Cork doctor with bowel cancer: 'More people are getting it under age 50'

Cork doctor Sarah Fitzgibbon didn't expect to hear that her scan had detected cancer, even though she knew it was only a matter of time.

Sat, 21 Sep, 2024 - 18:37

Helen O’Callaghan

Dr Sarah Fitzgibbon, who was diagnosed with bowel cancer 10 years ago, feels lucky that for six years after being successfully treated for metastatic cancer, she needed nothing further and her twice-yearly scans were consistently stable. Until May this year.

“Unfortunately, my scan wasn’t clear — an area in my liver had become active with cancer again.” It was a surprise: She had almost forgotten about the CT scan she’d had two weeks earlier.

“I was very disappointed. I’d been so lucky for so long. I was hoping my luck would hold out for another while. At the same time, I’d been diagnosed with stage-four cancer, so it was always going to be there in the background: I knew some day I’d need more treatment,” says Fitzgibbon.

In 2014, her discovery that her liver was “full of cancer” came after some warning signs: Unintended weight loss, night sweats, pain in her right side.

“I was unlucky that my bowel cancer had spread to my liver by the time it was diagnosed, but this is not very common.

I didn’t have many symptoms, which can happen sometimes with younger people.

However, this time, there were no indications anything was wrong. She felt well and was enjoying her job at the National Screening Service — she had switched from being a GP some years ago so as to better manage her condition.

“I’d just been walking on the Camino. I was fit, healthy, and well,” says Fitzgibbon, adding that this year’s scan alert highlights the benefits of her being monitored so closely. “Otherwise, I wouldn’t have known there was anything wrong. It’s good the scan picked it up before any symptoms started.”

Fitzgibbon has been having chemotherapy all summer, spending a day every two weeks in St Therese’s Ward on Lee Road, where Cork’s Mercy University Hospital has its oncology unit. “Once I got over the initial shock, I accepted this was what was going to have to happen this year: It was just get on with it.”

Chemo combination

She has been on a three-chemo combination, which is very effective for bowel cancer. “Certainly, they’ve worked very well for me in the past. I’ve had this combination three times before; knowing the side effects coming my way did make things easier.”

Every fortnight, after her stint on St Therese’s Ward, Fitzgibbon spent another two days at home and had a pump: A small bottle of the chemo drugs. Alongside, she took steroid tablets. “They gave me a lot of energy, made me come up with all sorts of crazy ideas. I had to watch overspending, and I tend to buy books online late at night.”

Early in her treatment, the Ballinlough-based doctor’s white blood cells dropped significantly. “I’ve had to have an injection to counteract that.”

This resulted in achy bones and fatigue, typically a few days after being off the pump and steroids.

Other side effects included digestive upset, while one drug gave her “acne like a teen” and caused the skin around her fingers to crack.

It’s uncomfortable, a bit unsightly. It’s unsettling when your physical appearance changes; it can be a little hard to accept.

She has noticed her hair thinning more than previously. “Maybe because I’m older. I won’t lose it, but it’s noticeable. I’m conscious of it. Physical changes can be challenging and affect confidence.”

By now, she has had six doses of chemo. And she is waiting. “To hear what the next step is.” A scan will determine this, she says. “It’ll be up to my team at the Mercy: They’ll tell me what to do.”

Fitzgibbon talks with humour about her cancer journey. “I try not to take anything too seriously. With cancer and advanced cancer — and what might be called terminal cancer — people can be unsure how to talk about it. I’m very open about serious illness and humour’s important in helping have these conversations.”

Dr Sarah Fitzgibbon talks with humour about her cancer journey

She started her blog, Adventures of a Sick Doctor, after her first diagnosis, to let scattered-around-the-globe family and friends know how she was doing. She never expected its broad public appeal.

“It connected me with others going through the same thing: Young people with bowel cancer; more people are getting it under age 50. There’s support and comfort in reading others’ experience.”

With her trademark glass-half-full outlook, Fitzgibbon is grateful for the timing of her latest diagnosis. It meant she was home all summer with her children: Ellen, 16, William, 13, and Catherine, 10.

“We were still able to enjoy the things we do in the summer: Travelling to West Cork, kayaking in Lough Hyne, swimming in the sea.”

The children are doing well. “They’re great for looking after me when I need it. They know I’ve to go for treatment every few weeks to keep me well. We try to answer their questions as openly and honestly as we can.”

Her husband, Derek, is doing well too, “keeping the home fires burning” and looking after the children on days she’s not up to it. The children have also been “just living their own lives”, and playing soccer is central. “Derek is involved with Avondale United Football Club, and all three kids are involved.”

Back to work

Fitzgibbon is looking forward to getting back to work. She’s delighted WiMIN (Women in Medicine in Ireland Network), the organisation she started in 2018 for female doctors, is still going strong. “A great committee of women” has been helping her organise its annual conference in Belfast on October 5.

Throughout chemo, she has kept up exercise, getting out in the fresh air and walking, which she loves. “I always feel better when I come back home.”

This is partly why she has set herself a challenge for September: To walk 100 miles as a fundraiser for Women’s Aid (exa.mn/Womens-Aid-Walk). “They do such a lot of work supporting families affected by domestic violence.

“When I saw the walk, it was probably the influence of the steroids but I thought 100km was very doable. Only after did I realise it’s 100 miles; quite a bit farther.”

On days she cannot walk too far, her family supports her.

“Derek’s doing some of it with me. Ellen intends to walk some, too, and my brother also. With their help, I don’t feel as much pressure. Ideally, I’ll walk as much as I can myself.”

When we talked, she had met her target for the first week. “I’m on track to keep going.”

Fitzgibbon doesn’t let our chat end without issuing a strong message about bowel-cancer symptom awareness. “Changes in bowel habits, losing weight, blood in poo; any of these, it’s very important to visit the GP. If you’re between 59 and 69, sign up for bowel screening.

“It’s one of the best ways of avoiding the bowel cancer journey I’ve been on.”

It all ties in with her vision of giving back. Since being diagnosed, she has tried hard to support organisations that support others. “There’s an element of karma. Life gives you back what you give.”

Bowel cancer symptoms

A lasting change in your bowel habit — going more often, looser motions or constipation.
Blood in your poo or bleeding from your back passage.
Pain or discomfort in your tummy area or back passage.
Trapped wind or fullness in your tummy.
A lump in your tummy area or rectum.
Feeling you have not emptied your bowel fully after going to the toilet.
Unexplained weight loss.
Feeling tired and breathless due to anaemia.
If you notice any of these changes, always get them checked by your GP

Source: Irish Cancer Society