Cork teacher on bowel cancer diagnosis at 45: ‘My life would never be the same again’

Secondary school teacher John O’Regan went to his doctor when he noticed a change in his bowel habits. The results from a follow-up colonoscopy were life-changing

John O'Regan, in Fountainstown, Co Cork. Pic: Larry Cummins.

In  The Matrix movie, there is a scene where the mysterious Morpheus offers Neo (Keanu Reeves) a red or blue pill. Take the blue pill and life would continue as normal, with the unpleasantness of his current experience removed from his memory. Take the red pill, however, and he would get to see the truth outside the illusion of the Matrix.

I took the red pill on January 19 this year when I attended the Mater Private in Cork for a colonoscopy. At 45, my life would never be the same again. “We found a polyp that we didn’t like the look of,” my consultant gastroenterologist explained as I lay in the recovery area after the procedure. I would soon learn the importance of having someone else with me in the future when listening to doctors, as you retain so little of what they actually say in those moments.

My mind suddenly started jumping two, four, six steps down the track as to what this meant to my life in the short term and I lost much of whatever else he told me. I heard something about seeing him in his rooms the following week to discuss the results of the analysis of the aforementioned polyp. I just wanted to get out of there and talk to my wife. The last question I asked him was whether I should withdraw from the school ski trip to Italy, which I was due to go on in a fortnight. “I would,” he said, confirming my worst fears.

It all began about a year previously with an increase in bowel movements. I had always been a once-a-day man, but now I had to go three, four or five times daily. I went to my GP and reported my symptoms. She took blood and sent away a stool analysis but the results were normal. She felt it was most likely just an IBS flare-up, but as I was in my mid-40s, it would be no harm to get a colonoscopy.

Waiting for that follow-up meeting with the consultant to discuss the lab report on my polyp was torturous. I was convinced it was cancer, that the cancer had likely spread and was probably in multiple locations in my body and that the probability was that I was on a short clock. Logic had left town, and worst-case scenarios were the only movies playing in my head. Concentrating on teaching or parenting was hard, and sleep became almost impossible.

It was made worse by the fact that it was relatively public. My withdrawal from the school ski trip meant I had to give my ten colleagues and the tour leader an explanation as to why this was the case. I know I could have made up some excuse but I’ve never been one to hide things. I have a long history with depression that has always been public knowledge and telling people the truth about what I was going through felt like the right thing to do. Everybody was incredibly supportive, but I got tired of retelling the same story and giving health updates.

Finally, I got a call saying my results were back and the consultant would see me at noon that same day. I texted my wife Jane and we arranged to meet at his office.

The consultant got straight to the point. The polyp was confirmed as cancerous but there was some positive news. A margin of 1mm surrounding the polyp was cancer-free. This gave him hope that the cancer was contained within that location and was unlikely to have spread elsewhere. He was upbeat and said that though the news was understandably disappointing, he felt my chances of a full recovery were excellent. My case was referred to the oncology department, which would assess the next steps.

John O'Regan: "I thought of Jane and our three young children, and there was no other option: I would have the surgery". Pic: Larry Cummins.

Days become a blur

It was a relief to receive the diagnosis: my imagination had dreamt up far worse scenarios, and this was one we could handle. But like Neo swallowing that red pill and starting a journey into the Matrix, I quickly realised my reality was about to change. The next few days are a bit of a blur. At some point, I got a letter from my new consultant, a surgeon, stating that I had an appointment the following Wednesday at 6.20pm.

“There’s a 90% chance the cancer is gone due to the margin around the polyp, but I don’t like the risk of that 10%,” the consultant told Jane and me.

He proposed the removal of the right side of my colon in an operation the following Thursday. I would be recovering for five to six weeks. I don’t know what I expected him to say but this felt more significant than anything I had previously considered. But then I thought of Jane and our three young children, and there was no other option: I would have the surgery. It was scheduled for February 15.

The day before the operation was awful for many reasons. I was scared, wondering what kind of shape I would be in when or if I emerged from the surgery. I had to go through the usual bowel prep, voiding myself of all food at home. I had to have two separate washes and apply a pre-surgical scrub to my body. By 11pm, I was done on all counts and climbed exhausted into bed next to Jane.

We travelled to Mercy Hospital in Cork the following morning at 7.30am, where I was quickly prepared for surgery. I gave Jane a last long hug and then was wheeled into a room where at least 15 gowned surgeons, doctors, and nurses waited for me. They made light of everything, and I laughed along nervously until I could remember nothing more.

