Auckland woman Amelia Noyes is speaking out about how cancer changes everything including fertility, why early detection matters so much, and how it shouldn’t be taboo to talk about poo..
Amelia Noyes was 26 when she was diagnosed with stage-three bowel cancer. Now 28, she’s talking to me over Zoom because she wants people to recognise the symptoms, and to advocate for themselves within the medical system. She also wants women to know how cancer affects fertility.
Amelia is brave, honest and gracious. “I’m perfectly comfortable sharing all this. In fact, I’m a bit of an over-sharer.”
First, a background fact: according to Bowel Cancer NZ, a family history or hereditary factors may be identified in approximately 30% of those diagnosed. Generally speaking, the more members of a family there are who get diagnosed, and the younger they are when diagnosed, the greater the possibility of a hereditary link.
Amelia’s grandmother died from bowel cancer. In 2019, Amelia’s mother died from bowel cancer aged 56, just three months after her diagnosis. Right around that time, Amelia, then 21, started getting concerning symptoms.
“I could see blood in my poo and on my toilet paper. I was also battling either constipation or diarrhoea. So I went to my GP. Knowing my family history, it was really important to me to know what was happening, because I’ve been a carer for family members who had bowel cancer. And being young, I want to live life, become a mother and one day a grandmother.”
Seeking Help
Her GP wrote a referral letter asking for a colonoscopy in the public-health system. “In Te Whatu Ora Health New Zealand’s eyes, they thought she’s 21, so it’s probably not cancer, and they said they’re not going to do a colonoscopy at this time.”
How did that make her feel? “Angry. Frustrated. I felt I was presenting red flags: these symptoms, and my family history. I think it [not getting a colonoscopy] heightened the stress I was under, because not only was I having health issues, but mum had just died, and I was about to finish my Bachelor of Communications [majoring in TV and screen production]. So I was just at an all-time high of emotions and stress.”
Amelia didn’t have the money to go private. “Looking back, maybe I could have approached family members, but I’d be really uncomfortable asking for thousands of dollars to do a colonoscopy.” Plus, you’re meant to trust the health system, and she hoped the symptoms would resolve on their own.
For the next three years, her on-and-off symptoms were attributed to minor conditions. “GPs would shrug it off as hemorrhoids or anal fissures. So I’d be given Rectogesic cream to apply, which burnt and stung.”
“In 2023 and 2024, I noticed my symptoms progressively become more persistent and harsher: blood in my poo, and frequent diarrhea or constipation. What helped get me the colonoscopy referral from a GP was showing photographs of what was happening in the toilet bowl over a week as evidence.” This time Te Whatu Ora Health NZ accepted the request.
Bad News
On December 16, 2024, Amelia had a colonoscopy. “The moment the gastroenterologist brought me into a white room with my partner, I went into hysterics.” He’d found a seven-centimetre rectal tumour but couldn’t confirm it was malignant cancer until the biopsy came back. The next day, a colorectal nurse specialist called Amelia. It was Stage 3 bowel cancer, meaning it had spread to her lymph nodes but not to organs like the lung and liver. “I went into more hysterics: ‘I’m dying, my time’s up’.”
The first line of treatment was radiation therapy and chemotherapy – a combined therapy called Neoadjuvant. “This involved 27 rounds radiation therapy to my pelvis with oral chemotherapy. Once I finished this, I then had eight rounds of FOLFOX – 5-FU IV-chemotherapy. Fortunately, radiation and chemotherapy worked, so I didn’t need to have surgery for the tumour.” She did have 12 pre-cancerous polyps (tiny fleshy bumps) removed.
Her aunt, a nurse, took her to appointments and procedures, something she hugely appreciates. “My fiancé – every day he had off work, he’d be there for me.” She gets teary. “Sorry, I’m a bit emotional.”
She’s often thought ‘why me?’. “I’ve been in hysterics on the bathroom floor, battling the constipation and diarrhoea you get from treatment, on top of an already reactive gut. I spend a lot of time in the bathroom.”
Treatment-wise, what’s next? “Active monitoring for the next five years.” Plus medicines, and hormonal replacement therapy.
Put on Pause
She’s had great support from family and friends. “But going through a cancer diagnosis and treatment feels quite lonely and isolating. In November 2024, I was processing grief around scattering my family members’ ashes. I’d just gotten engaged to my partner of eight years. Then came the diagnosis and everything was put on pause. Scenarios play out in your head. When can we have a wedding? When can we have children? My best friend and my godson were living with us, and I thought, will I see him graduate from high school? What about my nieces and nephews? Will I be here for the things that I’d really value being here for?”
The uncertainty is really difficult. “You don’t know what the future will be. You have to go through all the hard stuff, and you don’t know how radiation and chemo are tracking until they’re done. And you don’t know what your body’s limitations will be. To visit my dad and family in Australia, I wonder ‘will I even be able to sit on a plane for four hours if I’m sick?’.”
Amelia has never stopped working. She’s a programme delivery lead at Hato Hone St John, looking after volunteers who teach communities CPR and AED (Automated External Defibrillator) skills.
