When a Colon Cancer Warning Sign Was Written Off as a Pregnancy Problem
For most pregnant women, unexpected physical changes are a normal part of the journey. Swollen ankles, back pain, fatigue — these are things doctors and patients alike tend to expect. But for Gabby Zappia, a 37-year-old mother from Mission Viejo, California, one symptom that got filed under "normal pregnancy discomfort" turned out to be something far more serious: stage 4 colon cancer.
Her story is a sobering reminder that even when a symptom seems to have an obvious explanation, it is worth asking harder questions — especially when that symptom involves blood.
A Symptom Dismissed Too Quickly
Zappia was six months into her third pregnancy when she first noticed blood in her stool. She brought the symptom to her obstetrician, who reassured her it was almost certainly caused by pregnancy-related hemorrhoids. It is a reasonable-sounding explanation. Hemorrhoids are extremely common during pregnancy, affecting a significant number of women as increased blood volume and uterine pressure strain the rectal veins.
Trusting her doctor's judgment, Zappia returned to her daily routine. With two children aged four and five at home, life was a constant whirlwind of carpools, packed lunches, laundry, and dishes. There was little time to dwell on the symptom, especially when a medical professional had offered what seemed like a clear and benign answer.
"I still have a little bit of a hard time slowing down," Zappia told Business Insider — a reflection not just of her personality, but of the reality faced by millions of parents who push through discomfort rather than advocate more aggressively for themselves.
The Alarming Return of Symptoms
The day before her due date in June 2024, everything changed. Zappia noticed a dramatic increase in rectal bleeding — so severe she described it as "blood diarrhea." She immediately went to OB triage, where staff were visibly surprised by what she was describing, reportedly asking whether she had taken any photos of what she had seen.
A vaginal examination found nothing obviously wrong, and once again, the bleeding was attributed to the demands of a near-term pregnancy. But the volume and nature of what Zappia experienced was not something that could be quietly reassigned to hemorrhoids. In hindsight, this was a critical moment where a different clinical pathway — specifically, a referral for colorectal evaluation — might have led to an earlier diagnosis.
Months after giving birth, when Zappia finally underwent proper screening, the results were devastating. She was diagnosed with stage 4 colon cancer, meaning the disease had already spread beyond the colon to other parts of the body.
Why Colon Cancer Symptoms Are So Often Overlooked in Young People
Colon cancer has long been thought of as a disease that primarily affects older adults, typically those over 50. Screening guidelines have historically reflected that assumption, with colonoscopies recommended starting at age 45 in the United States following updated guidance from the American Cancer Society. But rates of colorectal cancer in adults under 50 have been rising steadily for decades, a trend that researchers are still working to fully understand.
Because young adults — and especially pregnant women — are not seen as high-risk for colon cancer, their symptoms are frequently attributed to other, more common causes. Rectal bleeding gets labeled as hemorrhoids. Changes in bowel habits are blamed on diet or stress. Fatigue is written off as a natural part of pregnancy or early parenthood. The result is that diagnoses are delayed, often until the disease has reached an advanced stage.
This is not a failure of individual doctors alone. It reflects a systemic gap in how medicine approaches cancer risk in younger populations, and in pregnant patients specifically, where invasive diagnostic procedures carry their own set of concerns.
Warning Signs of Colon Cancer That Should Never Be Ignored
Gabby Zappia's experience highlights why awareness of colon cancer symptoms is so important, regardless of age or life circumstance. While not every instance of rectal bleeding signals cancer, it is a symptom that always warrants evaluation — particularly when it is persistent, worsening, or accompanied by other changes.
- Blood in the stool or rectal bleeding: This is one of the most common early warning signs of colorectal cancer and should never be automatically attributed to hemorrhoids without proper evaluation, especially if it persists or worsens.
- Changes in bowel habits: Persistent diarrhea, constipation, or a change in the consistency of your stool lasting more than a few weeks is worth discussing with a doctor.
- Abdominal pain or cramping: Ongoing discomfort, bloating, or cramping that does not resolve on its own may indicate something more serious than indigestion.
- Unexplained fatigue or weakness: Chronic fatigue not explained by lifestyle factors can sometimes be linked to internal bleeding or other cancer-related changes in the body.
- Unintended weight loss: Losing weight without trying, particularly alongside other symptoms, is a red flag that always deserves medical attention.
- A feeling that the bowel does not empty completely: This sensation, known as tenesmus, can be a sign of a rectal tumor affecting normal bowel function.
The Unique Challenge of Diagnosing Cancer During Pregnancy
Pregnancy complicates cancer diagnosis in ways that go beyond simple misattribution of symptoms. Many of the standard diagnostic tools used to evaluate potential cancer — CT scans, certain contrast agents, and some medications — carry risks for a developing fetus. This creates a genuine clinical dilemma for providers, who must balance the mother's health against fetal safety.
However, experts in maternal-fetal medicine and oncology increasingly agree that delaying diagnosis out of excessive caution can be far more harmful than carefully managed diagnostic evaluation during pregnancy. MRI without contrast, for example, is generally considered safe during pregnancy and can be a valuable tool when cancer is suspected. The key is that providers need to actually suspect cancer in the first place — which requires a willingness to look beyond the most convenient explanation for a symptom.
Self-Advocacy Can Be a Life-or-Death Skill
One of the most difficult lessons embedded in Zappia's story is the importance of persistent self-advocacy in medical settings. Patients — especially those who are pregnant, young, or otherwise considered "low-risk" — often defer to their doctors' initial assessments, which is understandable. Trust in medical professionals is essential. But that trust should coexist with a willingness to ask follow-up questions, request second opinions, and push for further testing when something feels wrong.
If you notice rectal bleeding or any other persistent symptom that concerns you, do not accept a single dismissive explanation as the final word. Ask whether further testing is warranted. Ask what other possibilities might explain what you are experiencing. If necessary, seek a second opinion from a gastroenterologist or colorectal specialist.
A Story That Demands a Broader Conversation
Gabby Zappia's journey from dismissed symptom to stage 4 colon cancer diagnosis is not an isolated incident. It reflects patterns seen across the healthcare system, where young patients — and particularly women — face systemic barriers to timely cancer diagnosis. Her willingness to share her story publicly is a powerful act of advocacy, potentially prompting others to take their symptoms more seriously and to demand the same from their care providers.
Colon cancer, when caught early, is highly treatable. Stage 1 survival rates exceed 90 percent. By stage 4, that number drops significantly. The difference between those outcomes often comes down to timing — and timing depends on recognition, investigation, and action. No symptom that could indicate cancer should be left unexamined simply because a simpler explanation is available.
Zappia's story is a call to listen more carefully: to patients who report concerning symptoms, and to ourselves when something does not feel right.