I woke bleary-eyed in the recovery room, and the rest of the day was hard to piece together coherently. I remember Jane being there and holding my hand. My mum and dad arrived and I recall telling them how much I loved them. It was around midnight when I fully felt conscious. The pain in my abdomen started to kick in, and I couldn’t move in any direction without aggravating it. I had an oxygen mask on, which paradoxically seemed to make it harder to breathe, and I was hooked up to a drip and a pump device. Sleep was almost impossible. I was through the other side though and for that I was deeply grateful.

The next five days followed a pattern of slow but gradual improvement. I ate terrible hospital food, tried to read my book, was looked after by wonderfully kind nurses, chatted to other patients about our various ailments, and blew endlessly into a respiratory exercise device designed to clear any fluid in my lungs to lessen the chance of contracting pneumonia. I had to take a minimum of ten short walks a day to try and get my newly reattached colon working again so I spent long periods in the lovely glass corridor that connects two buildings in the Mercy Hospital gazing out on the river Lee.

On the Sunday morning, four currachs pulled past the window as they rowed up the river and I wondered when I would ever be able to do something that physical again. But it was also the day my bowels opened (a hospital phrase I was asked multiple times a day) properly, which meant that the following day, they were happy to send me home armed with a large bag of drugs.

John O'Regan: "I appreciate that recovery will take time. I am still raw, physically and emotionally, and it is not a case of flicking a switch and getting back to normal". Pic: Larry Cummins.

Positive news

The pain was still severe during the first few days and I grew frustrated at the lack of improvement. As a previously active dad, I had to watch as Jane tirelessly did everything. My kids were incredibly sensitive to my needs (we told them I had my appendix removed, which was true), but I could see how much they longed for me to turn them upside down or go outside and kick a football with them because that’s what you want from your dad when you are nine, seven and five.

On the plus side, we could do homework together every day, which I loved, as I am never normally around for it. We played board games and read books, and slowly but surely, I started to improve—my pain lessened and my energy increased.

The final hurdle in this initial phase was the results of the node analysis on the samples taken during surgery. I was prepared for the anxiety to ramp up ahead of my visit with the consultant, but a few days before the appointment, I got a surprise call from the nurse liaison in the oncology department. The news was positive. My cancer was at the pT1 stage, which means it was a small, low-grade metastasis with no spread to regional lymph nodes.

I would need to have three-month blood tests for the foreseeable future and an annual colonoscopy, but for now, it seems the surgery has been a complete success, and I would require no further treatment.

That evening we celebrated. It felt like we were emerging from a horrific nightmare and suddenly life was starting to look much more positive again. The joy was soon followed by conflicting emotions, which have endured. Part of me feels like a charlatan — I had a minor cancer that was scarcely worth even telling anyone about. The other part of me is still recovering from having the right side of my colon removed, which did not feel minor.

I appreciate that recovery will take time. I am still raw, physically and emotionally, and it is not a case of flicking a switch and getting back to normal.

It is impossible to emerge from a cancer diagnosis and not have a different perspective on life in all sorts of ways.

I treasure my family with a deeper intensity. But I feel far less sure I will be there to watch my kids grow into adulthood. Writing that sentence brings a tear to my eye. The thought of Jane doing it all alone and the kids growing up without a dad have become possibilities that never entered my mind before January.

Ultimately, Neo had to learn hard lessons about what the Matrix meant, which fundamentally altered his viewpoint on everything. I feel the same. I am looking at the world through a different lens now.

Like in the movie, green code is flying all around me in every direction, and I’m not sure if I’ll ever be able to go back to the way it was before I took the red pill.

Helen Dunne says she is lucky her bowel cancer was caught early. Photo: Gareth Chaney

‘It could be nothing, but the earlier it’s checked the better’

Bowel cancer is often associated with older people, but the incidence is rising among younger age groups, writes Arlene Harris

Constipation is common during pregnancy, so Helen Dunne wasn’t too concerned when this was a feature of her first two pregnancies.

However, when she gave birth to her third child early last year, she experienced rectal bleeding. Her midwife suggested that she had a haemorrhoid.

She assumed the bleeding would go in time but, in April 2023, she noticed that the blood was becoming darker.

She made an appointment to see her GP, who immediately referred her to a specialist.

The 37-year-old was booked in for a private colonoscopy within weeks.

“I had sedation [for the procedure], but I remember seeing what looked like a bloody mass on the screen,” she says.

The mother of three was told that a biopsy had been done, and she was booked in for a CT scan and MRI the following week.

However, a couple of days later, she was told she needed to go back for a second colonoscopy. In the follow-up consultation, she was given the devasting news that she had bowel cancer.

“The consultant assured me that it was just a ‘bump in the road’ and that I would be fine, but I was floored,” she says.

