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Woman reveals how GP visit revealed cancer that may have killed her

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Katherine Hawkes, a college innovator, attributed an unusually difficult period to the stress of being in an unfamiliar environment.

After all, the then 19-year-old was away for the first time from her home in Diss, Norfolk, with her parents Sally, an administrator, and Roy, a computer programmer.

But she also felt exhausted and two days later she also passed out. So Katherine put aside her shame — “A heavy period seemed so trivial,” she says — and booked an appointment with her doctor.

The decision saved her life. Within hours she was in hospital for life-saving treatment.

Katherine’s heavy periods were a symptom of acute promyelocytic leukemia (APL), a rapidly developing blood cancer. If left untreated, the doctors told her, it would almost certainly have killed her within a week.

Katherine Hawkes, as a ‘newer’ at university, attributed an unusually difficult period to the stress of being in an unfamiliar environment

It was crushing news. Her doctor had done a blood test only as a precaution and told Katherine she would get the results in a few days. But that same day at 6:00 PM, he called her to tell her that she was so anemic that she had to go straight to the hospital.

Stunned, Katherine left for York Hospital with two roommates. There, a doctor took Katherine to a quiet room and told her, “There’s a good chance you have leukemia. It’s so aggressive that we have to start treatment tonight.’

“It was so shocking I couldn’t believe it,” says Katherine, now 22.

APL occurs when the bone marrow (the source of all blood cells) makes immature white blood cells, meaning there is not enough room for other healthy blood cells to develop.

As a result, there is a shortage of red blood cells (these carry oxygen around the body and a shortage leads to shortness of breath and lethargy) and white blood cells, which fight infection.

Crucially, it also means a lack of platelets, the component of blood that helps it clot and stop bleeding. This causes symptoms such as bruising, due to uncontrolled leakage from small blood vessels – and heavy periods.

dr. Elaine Hampton, a family physician at the charity Macmillan who helps doctors educate about the signs and symptoms of leukemia, says, “Along with fatigue and bruising, heavy bleeding is a major symptom of APL.”

“Patients often have nosebleeds and bleeding gums, and a sudden change in an unusually heavy period can be a warning sign.”

While APL is rare – affecting around 160 people in the UK each year – unusually heavy periods can in fact be a sign of other forms of leukemia, with an average of 10,000 new cases a year in the UK.

Katherine’s heavy periods were a symptom of acute promyelocytic leukemia (APL), a rapidly developing blood cancer. If left untreated, the doctors told her, she would almost certainly have died within a week

dr. Hampton says women who are concerned about unusually heavy blood flow shouldn’t be ashamed of going to their primary care doctor, who will usually offer a blood test (to check for anemia due to heavy bleeding, but can also indicate problems in the bone marrow). to detect).

A recent Leukemia Care poll found that 53 percent of female patients had experienced a heavier than normal period leading up to diagnosis.

Katherine was three weeks into her first semester of a psychology degree in 2018 when she had a period so heavy that she had to use both a tampon and a sanitary pad.

“In the end I was wearing a raincoat during every lecture to prevent bleeding and hoping to go to the toilet during the break,” she says.

‘I reasoned it away. I was warned that your body needs time to adjust when you make a big change, like starting university.’

But looking back, she realizes there were other symptoms as well. A few days after she settled into her room, she noticed a large bruise between the thumb and forefinger of her right hand and then began to develop large bruises on her legs – one the size of a hand – but attributed that to her. to her natural clumsiness.

However, a week after she noticed the first bruise and five days after her period, Katherine was sitting on the bus when she thought she was going to pass out.

She decided she must be anemic and tried to see a GP but had to wait five days for an appointment.

Her primary care physician suggested taking blood samples to check for anemia. This showed that Katherine’s white blood cell count was 186; the score of a healthy person is ten.

Such a high level could be a sign of leukemia, so the GP called Katherine and urged her to go straight to the hospital.

Katherine only had time to call her parents quickly before she left. When she arrived at the hematology department, a doctor came to her right away.

