Over and over again, from the age of 19 to 21, Milli Tanner would hear the same words: ‘You’re just too young to have bowel cancer.’
She would visit the GP an astonishing 13 times over the course of two and a half years with abdominal pain, exhaustion and bleeding every time she went to the loo. And yet not even a faecal immunochemical test (FIT), to detect blood in the stool, was ordered ‘because of my age’.
When she took herself to A&E, at her wits’ end and increasingly ill, she heard the same thing. On one occasion she even asked for a second opinion, and, after a wait: ‘The doctor came back into the room and said: “Right, I’ve just spoken to another A&E department. You’re just too young. Are you happy?” and sent me on my way,’ she recalls. As her symptoms grew worse, the official diagnoses stayed the same. At 19, she had ‘possibly had too much to drink on a night out’ and the alcohol had irritated the lining of her stomach. Later: ‘I was repeatedly told it was “just piles”, “irritable bowel syndrome [IBS]” or “linked to my periods”. I knew it wasn’t and, while I was being told that I was “too young” to have bowel cancer, it was spreading,’ she says.
Indeed, weeks after that A&E visit, 30 months since her symptoms began, she was finally diagnosed with stage three bowel cancer, which had spread to her lymph nodes. It was November 2023. Milli had just turned 22.
Of course she is angry at the time it took – yet in some ways she is also an important lesson for the medical profession. Bowel cancer is exceptionally rare in young people, but it’s not as rare as it was. And in England, rates are rising faster than almost anywhere else.
‘The doctor came back into the room and said: “Right, I’ve just spoken to another A&E department. You’re just too young. Are you happy?” and sent me on my way,’ Milli Tanner recalls
Those doctors who thought Milli was too young were wrong, but the textbooks they’d read as medical students no doubt assured them they weren’t.
Every year in the UK, 2,110 teenagers and young adults aged 15 to 24 are diagnosed with cancer. But the latest government figures, from 2017, show fewer than 2 per cent have bowel cancer (and it’s so rare in the under-15s, there are no official figures at all). That’s fewer than 40 people per year.
And yet since the early 1990s, rates of bowel cancer among the age group 0 to 24 have increased by a huge 74 per cent, much more than in older demographics. A study funded by Cancer Research shows 12 different cancers are increasingly found in young people, but bowel cancer is spearheading the early-onset trend. And it’s the trend that’s important.
Just a little bit older, and the figures become even starker: the number of people aged 20 to 29 being diagnosed with colorectal cancers is rising by almost 8 per cent per year. What’s more, a study by Cancer Research shows that England has experienced the fourth fastest rise in the rate of bowel cancer among the under-50s in the world.
Early theories for the rise include childhood exposure to a toxin produced by the bacteria E-coli, and western diets high in red meat and ultra-processed foods. It’s a fact that those born in 1980 have a higher risk of early-onset cancer than those born in 1970, those born in 1990 a higher risk still, and so on.
What Milli shows is that teenagers do get bowel cancer and doctors are likely to see more of them.
Since her diagnosis she has had chemotherapy, radiotherapy and surgery and has a permanent stoma.
‘I’m angry that a lot of what I’ve been through could have been avoided if I’d just been listened to sooner,’ she says. Now 24, she lives with her partner Tom, 34, in Evesham, Worcestershire, and to look at her – a radiant picture of health – you wouldn’t guess any of it. Yet as she discusses the repeated failures of care, her manner has a world-weariness older than her years.
For her, the worst of it is the effect it may have had on her chances of becoming a mother. Despite having eggs retrieved before treatment, the impact of radiotherapy on her womb may rule out pregnancy.
‘I’ve always been maternal – I have three younger sisters and love children – so the thought of being infertile is just heartbreaking,’ she says.
Indeed, weeks after that A&E visit, 30 months since her symptoms began, she was finally diagnosed with stage three bowel cancer
‘When I learnt this was a possibility, I felt so bad I told my mum I wanted to take my own life.’
Milli was offered counselling to help her cope with these feelings, but didn’t feel ready, though she is now on a waiting list. She is also awaiting an endoscopy to verify the condition of her uterus lining.
While being robbed of the chance of motherhood is now her greatest fear, she is aware that, were it not for her persistence in getting a diagnosis, she might not be here at all.
Perhaps the most remarkable part of her story is that – despite classic symptoms of bowel cancer, including opening her bowels up to ten times a day and passing blood clots when she did – she wasn’t even offered a FIT test until the end of her two-and-a-half year attempt to get answers. This is an at-home test everyone over 50 is routinely given every two years in the UK.
Milli was referred for an ultrasound to check for gallstones and to a physiotherapist for back pain but was told she was ‘too young’ for the tests that would have properly investigated the issues she had.
Even when she ordered a private FIT test online and went back to her GP with results inevitably showing the presence of blood in her stool, still no urgent steps were taken.
