A young mum has revealed how she gave birth and went into the menopause just weeks apart thanks to treatment for the bowel cancer doctors found when she was 35 weeks pregnant with her first child.
When English teacher Sima Davarian, 37, of Plymouth, Devon, saw bright red blood after going to the toilet, she assumed she had piles – swellings inside or around the bottom containing enlarged blood vessels – a common problem during pregnancy and saw her GP.
Then in the third trimester of what had been a healthy pregnancy, it did not cross her mind that it could be cancer until her GP sent her to hospital, where a doctor found a small lump in her rectum and took a biopsy – a sample of tissue to be examined under a microscope.
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She said:
“My husband Michael, who works in travel destination marketing, was abroad at the time, so I went to the hospital appointment on my own, expecting the tests to show I had hemorrhoids or piles."
“I was nervous but not really worried, until the consultant said he hadn't expected to find what he discovered, which was a small lump measuring just over an inch."
“He told me it had nothing to do with the pregnancy and took a biopsy, after which I had to wait for 12 days for the next appointment with the colorectal, or colon specialists, at Derriford Hospital in Plymouth."
She continued:
“It was a strange time. I went through lots of emotions but eventually felt quite peaceful thinking whatever happens happens."
To Sima's horror, when she and Michael, 43, went to her follow-up appointment, with her by then 35 weeks pregnant with her daughter, Mathilda, now three, the doctor told them:
“It's cancer."
The biopsy had revealed a stage three cancerous tumor, which had embedded itself into the intestinal wall.
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“It's like having a pause button on your life when you hear those words," said Sima.
“We were all taken aback, including the doctors and the nurses. My husband cried and I felt something drop in the pit of my stomach."
“The doctors told me it is very rare for someone of my age – I was 34 then – to have this cancer and that there were no more tests that could be done until after I'd given birth. I would need major surgery and a colostomy – diverting my waste into a stoma bag."
“But before any of that could happen, I would have to have my baby."
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She continued:
“The doctors made it clear there was no choice about this and left Michael and I alone in the room for a while with a box of tissues."
Just five days later, on 7 September 2015, Mathilda was born at Derriford Hospital by caesarean, weighing 5lbs 8oz, leaving both Sima and Michael feeling they had been robbed of the joys of a normal delivery and natural birth.
“It was surreal, strange and traumatic," said Sima.
“It was very, very difficult to become a new mother in those circumstances. In a way, it felt as if giving birth had become a medicalized experience because of the cancer."
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Sima continued:
“Everyone was taken aback by my diagnosis. It was shocking for everyone around me, family, friends and work colleagues, because they all knew I was a healthy person."
After Mathilda's birth, doctors gave Sima a couple of weeks to recover, as well as to spend quality time with their new daughter, before commencing treatment to tackle the tumor.
Despite knowing it would leave her infertile and unable to have any more children, Sima followed the medical advice and had radiation therapy every day for a week, before having surgery a week later.
“I had an abdominal perineal resection, which means surgeons took away my rectum, anus and the descending colon to make sure they removed all the cancer in a six-hour operation."
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She explained:
“It was brutal, but we knew it was for the best. Because I was so young, they wanted to be as thorough as possible to ensure it could never come back."
“But it was becoming hard to untangle being a patient from being a new mother."
While her operation on 26 October 2015 was a major ordeal and the thought of life with a stoma bag was grim, Sima said her surgeon told her the operation was not about surviving the cancer, but about ensuring she would enjoy a normal life span.
“He told me it was highly curable with the operation and we had caught it in the nick of time," she said.
“If I went ahead with everything they recommended, it would mean I would most likely live until old age, as normal."
As doctors found cancer cells in Sima's lymph nodes following the colostomy, she also needed four rounds of intense chemotherapy, making looking after a new baby very hard.
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She said:
“The chemotherapy knocks the stuffing out of you."
“Both my white blood cells and platelets were low, so I was high risk for infection and was hospitalized with the flu during the chemotherapy treatment."
“It was a hard slog just to get up in the morning. My immune system was battered and I was running on empty."
She continued:
“That meant Michael had to be even more hands-on with Mathilda, doing the night feeds and so on. It was tough on all of us."
Sima has now been pronounced cancer free, but as well as attacking the cancer cells, the radiation treatment she had at the start also destroyed her ovaries – plunging her into an early menopause.
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Since May 2016, she has been taking HRT to compensate for the loss of the female hormone estrogen, but she has struggled coming to terms with menopausal changes, such as rapid changes in temperatures and fatigue, as well as a general low mood, which a woman does not usually experience until she hits her mid-40s to 50s.
While HRT is often not recommended for certain cancer patients, as their tumors can be estrogen responsive, due to Sima's young age and the fact her body would have been producing the hormone naturally if it was not for the radiation therapy, doctors recommended she started the treatment as soon as possible.
“It has been quite tricky," said Sima.
“Last summer, I was suffering from awful cramps and nausea. The doctors thought perhaps, despite the radiation treatment, my ovaries may have some slight function which was causing that – but this has now settled down, because of hormone therapy."
Luckily, Sima is now able to fully enjoy family life with her loving husband and their daughter, after cancer turned all their lives upside down.
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“It was very hard for both of us when it all started," she said.
“Michael wasn't sure how best to help me and so threw himself into looking after Mathilda when he wasn't working, meaning we were often apart."
“If I woke up having a bad day after a round of chemotherapy it was hard for him to go to work and leave me, but somehow, we got by."
Looking death in the face so young has helped Sima to find her inner strength and made her determined to raise awareness of bowel cancer.
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She said:
“It is very sobering to have a brush with your own mortality at such a young age."
“I do feel strong for managing to get through it all and I am now much more appreciative of what's important – which is family and friends."
“I have also learnt how crucial it is for other young people talk about bowel cancer, which is more often associated with an older generation. It's important to remove any stigma about it to learn to talk about uncomfortable things."
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She continued:
“I remember feeling like the only person under 40 who had it, but it can and does affect young people. I learnt that when I watched the Never Too Young video on the Bowel Cancer UK website which really helped me feel less isolated and alone."
For more information see www.bowelcanceruk.org.uk
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