A drama teacher who gave an “Oscar worthy performance" for her family on Christmas Day – three days after learning she had bowel cancer – says having the courage to discuss changes in her stools saved her life.
Sarah Bates, 42, was on maternity leave when she first noticed small amounts of blood in the toilet basin and, having recently given birth to her son, Theo, now four, with her CEO husband, Dan, 42, she believed it was harmless spotting and thought nothing of it.
When the bleeding continued, then just 39, Sarah – who also has two daughters, Freya, 13, and Esme, 11 – saw her doctor, who referred her for a colonoscopy, a test to check inside the bowels. This detected some harmless polyps, or growths, which were removed.
Sarah with Theo on Christmas Day (PA Real Life/Collect)
But, within months, the bleeding returned and, thinking the polyps had grown back, Sarah, of Richmond, south west London, saw her doctor and was sent back to the hospital, only to be told on December 22, 2016, that it looked like she had cancer.
She recalled: “I'd gone from putting the final finishing touches to Christmas around the house, thinking I had nothing to worry about, to being told I needed an all-over body scan to see if I had cancer and if it had spread."
Thankfully, after five hours in surgery on January 7, 2017, followed by 15 weeks of grueling chemotherapy, Sarah was given the all clear, although she still has six monthly check-ups.
Sarah enjoying a glass of fizz (PA Real Life/Collect)
Now, as she approaches the third anniversary of her diagnosis this Christmas, she is keen to encourage people to discuss their stools, so bowel cancer can be diagnosed earlier and more lives can be saved.
“We spend so much time talking about food, recipes and restaurants but we never talk about how it comes out the other end," said Sarah.
“It still makes my toes curl talking about this, but being open about our bowel habits really is key when it comes to early diagnosis of this awful disease. Talking about poo is what saved my life!"
In December 2015, Sarah noticed “small amounts of blood" in the toilet, which she put down to spotting, having given birth only weeks before.
But when the symptoms persisted, in March 2016, she saw her GP, who referred her for a colonoscopy.
“There wasn't loads of blood and the doctor didn't seem too concerned – she just wanted to be cautious – so I really wasn't too worried," she recalled.
Sarah at home (PA Real Life/Collect)
Just two weeks later, a colonoscopy at New Victoria Hospital in Kingston-upon-Thames, south west London, revealed three polyps – small growths on the lining of the colon, which affect one in four people during their lifetime, according to the NHS – which were removed during the procedure.
“It all seemed quite straight forward and the doctor told me that while there was a chance the polyps may come back, I shouldn't worry as I would be monitored regularly," she added.
Throwing herself into the rest of her maternity leave, it was not until December that year, as Christmas drew closer, that Sarah's symptoms returned.
Sarah sledging with Esme and Theo (PA Real Life/Collect)
After talking to the surgeon who had removed her polyps, Sarah was referred for a second colonoscopy at the same hospital, on December 22.
But this time the news would change her life forever.
“I went into the colonoscopy feeling very positive again thinking that, worst case scenario, the polyps had returned," she recalled.
Instead, immediately after the colonoscopy, doctors revealed they had discovered a tumor on her bowel.
“The consultant told me it was very likely the tumor was cancerous, but I needed further tests to confirm whether it was malignant and if it had spread," she added.
Booked in for a full-body scan the next day – just two days before Christmas Day — Sarah had to juggle the pressure of providing a festive feast for her young family with her anxiety as she waited for her results.
Sarah getting treatment (PA Real Life/Collect)
“There was a horrible cloud hanging over us for the whole holiday," Sarah said.
“Theo was too young to understand, but the girls could sense something wasn't quite right.
“We decided to be honest and tell them that they'd found a small tumor in Mummy's bowel, but that doctors were going to treat it as best they could.
Sarah in hospital (PA Real Life/Collect)
“As a Christian, Christmas is such an important time for me and my family, and faith and belief has been a huge part of my entire journey.
“Christmas Day almost felt normal at times, eating turkey and opening presents, but every now and then when I was on my own – doing the dishes or brushing my teeth – it would suddenly catch me and I'd remember.
“Talking with family really was the best medicine to take my mind off the lingering diagnosis."
