health

How one doctor's mistake left Michelle Cox unable to ever have children of her own.

For nine months, Michelle Cox fought to be taken seriously.

When she was 30, the Sydney woman’s doctor misdiagnosed her cancer for so long that it cost her fertility.

September is International Gynaecological Cancer Awareness Month. Every day four women in Australia die from a gynaecological cancer and 16 more are diagnosed. There are currently more than 18,400 women living with these cancers.

There are seven gynaecological cancers – ovarian, uterine (endometrial), vulvar, vaginal, cervical and two rare pregnancy cancers. Ovarian cancer has the poorest outcomes, with only one third of women surviving five years following diagnosis.

Michelle, now aged 46, told Mamamia had a history of cancer in her family – her grandmother and mother both died of the disease – so she was always vigilant with checks.

At 29 she had an ‘abnormal pap’ and had a cone biopsy to remove abnormal cells from her cervix.

Not long after, at age 30, Michelle started noticing weird symptoms including watery discharge and a distended stomach. Having only recently moved to Sydney, Michelle went to a new doctor for treatment and was diagnosed with thrush.

Michelle Cox
Michelle said she lives an often hectic, fulfilling life. Following a successful career in tourism, she is now executive director for Bastion Collective. Image: Supplied.
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She said the doctor put her on three different courses of antibiotics over the nine months, but Michelle felt it wasn't right.

"I kept saying 'This doesn't sound like thrush to me, are you sure it's not something else? I've had a history, should we not get a second opinion?' and she kept telling me 'No it's fine, it's just thrush'."

Michelle was using sanitary products 24/7 to deal with the discharge and showering up to four times a day to feel clean.

She demanded her doctor refer her to a gynaecologist, which she said said eventually happened reluctantly.

"Thank you in advance for seeing Michelle as I’ve diagnosed her with thrush but she is insistent on seeking further treatment which I believe to be a waste of time," the referral letter read.

On a Friday afternoon, Michelle saw a specialist for a biopsy. She left feeling glad that someone was finally taking her seriously.

"When I finished with him I said to him 'Have I wasted your time?' and he looked at me and said 'Why would you even say that?'... He put his hand on my hand and gave me that sense of affirmation that 'you've done the right thing, it's good that you're here'."

The following Monday she was in Darwin for work and received an urgent call from the specialist: She needed to fly back to Sydney for surgery. Right now.

There was a small football-sized tumour on her cervix. She took a late plane out of Darwin and was in surgery in Sydney at 8am on Tuesday morning.

The surgeon said they had a new progressive surgery that would allow them to rebuild her cervix as she wanted to be able to have children, but Michelle was woken up half an hour into the surgery to sign away her fertility. They needed to remove her whole cervix.

While survival rates across all cancers have improved by 19 per cent over the past 25 years, the relative survival for all gynaecological cancers has improved by only seven per cent.

Associate Professor Philip Beale told Mamamia this is because most women will present at a late stage, when the cancer has already spread. Currently, there is no screening test for gynaecological cancers except for cervical cancer.

"While there has been a lot of research into improving the treatment options there has been no major breakthrough which would change the survival rates significantly," Professor Beale said.

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"The biggest change we can expect will be by the development of more effective targeted therapy or by developing an effective and reliable screening method for these cancers. "

One of the main barriers to treatment is the lack of awareness surrounding symptoms, including bleeding, discharge, pain and anaemia.

"Currently most of these cancers will be detected after the presentation of the patient to a doctor with symptoms," he said.

Michelle did present to her doctor, but was misdiagnosed. Her doctor said her 'thrush' could take 18 months to two years to recover and Michelle is frank about what could've happened if she didn't push hard for a referral.

"I actually wonder if I'd still be alive, because she was that flippant about the whole thing. That is pretty horrendous for me to think about."

She holds the doctor fully responsible for the loss of her fertility.

Following surgery, Michelle said she had to go through a grieving process.

"There's a lot of stuff around the physicality of women's cancers where you have your breast cut off or you have your cervix removed. These are quite symbolic things for a woman and so you go through a process of 'am I less of a woman now? How do I deal with that? Am I less sexy?', all those kinds of elements."

"I had to grieve for my life that never would to be."

Michelle met her now-husband only months before her ordeal. They've been together for 17 years and she has two stepsons.

Michelle Cox
Michelle with her husband and two stepsons. Image: Supplied.

Following her surgery they considered adoption or surrogacy, but neither option worked for them.

"I thought well, let's look at this differently. How can I surround myself with children because I love them so much, and have a lot of kids in my life? Instead of being able to give my love to one or two children of my own, I actually had a lot of love to give and I had a lot of children to be able to share that with. That was how I flipped my attitude on it."

Her advice to everyone is to be vigilant with their health and trust their gut.

"You know your body better than anyone does, and if there's anything I've learned it's that doctors are not god-like.

"I want people, if they're not happy with the advice they've been given to go and get a second opinion, go and get a third opinion if you need to. Until you get that peace of mind, it's better to be vigilant about it."

She is speaking out in support of 'Save the Box', a campaign aiming to lift the taboo around gynaecological cancers and raise much-needed funds for research.

"I want people to talk about it, I want people to know my story is gruesome and it's not nice talking about, but if it helps to save someone else's life or helps them to enable them to keep their fertility then that's fantastic to me," Michelle said.

"I think that the sisterhood is a wonderful thing and the more that we can share our stories, the positive and the negative, the more we can help each other."

September is International Gynaecological Cancer Awareness Month and ANZGOG are urging all Australians to get involved to help raise funds for critical research. Simply register at www.savethebox.org.au and ANZGOG will send a Save the Box fundraising kit.

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