SILENT KILLER
Man, 32, who blamed ‘bone-white poos’ on a hangover is left fighting for life with a year to live
Find out what the colour of poo can tell you about your health
A MAN who blamed his 'bone white poos' and dark pee on a hangover was given a year to live after doctors diagnosed him with cancer.
Matthew Rosenblum was just 32 when he noticed his poop was jarringly light after a night out but a doctor reportedly told him: "If you have cancer, I will roll over in my grave."
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Initially, the former PhD candidate wasn't too phased by the colour of his stools and pee, chalking them up to hangover as he'd had a few drinks the previous night.
"I had dark urine and bone-white stool," Matthew told The Patient Story.
"I didn’t even notice the stool colour for a while," he recalled.
"At first, I thought I was hungover. I had a few beers the night before so I drank some Gatorade and lay in bed, but the urine did not get lighter."
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It wasn't until Matthew's palms and feet started to itch uncontrollably that he decided to visit a doctor.
Even then, it took months, multiple trips to doctors before he was diagnosed with pancreatic cancer.
Doctors gave Matthew a bleak prognosis, giving him one to three years to live even with treatment.
"People think that pancreatic cancer is an old person’s disease," he told The Patient Story.
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"I think that’s why no one ever looked, because no one ever even thought that I could have pancreatic cancer.
"I’ve heard over and over again that I’m too young."
I'm a doctor, NEVER ignore these pancreatic cancer symptoms
In the UK, pancreatic cancer is most commonly diagnosed in people over the age of 75. Around 10,500 people are affected each year.
FIRST SIGNS
Having been diagnosed with Crohn's disease seven years earlier, Matthew was no stranger to "gastrointestinal distress", one of the most obvious symptoms of pancreatic cancer.
"I probably wouldn’t have noticed even if I didn’t have Crohn’s," he said.
Aside from tummy troubles, Matthew also lost some weight in the months leading up to January 2021.
This is when he was struck with more "distinct" symptoms, such as the "bone-white" poop, dark urine and itching on the palms of his hands and bottom of his feet.
Matthew said: "The bathroom symptoms were pretty jarring, seeing urine that dark and poop that pale, but the itching was probably the worst.
"It was worse at night. I never felt anything like it before and those are hard places to scratch.
"After a whole night of itching, I put my hands and feet in the tub under hot water to numb the sensation."
He noted that not all pancreatic cancer patients experience itching.
"The earlier symptoms are very nuanced, can go unnoticed, and can also be misdiagnosed as a multitude of other things," Matthew said.
"By the time you’re experiencing symptoms, the cancer has spread outside of the pancreas. I don’t want to say it’s too late, but that’s what conventional wisdom is."
What the colour of your poo means
YOU might think paying attention to your poo is gross, but it can give you vital clues about your health.
Here's different colours can tell you:
- Brown - this colour of poo is normal and healthy
- Black - liquorice, iron tablets or certain medicines can dye your poo a darker hue, but it can also indicate bleeding in your stomach. Contact your GP if it's black, tarry and smells bad, and you have tummy pain
- Grey - medicine to treat diarrhoea can cause this but very pale or grey poo might mean your pancreas or liver is not working properly. contact your doctor as soon as you can if your poo suddenly becomes pale, especially if there has been no change in your medicine
- Green - antibiotics or eating lots of green veggies can be the cause, as well as a gut infection like food poisoning or gastroenteritis. This will also change the consistency and frequency of your poos
- Red - caused by beetroot and red food dye in food and drinks but it could also indicate bleeding in the bowel. Contact your doctor if you haven't eaten red foods
- Orange - vitamin A supplements and eating large amounts of food with beta carotene (e.g. carrots) can cause this, as well as condition called bile acid diarrhoea, where bile stays in the stools without being reabsorbed
- Yellow - this can indicate too much fat in the poo (steatorrhoea), a marker of IBS, Coeliac disease or pancreatic exocrine insufficiency
- Silver - a very rare colour of poo and is not a good sign. Discuss it with your doctor urgently as it may be a symptom of cancer
- Mucusy (clear) - sometimes people with IBS see visible mucus around their poo and this can also happen sometimes if someone is constipated. See a doctor if this is a new symptom
Source: Guts UK
THE ROAD TO DIAGNOSIS
Matthew visited an urgent care centre 48 hours later where he was told that his blood was high in bilirubin - a byproduct of broken-down red blood cells that influences stool colour - and told to go to A&E.