On December 29, Sarah was told that the tumor was malignant.
Booked in for a left hemicolectomy, where doctors remove a section of the left side of the colon on January 7, 2017, at south west London's Kingston Hospital, Sarah woke up from the five-hour operation to be told it had been a success.
“I woke up with my husband beside me and I remember being in a lot of pain and very confused," she said.
Sarah with the family (PA Real Life/Collect)
“The main thing I remember is being told I didn't need a colostomy bag and being so relieved," she continued.
“I know it shouldn't matter, but battling cancer is enough without having to deal with the added stress of that."
After running further tests on 11 lymph nodes that they removed during the operation, doctors also discovered traces of cancer in one, meaning Sarah had stage three bowel cancer and needed chemotherapy treatment.
Sarah with her daughters, Freya and Esme (PA Real Life/Collect)
She added: “I felt like we were covering all angles – a belts and braces approach to blasting the cancer."
The grueling treatment – which began in March 2017 and involved Sarah receiving chemotherapy drugs through an IV drip one day, followed by two weeks of daily oral administration, then a week off, over the course of three weeks – was repeated five times.
“I might have been grateful for the chemotherapy but that didn't mean it was a walk in the park, " she said of her 15 weeks of treatment.
“It was awful and got worse as each week went by. I was constantly sick and my fingers would tingle so badly that I had to wear gloves inside the house," she continued.
“Theo was just one at the time and I was so scared about the toxicity of the pills I was taking that I handled them with disposable gloves to avoid any chance of cross contamination.
“The only saving grace was that I didn't lose my hair – it did thin – but I was so grateful not to lose it."
As the treatment came to an end in July 2017, Sarah admits she found the time immediately afterwards the most difficult period of her journey.
“Obviously, being diagnosed and going through the chemo was incredibly difficult, but there's a whole mentality of, 'I've got to get through this.'
“I'd gone from spending over six months of my life battling this cancer and being seen by specialists every three weeks, to every three months."
Sarah, Esme, Theo, Freya and Dan (PA Real Life/Collect)
“All of a sudden I felt cast adrift. It was like being rescued from a sinking ship then floating into the unknown on a life boat," she continued.
“To cope with it all, I threw myself into being 'super mum' and 'super wife.' I put so much pressure on myself to make the most of life after having this possible death sentence lingering over me."
Thankfully, after being told there were no signs of the cancer returning after her first check-up in October 2017, Sarah learned to “step back" and set herself a “better pace."
“I realized the mentality of doing everything I could in as little time as possible was detrimental, following my first check-up," she added. “I pressed pause and decided to take things at my own speed."
Now, with the third anniversary of her diagnosis just days away, Sarah admits that Christmas same forever remain a difficult time for her now.
“It's always going to be a difficult time of year because it marks a period in my life when things changed for me in a very big way," she explained.
Sarah in hospital (PA Real Life/Collect)
“But, in a way, Christmas is a time to take stock and reflect and my diagnosis and journey very much plays into that," she continued.
“With each Christmas that goes by, I remind myself it's another year when I've survived and been here with my family.
“We've stuck to traditions – turkey and presents – but each year it feels more special."
Now working with the charity Bowel Cancer UK, Sarah is hoping to break the stigma surrounding discussing the symptoms of bowel cancer.
“I used to hate talking about going to the toilet. In fact, not long ago, I would have wanted everyone to believe I didn't go to the loo at all," she said.
“We're obsessed with the latest super foods and the benefits of eating organic, stressing how important what we put into our body is. But what about the other side?"
“If you notice something not right with your bowel habits, even over Christmas, don't hesitate to see someone about it," she continued.
“The last thing I wanted to do was talk about my poo with the doctor, but I bit the bullet, and it saved my life."
Dr Lisa Wilde, Director of Research and External Affairs at Bowel Cancer UK, says: “Every year in the UK, over 42,000 people are diagnosed with bowel cancer, and it's the UK's second biggest cancer killer."
Sarah with Theo (PA Real Life/Collect)
She concluded: “Being aware of the symptoms and visiting your GP if things don't feel right can help increase chances of an early diagnosis.
“Your doctor sees people with bowel concerns every day so there is nothing to be embarrassed about. It could save your life."