“The first thing she asked me was if my parents lived far away,” Katherine says. “I told her it was a four-hour drive from Norfolk. It was such a strange question. Why did she want to know?’

Fearing they wouldn’t have time to wait for them, the doctor told her she needed a bone marrow biopsy to confirm a suspected cancer diagnosis.

Katherine was stunned. “I decided it had to be a mistake,” she says. “I called my parents and said, ‘I have cancer.’ Then I started to cry. The nice doctor picked up the phone and explained that I was in good hands. She didn’t leave me until my parents arrived.’

While Katherine waited, a consultant reiterated the gravity of her situation. Her cancer was so aggressive, he told Katherine, that if she hadn’t gone to the doctor that morning, “You would have been dead by the end of the week.”

To receive the specialist treatment she needed, Katherine had to be transferred that night from York Hospital to St James’s Hospital in Leeds.

Because she didn’t have time to wait for the results of definitive bone marrow biopsies, doctors put her on an infusion of the chemotherapy drug idarubicin, the standard treatment for APL.

Treatment leads to remission in up to 90 percent of cases. But within minutes of Katherine being put on it, it triggered differentiation syndrome — a common but potentially serious complication in APL patients where the dying white blood cells targeted by the chemotherapy flood the lungs. This prevented Katherine’s body from absorbing oxygen, threatening acute organ damage.

Katherine’s parents arrived just in time to see her put into an artificial coma.

She remained in an intensive care unit coma for eight days while doctors controlled the differentiation syndrome. When she came to, she noticed that her shoulder-length hair was beginning to fall out.

“When I was finally brave enough to look in the mirror, I didn’t recognize this balding, frail woman looking at me,” she says. “I had lost my health, dignity and independence. Now I had lost my hair.’

In November, Katherine was transferred to Addenbrooke’s Hospital in Cambridge, closer to her family home, to begin the second of four cycles of chemotherapy on an outpatient basis. In addition to idarubicin, she was prescribed ATRA, a form of vitamin A that matures white blood cells so that they can be killed more effectively.

The side effects of both drugs meant that Katherine had to go in and out of the hospital. “First, the chemo inflamed my heart, causing pericarditis, where fluid pooled around my heart and had to be drained,” she says. “Then, on Christmas Eve, my right lung collapsed and had to be blown up.”

Katherine’s treatment ended on February 26, 2019, five months after her diagnosis. She returned to York University in September to resume her studies and is now in her third year.

Doctors have reassured her that her treatment has been a success and that the cancer is unlikely to return, but she has follow-up appointments every three months.

“I have one more appointment before they release me and tell them not to see me again,” she says.

‘I feel incredibly happy. I enjoy my course and made great friends. My experience also shapes my career plans – I plan to train as a clinical psychologist specializing in pain management,” says Katherine.

“But the emotional consequences were terrible. I have nightmares and panic attacks when I walk into a hospital. I’ve been told it’s a form of post-traumatic stress disorder.”

And there’s one thing she never forgets: “If I’d just ignored my symptoms for a few more days, I’d be dead by now.”

leukemiacare.org.uk

The simple life

Simple changes to your daily routine can boost your health. This week: Buy shoes for your age

Wearing the right pair of shoes can help improve your balance, but the best type for you may depend on your age.

If you’re over 65, shoes with less arch support and structure may encourage your brain to respond better to movement and thereby improve your balance and gait, according to a study published in the journal Scientific Reports.

Scientists from the University of Liverpool observed 30 people, with an average age of 68, walking and standing, wearing normal, structured trainers, ‘minimal’ shoes (with less arch and side support) and barefoot.

They found that those in the minimal shoes were the most mobile, suggesting that such shoes can help improve balance and prevent falls.

Meanwhile, a 2018 study suggested that sandals were the best option for better balance and posture for 20- and 30-year-olds. Scientists at King Saud University in Saudi Arabia compared sandals to regular shoes and bare feet.

They suggested that the type of shoes you wear affects balance through the pressure it puts on the main tissue of the foot, which then sends messages to the central nervous system, which is connected to the brain.

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