‘Even then, I was told they had to follow the NHS guidelines and couldn’t put me forward for an urgent colonoscopy because of my age,’ says Milli. ‘This meant I was on a 60-week wait list. I couldn’t wait that long, so I rang up every day trying to get them to put me forward for an earlier one.’
She was told to ‘go to A&E if the bleeding gets worse’, which it did, but even there her symptoms were ignored.
Finally, in November 2023, after more pleading from Milli, her GP practice did its own FIT and she was referred for an urgent colonoscopy.
‘Very soon into the procedure, I saw this mass in my rectum and asked: “What’s that?”’ she recalls.
‘The doctor said: “It’s a tumour.” And I said: “Is it cancer?” All she said was: “I’m really sorry.”
Milli in hospital with her partner Tom, whom she now lives with in Evesham, Worcestershire
‘I can’t remember much else after that, everything was a blur, until I was back on the ward and a nurse was asking if I’d like my partner to be there when I spoke to the doctor.
‘I messaged Tom saying: “Can you come in and, just be prepared, it’s not good news.”
‘When he arrived, the doctor took us into an office and told us [it was cancer]. Tom broke down in tears. I’d never seen him cry before and that was the first time I cried too.’
Since then there have been many tears shed, most, says Milli, about the impact on her fertility. ‘I’ve cried with everyone: my surgeon, my oncologist, the colorectal nurses, people from Teenage Cancer Trust, who have really supported me, family, friends, strangers,’ she says.
After the gastroenterologist confirmed the tumour was cancerous, Milli messaged her parents, former nurses who run a cafe in Evesham, to tell them the devastating news.
‘Mum told me afterwards that they both stood in the cafe kitchen in tears, before telling the customers they had to close,’ says Milli. ‘Tom and I went to my parents’ from the hospital. No one knew what to do, so we just sat, talking and crying.
‘My dad was really angry that it could have been caught much earlier. I was too numb to feel much at that point. I wasn’t shocked by the results – I’d known for a while, deep down, I had bowel cancer – so there was a sense of relief that, finally, my fears were being taken seriously.’
Tests revealed the cancer was stage three and had spread to lymph nodes. Now there were nine gruelling months of treatment, including chemotherapy, radiotherapy, and finally – in August 2024 – surgery at Alexandra Hospital in Redditch, to remove the tumour, lymph nodes, and her rectum.
Her recovery took months. ‘I really, really hated having a stoma at first, and had a lot of accidents, which was horrible,’ says Milli. ‘After a lot of trial and error, I’ve now learnt to have spare bags and clothes with me when I go out.’
In May this year, nine months post-op, a CT scan, followed by a colonoscopy, confirmed the cancer was gone. After her diagnosis, Milli’s GP tried to get in touch. Milli told her she didn’t want any further contact and was moved to another doctor in the practice.
‘”What were you eating? Do you eat this or that?” which comes across as victim-blaming. Regardless of what I ate, I didn’t need to be left for two-and-a-half years dealing with it’
Her MP contacted the hospital to complain about the A&E doctor who had told Milli she was ‘too young’ to have bowel cancer.
‘I’m not sure who it was who responded, but we did get an apology for that,’ she says. ‘Though no one has apologised for the two-and-a-half year delay in me getting a diagnosis.’
It would be easy to imagine this is an isolated case, but Teenage Cancer Trust says the issues Milli faced are widespread.
Amy Harding, the charity’s director of services and impact, says: ‘Milli’s story, although extreme, is sadly not unique. We know from recent evidence and through the young people we support that far too often the path to a diagnosis is challenging, traumatic and too long for young people.’
The charity is calling for the National Cancer Plan for England, a government strategy to improve prevention, early diagnosis, treatment and care, to include actions to speed up diagnosis for teens and young people. There’s another sting in the tail for Milli, however. Since she told her story, she has been hurt by online commentators questioning whether she brought the cancer on herself through a poor diet.
‘People have asked, “What were you eating? Do you eat this or that?” which comes across as victim-blaming,’ she says. ‘Regardless of what I ate, I didn’t need to be left for two-and-a-half years dealing with it, unsupported.’
And, of course, the trolls are missing the point. The diet that might have something to do with the rise in cancer cases isn’t confined to one person. We all eat it. Very few countries in the developed world are not seeing a rise in early-onset bowel cancer.
Milli tells me she has always eaten a ‘balanced diet’, including fruit and vegetables, while junk food ‘wasn’t a big part of my life’.
There are genetic conditions, such as familial adenomatous polyposis (FAP) and Lynch syndrome which can cause bowel cancer at a young age, but they account for only 5 per cent of cases.
Milli has no family history of bowel cancer but has been told by an oncologist there could still be a genetic link, even if she is the first to develop it.
‘I’m angry that a lot of what I’ve been through could have been avoided,’ she tells me. ‘But I want to direct that into helping raise awareness among other young people – and doctors – that you really can have cancer in your teens and early 20s, and that symptoms must be taken seriously.
‘If me talking about what I’ve been through helps others avoid the same fate, some good will have come of it.’
teenagecancertrust.org