High levels of bilirubin can indicate a blockage in the bile duct, a tube-like structure that connects the liver to the small bowel.
Ultrasounds revealed narrowing of this tube, which doctors attempted to stretch using a stent.
Matthew recalled: "There was no sense of urgency. I was an otherwise healthy person with a history of colitis.
"They didn’t think that this was anything scary."
But his symptoms returned after they removed the stent, leading doctors to conclude that they were caused by his gallbladder.
Matthew had surgery to remove the organ, but still suffered symptoms.
Visiting his gastroenterologist in late April 2021, she told him: “I don’t know what’s happening, but you for sure don’t have cancer.
"If you have cancer, I will roll over in my grave.”
Matthew left her office feeling "pretty confident" but just three hours later, his results came back to show that he had a tumour in the opening at the start of the small intestine where the pancreatic and bile ducts join, known as the ampulla of Vater.
'ABRASIVE' TREATMENT
Matthew was scheduled for surgery to remove part of his pancreas and small intestine - but this didn't go to plan.
"My surgeon told me that they cut me open and, contrary to what they thought, found a tumour on the head of my pancreas that had spread outside of the pancreas.
"Metastatic pancreatic cancer is considered inoperable so when they saw that, they closed me up," he explained.
Doctors suspected that Matthew had a mutation of his BRCA2 gene, which is associated with several forms of cancer, including breast and pancreatic.
He was told by his oncologist: “With treatment, you might have one to three good years left, but that’s it.”
Matthew started a six-month course of chemotherapy in May 2021, using a potent concoction of drugs which were '"really, really abrasive" but failed to stop the cancer from growing and spreading to his liver.
"At this point, I was not confident that I would be a special case or a miracle. I thought this was it," he said.
What are the symptoms of pancreatic cancer?
PANCREATIC cancer doesn't usually cause symptoms in the early stages.
As the cancer grows it can start to cause symptoms like:
- Tummy or back pain
- Yellowing of the skin or whites of your eyes (jaundice)
- Unexplained weight loss
- Changes to your poo
Symptoms of pancreatic cancer can be vague. They can be caused by other conditions, but it's important to get them checked by a doctor.
Source: CRUK
BEATING THE ODDS
Doctors switched Matthew to a new combination of chemo drugs, which banished some of the spots on his liver.
"I thought I was still dying sooner rather than later so I was trying to have fun and it certainly made having fun a lot easier."
By March 2022, doctors couldn't identify any cancer outside of Matthew's primary tumour and were able to perform a successful Whipple surgery to remove the majority of the cancer.
Since then, Matthew has had scans to monitor his cancer on a three-monthly basis.
"I get a scan every three months for the next six years, but the chances of me living out those six years are astronomically small," he explained.
"Pancreatic cancer has a remarkably low five-year survival rate. It’s unlikely that I will see all of that time, at least on paper."
Despite his bleak prognosis, Matthew advised others in his situation not to lose hope.
"We assume that if treatment will work, it will work immediately.
"In my experience, that’s not true. Sometimes things get worse before they get better and it’s not a reason to lose heart."
He went on: "It’s important to remember that you are not a statistic.
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"I was diagnosed with something I wasn’t supposed to have at my age. It was very unlikely.
"It was supposed to kill me and I didn’t die so, in a sense, I beat the odds not once, but twice."
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