Texas mother's severe pregnancy heartburn misdiagnosed, later revealed as stage 3 colon cancer

Geraldine Levano, a 31-year-old mother in Houston, Texas, had severe pregnancy heartburn dismissed as routine by healthcare providers before being diagnosed with stage 3 colon cancer shortly after giving birth in April 2022. An eight-centimeter tumor pressing against her stomach caused the reflux. Following surgery, chemotherapy, immunotherapy, and a temporary colostomy bag, Levano achieved over three years of remission. Testing also revealed Lynch syndrome, raising awareness of early-onset colorectal cancer warning signs.

Pregnancy heartburn symptoms dismissed

• ▪Geraldine Levano, a 31-year-old medical assistant from Houston, Texas, experienced severe heartburn during her pregnancy that co-workers and her OB-GYN attributed to normal pregnancy symptoms.
• ▪Geraldine Levano sought hospital care multiple times for severe heartburn during her pregnancy, but hospital staff reassured her that her symptoms were normal and that her baby was healthy.

Levano's pregnancy symptoms

• ▪Geraldine Levano found that medication failed to relieve her pregnancy reflux, which she described as a burning pain with a sensation that something was stuck.
• ▪Geraldine Levano also experienced unexplained weight loss, chronic constipation, and anemia during her pregnancy, which are symptoms associated with both pregnancy and colon cancer.

Tumor discovery and diagnosis

• ▪Colorectal surgeon Dr. Amit Agarwal explained that Geraldine Levano's colon tumor was pressing up on her stomach from behind, preventing normal digestion and causing her severe acid reflux.
• ▪Testing following the birth of her son in April 2022 revealed that Geraldine Levano had an eight-centimeter stage 3 tumor obstructing her colon.
• ▪About two weeks after giving birth in early April 2022, Geraldine Levano discovered a painful lump under the left side of her ribcage.

Cancer treatment and recovery

• ▪Following several months of chemotherapy and subsequent immunotherapy, Geraldine Levano had her colostomy bag removed in December that year and rang the bell celebrating the end of treatment in August of 2023.
• ▪Geraldine Levano reached more than three years of cancer remission following her stage 3 colorectal cancer treatments.
• ▪Geraldine Levano underwent surgery about two weeks after her diagnosis to remove the tumor and was fitted with a temporary colostomy bag to prevent bowel obstruction during subsequent chemotherapy.

Lynch syndrome diagnosis and management

• ▪Genetic testing revealed that Geraldine Levano has Lynch syndrome, an inherited genetic condition that increases the risk of developing colorectal, uterine, and other cancers at a young age.
• ▪Following her Lynch syndrome diagnosis, Geraldine Levano elected to have a partial hysterectomy and committed to ongoing annual medical screenings including colonoscopies and endoscopies.

Colorectal cancer indicators and trends

• ▪Colorectal cancer cases have been rising among younger adults, although the disease continues to be more common in older age groups.
• ▪The American Cancer Society highlights persistent changes in bowel habits, blood in the stool, abdominal discomfort, unexplained weight loss, fatigue, and rectal bleeding as potential indicators of colorectal cancer.

NCI study on early warning signs

• ▪A study reported by the US National Cancer Institute analyzing over 5,000 colorectal cancer patients under age 50 identified abdominal pain, rectal bleeding, diarrhea, and iron-deficiency anemia as four early warning signs.
• ▪The US National Cancer Institute study showed that having one of the four early warning symptoms doubled the likelihood of an early-onset colorectal cancer diagnosis, while having three or more increased it sixfold.