Today marks the fourth anniversary of the death of my sister-in-law. She was thirty-five, and left behind my brother, a 3 year old son and an 18 month old son. Her death was due to colon cancer, making her one of the few young people to die of this disease. You are not “too young” to have colon cancer.
About a year before her death, she had her last period. She took a pregnancy test, which came back negative; a week later, another negative pregnancy test — still no period. But she still didn’t see a doctor. Then she started losing weight. After having struggled all her life to lose weight, she was pleased to see it begin to drop off so effortlessly. So she still didn’t see a doctor. In April, she went to the doctor to see about the bowel problems she had been having recently. She had had difficulties with constipation most of her adult life, and they were getting worse. Although the concerns and complaints were classic symptoms of colon cancer, she was “too young” to have colon cancer, and the doctor did not order an immediate colonoscopy, but instead scheduled one for mid-June. In early June, she took the children to visit her parents (in Nebraska, about a 14-hour drive). While there, she noticed her abdomen was swelling, so went to her old family doctor. He tentatively diagnosed her with some sort of liver ailment — possibly liver cancer — and sent her for more tests. Within a few days, the diagnosis was positive for cancer in the liver, and before long, it was confirmed that it was colon cancer. Stage IV (four) — there is no “stage five”. (Of course, my brother drove up as soon as the initial diagnosis was made.)
The prognosis was 3-6 months without treatment, and as long as 24 months with chemotherapy. A family friend was also fighting breast cancer at the same time, and she had opted for chemotherapy, which gave her several more months of life, but took her dignity, her hair, and her health in the meantime. Ellen chose to try an alternative treatment for her cancer (going somewhere in Mexico), and seemed to get better for a few weeks. It was not to last.
I went down in late August for a visit (my first time to go home since getting married eighteen months before); it was also the time of her older son’s third birthday. Ellen was wasted; emaciated. She looked like a pregnant skeleton — the cancer was causing an accumulation of fluid in her abdomen. It was drawn off several times during the course of her living death; one time I remember they drained 5 quarts of fluid at once. I hugged her one time, and she felt as frail as a ninety-year-old woman — I can still feel her spine poking out of her skin. But she looked good compared to what she looked like at the end of her life. By the time the cancer killed her, she looked like she had not survived Auschwitz.
In addition to my brother and two children, she left behind mother, father, stepmother, sister and brother-in-law, two stepbrothers and sisters-in-law, a stepsister and brother-in-law, grandmother, and a whole host of aunts, uncles, cousins and friends.
This is the sister-in-law who had two C-sections — the first after an attempted home birth with a 40+ hour labor, many hours of pushing, as well as a forceps attempt; the second was elective, due to her fear of a repeat of the first. Since C-sections can cause bowel adhesions and other problems, sometimes I wonder how much, if at all, her C-section contributed to her development of colon cancer. It’s possible that the cancer (since it is typically slow-growing in the initial stages) had been in her body for years — while she was pregnant with her younger son, and possibly also with her older son, and the C-sections did nothing. But then again….