A 26-year-old woman faced a life-threatening bowel cancer diagnosis after a tumour so aggressive it obstructed her colon, leaving her in excruciating pain and unable to keep food down. Charlotte Rutherford, now 32 and living in Bristol, was told by doctors that when she was rushed to hospital in Australia in December 2020 she was “maybe 48 hours away from my heart just giving up”. The experience, she says, profoundly shifted her perspective, making her realise “how fragile life is” and driving her mission to raise awareness that “this can be happening to young people”.
Diagnosis and Initial Treatment
Ms Rutherford had been living in Australia for three years when intermittent symptoms – severe stomach pain, vomiting, loss of appetite, and altered bowel habits – escalated to a constant crisis. For roughly 18 months she had endured these signs on and off, but it was only when her condition reached an “emergency state” that a CT scan uncovered Stage 3B bowel cancer. The tumour had not only obstructed her colon but also spread to her lymph nodes. Upon admission, doctors immediately asked about any family history of bowel cancer. “I said: ‘I don’t have cancer, do I?’” she recalled. Within 24 hours, on 11 December 2020, she underwent surgery to remove the obstruction for biopsy. Six days later, the devastating confirmation arrived: advanced bowel cancer, estimated by doctors to have been developing for three to five years.
Alone in hospital during the Covid-19 pandemic, Ms Rutherford thought she was going to die. “To be honest, the thing that was going through my mind because of how unwell I felt… I just thought I was going to die in the hospital,” she said. After the primary tumour and affected lymph nodes were surgically removed, she underwent 12 weeks of preventative chemotherapy, administered both intravenously and orally. On 6 April 2021, she received the news that she was in remission.
Recurrence and a Difficult Choice
Returning to the UK in April 2021, Ms Rutherford underwent six-monthly scans and blood tests for monitoring. By 2023, aged 29, there had been no sign of recurrence. Her routine scan in February 2023 was approached with unusual calm; she “felt so fit and so healthy, it was probably the scan I went into with the least amount of scan anxiety”. Yet, just nine days later, a call from the hospital shattered her peace. At a subsequent appointment, she received the devastating news that the cancer had returned – this time on her lung, leading to a Stage 4 diagnosis as it had metastasised from its original site. Crucially, she had had no symptoms of this recurrence before the scan.
A significant factor in her treatment decisions was her fertility. “I essentially had to weigh up whether it meant more to me to not have chemo and protect my fertility, or have chemo and reduce my chance of the cancer coming back,” she explained. Due to the tumour’s small size, keyhole surgery was possible in April 2023. Following two weeks of bed rest, she embarked on a slow process of rebuilding her fitness. By August 2023, she was once again in remission.
The research briefing notes that fertility preservation options for women in the UK include egg freezing, ovarian tissue freezing, and embryo freezing, with some treatments available on the NHS depending on eligibility. Ms Rutherford’s surgeon also indicated that her routine two-year scan had been postponed by a few weeks due to hospital resources – and that if it had occurred three weeks earlier, the small tumour might not have been detected, potentially allowing it to grow undetected for another six to twelve months.
The Emotional and Physical Toll of a Recurrence at a Young Age
The physical recovery from her recurrence was arduous, particularly the breathlessness. “I couldn’t walk anywhere without being so breathless… It took a long time to build up my fitness again,” she said. The recurrence itself was a profound shock. “Maybe it was naive, but I really didn’t think I was going to have a recurrence during my remission… It was a huge shock, because I felt so fit and healthy.”
Battling cancer twice in her late twenties has also exacted a significant emotional toll. “Because I was so young, you’re around an age group where people are progressing with other areas of their life, like buying houses and work and stuff. You just feel so behind where everyone else is, for something that is just so out of your control,” she reflected. The research briefing adds that younger bowel cancer patients often have a different experience of diagnosis, treatment, and care, being more likely to be diagnosed in an emergency situation and at a later stage – a point highlighted by Bowel Cancer UK’s “Never Too Young” campaign.
Raising Awareness and Supporting Others
For Bowel Cancer Awareness Month in April, Ms Rutherford, who now works as a community manager for the cancer charity Mission Remission, urged both young individuals and medical professionals to recognise the warning signs. The NHS highlights key symptoms: changes in bowel habits, blood in stools (appearing black or red), persistent stomach pain, unexplained weight loss, and bloating. Other symptoms can include diarrhoea or constipation that isn’t normal for you, feeling the need to poo even after going to the toilet, a lump in the tummy, and feeling very tired for no clear reason. A bowel obstruction can cause sudden severe stomach pain, bloating, and nausea.
Data from Bowel Cancer UK reveals that over 2,500 people under 50 are diagnosed with bowel cancer annually in the UK. Rates in those aged 25 to 49 have increased by 62% since the early 1990s, with a higher rise in women (69%). One in 20 cases of bowel cancer in the UK occur in those aged under 50. The research briefing notes that symptoms in younger patients can be mistaken for more common conditions such as irritable bowel syndrome (IBS) or haemorrhoids, and that some hospitals are not consistently testing under-50s for Lynch syndrome, a genetic condition that increases bowel cancer risk. Cancer Research UK, however, warns that reporting statistics on rising cancer rates without context can create an alarming impression and affect public understanding of risk, emphasising the need to provide clear guidance on actions people can take.
“There isn’t quite that awareness still that this can happen to young people,” Ms Rutherford said. “I think that just raising awareness of the symptoms and making sure people have the confidence to get checked if something doesn’t feel right… To not have that immediate thought of: ‘You’re too young to have bowel cancer’ is important.”
This Bowel Cancer Awareness Month, Bowel Cancer UK and Takeda UK are highlighting their Stage4You campaign, developed and funded by Takeda UK and supported by Bowel Cancer UK. The initiative aims to address the unique challenges and unmet needs of those living with Stage 4 bowel cancer, offering practical and emotional support including resources for managing mental health, life admin, financial concerns, and connecting with communities. The campaign encourages patients to take “self-awareness days” to focus on their well-being. For Ms Rutherford, Stage4You offers crucial support because it “acknowledges the mental toll of what we’re going through, and gives us that acknowledgement to be able to just take some time, and to see that life doesn’t just go on as normal sometimes”.
Reflecting on her journey, she concluded: “I think my whole perspective on life changed (after cancer). I say yes to more things. I make sure that all of the time I have is spent doing things that I actually want to do. I think it shows you how fragile life is.”