
I make an effort to stick to fresh, unprocessed food whenever possible. I still eat salads, though I wash them more assiduously. I’m playing tennis every week with Georgia and doing plenty of other exercise. My six-monthly CT scans always elicit a few days of dread, but the years of my treatment now seem like a bad dream.
Survivor’s guilt is inevitable. I can’t help wondering why I was given a second chance when so many others are not. I also feel a sense of shame that the taxpayer spent thousands of pounds keeping me alive when – perhaps – it could all have been avoided if I’d maintained better eating habits. And I’m haunted by visions of the damage it would have wreaked on Bethan and my girls if I’d died.
Yet I know that if I allow my life to be ruled by these thoughts, I’m making a mockery of that second chance. It’s my duty to be happy, to make the most of my remaining years. They are a gift.