“I was told that I would have to go through chemotherapy for a few months and then surgery — it was such a shock, and I was so worried.

“Everything set me off crying. I didn’t want to tell people apart from my family and a few friends.

“My husband Jamie and I had a family holiday booked at the time, and the doctors told me to go ahead with it and they would start treatment when I returned. While it was lovely, there were times when I was thinking terrible thoughts.”

Bowel cancer survivor Helen Dunne: "I would say to anybody who is experiencing any changes [in bowel movements] or bleeding to get a colonoscopy". Photo: Gareth Chaney

The week after the family returned home, she started treatment. “Having the port [a catheter which is inserted to administer medication] put in was one of the worst days. Everyone seemed so shocked at how young I was.”

The primary school teacher’s treatment began in June last year, starting with an intensive course of chemotherapy — which caused her hair to fall out — and she suffered from nausea and exhaustion.

After five chemotherapy sessions, a scan revealed the tumour had significantly reduced. After 12 sessions, it couldn’t be seen.

She subsequently underwent surgery to remove part of her bowel, and, after five days recovering in hospital, she was discharged.

Today, the Cavan woman who lives in Dublin is doing well and although she still has some side effects — such as numbness in her hands and feet — she is very much on the mend.

She would advise anyone who has any symptoms not to think they are too young to get bowel cancer, as she believes that if it wasn’t for the quick thinking of her doctor, the outcome might have been very different.

“I would say to anybody who is experiencing any changes [in bowel movements] or bleeding to get a colonoscopy,” she says.

“Don’t take no for an answer, because it is so important to catch cancer early because it can be treated.

“I know you might feel nervous, but just get it checked out —it might not even be cancer. It could be nothing, but the earlier it’s checked the better.”

She will have scans every six months and another colonoscopy in early January, but is considered to be cancer-free.

“I feel so lucky that mine was caught early. I’m now doing really well mentally and physically, and I am looking forward to getting back to work and back to normal.”

Bowel cancer survivor Helen Dunne: "Don’t be afraid to tell your doctor if you think they have missed the biggest clue. If you would really like them to refer you on, ask them if it could be colorectal cancer". Photo: Gareth Chaney

Dublin-based GP Fiona Macken says Dunne’s story is “unfortunately no longer rare”.

“A recent study carried out in June 2022, through the National Library of Medicine, noted that the incidence of colorectal, breast, kidney, and pancreatic cancers are increasing in younger age groups,” she says.

“Doctors need to be aware that colorectal cancer is no longer a disease of the over 50s.

“My advice to doctors would be to ask themselves if it could be colorectal cancer.

“And for the patients, I would say that doctors are humans working as detectives. They are putting a case together based on your symptoms, signs, and the latest guidelines and research.

“So don’t be afraid to tell your doctor if you think they have missed the biggest clue. If you would really like them to refer you on, ask them if it could be colorectal cancer.”

Macken says that, while colonoscopies and faecal occult blood tests are the primary ways of identifying colon cancer, research into developing a blood test is ongoing.

“It seems to be picking up DNA fragments secreted by the cancer into the bloodstream,” she says.

“The blood test is called Shield, and seems to pick up 87% of early cancers.”

She says the test appears to show great promise, but it picks up only 13% of large polyps. By contrast, a colonoscopy picks up 94% of polyps.

“So there are pros and cons to the blood test,” says Macken. “It’s still very costly, and therefore I see it will be an adjunct to what we already have, not a replacement.

“But it’s great news that such a test exists and offers great hope to us that we will be able to pick these tumours up earlier.”

• April is Bowel Cancer Awareness Month, and the Marie Keating Foundation’s #NoRegrets awareness campaign urges people not to regret not getting their symptoms checked out.
• For more advice on Bowel Cancer Awareness month, visit www.mariekeating.ie

Bowel cancer: the fact file

Around one in 20 people get bowel cancer. Almost 18 out of 20 cases of bowel cancer in Ireland occur in people over 60. However, 22% of bowel cancers diagnosed during 2014-2018 were diagnosed in those under 60.

Some 2,560 people are diagnosed with bowel cancer in Ireland every year - 1,466 men and 1,093 women.

It is the second most common cancer in men in Ireland and the third most common cancer in women after non-melanoma skin cancer. 

Symptoms include:

• A change in normal bowel pattern such as looser stool, going more often or constipation for no obvious reason
• Bleeding from the back passage or blood in or on the stools 
• Unexplained weight loss
• Pain in the abdomen or rectum (back passage) 
• A feeling of straining as if you need to go to the toilet even after opening your bowels 
• A lump in the back passage or tummy (abdomen), more commonly on the right side 
• Tiredness and breathlessness