However, the day to day isn’t easy. “The fatigue has been huge. I get tired often and have to go to sleep early. The medications I’m on make me quite drowsy, so I have to take a lot of them at night – because if I take them during the day and have to drive somewhere, that’s not ideal. Also I can’t recognise the urgency and the signals of when I need to go to the bathroom, not just for bowel motions, but also for urination. So there have been a few accidents.”
“And because I have chronic anal fissures, I still bleed when I have bowel movements.” A doctor injects Botox to help the sphincter muscle relax.
She’s been focusing on eating wholefoods and more fibre, and is working with a physio and trainer to keep her body moving. “But since I’ve had my Botox procedure, I’ve had to dial down on what I do in the gym.”
Let’s Stop Being Squeamish
Should people talk about poo more even if they feel squeamish? “Yes. Because poo is a good indicator of what’s happening in your gut.”
And when caught early, bowel cancer is more than 90% curable.
If you experience any of these symptoms – blood in your poo, ongoing changes in bowel habits, unexplained weight loss, persistent tiredness, abdominal pain, or feel a lump in your tummy – see your GP, regardless of your age. “You’re never too young to get bowel cancer,” Amelia says.
“Please, have those uncomfortable conversations, even if it starts with not going to the doctor just yet. Sit down with a trusted family member or friend and say ‘hey, this is what I’ve been experiencing, I feel something’s not right, what shall I do?’.”
What would she say to someone else denied a colonoscopy? “Advocate for yourself. Be proactive to fight for what you truly believe you need. In this country, we shouldn’t have to fight for the standard of care we need, but you honestly have to. You don’t want to be told ‘there’s nothing we can do’ when it’s been going on for a while.”
Speaking Up
Last year the government lowered the free National Bowel Screening Programme’s eligibility age to 58, and in September it will drop to 56. However, Bowel Cancer NZ is lobbying for it to lower to 45, something Amelia supports. “Personally, I think that any cancer screening should be at any age. But the data shows that people in their 30s and 40s are getting diagnosed the most with bowel cancer, and also too late.”
In February, Amelia spoke in Parliament at the launch of Bowel Cancer NZ’s Never Too Young report. Hosted by MP Sam Uffindell, the evening brought together MPs, representatives from Te Whatu Ora Health NZ and the Ministry of Health, plus researchers, patients, and supporters.
Amelia said in her speech that: “young people get bowel cancer. We do not fit the profile, and because of that, our concerns are too often dismissed. Early intervention saves lives. But listening saves dignity.” She was a bit disappointed that only three MPs attended. One was health minister Simeon Brown, who spoke to her briefly then had somewhere else to be.
As Amelia tells me, “I enjoyed having the opportunity to speak at Parliament not just for myself, but for others diagnosed with bowel cancer, especially people who find out too late. The point of that speech was that early detection saves lives and we need to have people getting checks done earlier and be okay with talking about uncomfortable things.”
But when she made that speech, looking composed, she was anything but composed inside. “The negatives in life were outweighing the positives. I felt like I almost lost my identity and my understanding of myself. Hospital appointments, conversations with doctors, medications, treatment and care really consumed my life all last year. I started to not feel anymore like a person with values, beliefs, inspiration and ideas. I felt like this lab rat trying to survive and overcome something that a lot of people don’t get the opportunity to survive and overcome.”
“Looking at the port-a-cath scar on my chest, it doesn’t feel like me.” A port-a-cath is a small device placed under the skin, used to deliver medications like chemotherapy directly into a large vein near the heart. “It never felt like all this was meant to be part of my journey, but it is. And it’s just coming to terms with that. How to move on from that is the challenge at the moment.”
Fertility Talk
Fertility advice isn’t routinely provided to people with bowel cancer.
Amelia wants people to have discussions about how any type of cancer can affect a woman’s fertility. “Planning for family and fertility is often a conversation that doesn’t cross anyone’s mind until it’s too late, which was the case for me. If there are other women in that position, I want them to know they’re not alone.”
Right before chemotherapy and radiation, Amelia got her eggs frozen, and created embryos with her fiancé. She won’t consider motherhood until the time feels right. “But I have some uncomfortable feelings and emotions about it, because I can’t carry my own child.”
They’d need a surrogate, but there’s serious red tape involved in surrogacy in New Zealand. You have to get approval from the Ethics Committee on Assisted Reproductive Technology, find a surrogate yourself who meets certain health expectations (you can only pay her ‘reasonable expenses’), adopt the child after proving you’re a suitable adoptive parent, and go through counselling. “And you have to get lawyers and have Oranga Tamariki involved. The processes scare me, and sound like more stress than I need.”
Wedding Bells
Amelia is thankful for her loved ones and colleagues. Friends and family took part in fundraising for Bowel Cancer NZ, an organisation she really appreciates. “My friends also put on a fundraising concert in my backyard, and my workplace took part too, and they fundraised $11,000 dollars to go towards our wedding.” It’s in February next year and she’s enjoying planning it. “I’m so proud of myself for going through what I’ve been through, and fighting for my life and how I want to live it.”
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