Susan Schmidt, a 47-year-old mother of two from Brisbane, Australia, had always considered herself healthy and active.
A physiotherapist by profession, Susan was accustomed to long days on her feet, guiding patients through rehabilitation exercises and maintaining her own fitness.
For years, she managed the routine stresses of modern life with energy and resilience. Yet, in 2023, she received life-altering news that no one anticipates: she had stage 4 bowel cancer, a diagnosis that would profoundly reshape her life and perspective.
Susan’s journey underscores a critical reality about colorectal cancer: it often develops silently, with early symptoms so subtle that they are easily dismissed or misattributed to lifestyle factors, stress, or even aging.
For many adults, this creates a dangerous gap between the onset of disease and the point at which medical care is sought. In Susan’s case, months of fatigue, minor digestive changes, and sporadic abdominal discomfort went unheeded — a cautionary tale that illustrates the importance of awareness, self-advocacy, and early detection.
The Subtle Onset of Symptoms
Susan’s first warning signs were far from dramatic. In the months leading up to her diagnosis, she began experiencing fatigue so intense that it interfered with her daily routines. “I’d drive my daughter to rowing and then have to stop and nap for 40 minutes on the way home,” she recalled in an interview.
For someone who had spent years balancing a busy professional life with family commitments, this was unusual. Yet, Susan attributed her tiredness to stress and the early onset of menopause, neither of which seemed alarming at the time.
Digestive changes soon followed. While attending a wedding in France, Susan noticed constipation, something she had never experienced before. “I blamed it on the food — too much cheese, too much indulgence,” she admitted. This initial dismissal is common; many individuals associate temporary bowel irregularities with diet or travel rather than viewing them as potential warning signs of a serious condition.
However, upon returning to Australia, her symptoms escalated dramatically. Susan described a terrifying episode of abdominal pain, vomiting, and diarrhea so severe that she found herself on the bathroom floor, unable to move comfortably.
“It was worse than childbirth,” she said, recalling the intensity of the cramps and nausea. Even then, she initially suspected food poisoning or a severe gastrointestinal infection. These experiences, while distressing, were not immediately recognized as indications of colorectal cancer.
The Path to Diagnosis
Despite her extreme discomfort, initial medical tests provided little clarity. Blood tests and stool analyses appeared normal, failing to reveal the underlying malignancy. It was not until Susan underwent a colonoscopy that the severity of her condition became apparent.
During the procedure, physicians discovered a tumor in her colon. The moment the gastroenterologist informed her of the findings was surreal: “When I woke up, I knew something was wrong. They didn’t offer food or drink, and the doctor came in and told me he had found a tumor,” Susan recalled.
Subsequent imaging revealed the cancer had already metastasized — spreading to her uterus, pelvic lymph nodes, and right lung. The diagnosis: stage 4 metastatic bowel cancer. At this stage, colorectal cancer has moved beyond the colon or rectum, affecting distant organs, and curative treatment is generally unlikely. Instead, management focuses on prolonging life, alleviating symptoms, and preserving quality of life.
Understanding Stage 4 Colorectal Cancer
Stage 4 colorectal cancer represents the most advanced form of the disease, accounting for roughly 20% of new colorectal cancer diagnoses worldwide. According to the American Cancer Society, the five-year relative survival rate at this stage is approximately 14%, reflecting the seriousness of metastatic spread.
Despite these statistics, modern therapies can substantially improve patient outcomes, reduce pain, and maintain functionality, allowing individuals like Susan to continue living meaningful lives.
Treatment for stage 4 colorectal cancer is typically multimodal:
Chemotherapy: Systemic drugs aim to slow cancer progression and target malignant cells throughout the body.
Targeted Therapy: Certain medications act on specific molecular pathways in cancer cells, limiting collateral damage to healthy tissues.
Surgery: While curative surgery may not always be possible, procedures can remove tumors that are causing pain or obstructing the bowel, improving comfort and quality of life.
Palliative Care: Focuses on symptom management, including pain, fatigue, digestive issues, and psychological support, enabling patients to maintain daily activities and enjoy time with loved ones.
Susan’s approach has been holistic. Rather than concentrating solely on treatment, she prioritizes maintaining an active and fulfilling life. Traveling with her family, spending time with her children, and advocating for others are now central aspects of her daily routine.
Breaking the Silence Around Bowel Health
One of the most significant barriers to early diagnosis, Susan explains, is the societal taboo surrounding bowel health. Discussions about digestive habits, bowel movements, or gastrointestinal discomfort are often considered embarrassing or impolite, even with healthcare professionals. “I didn’t talk about my bowel habits — who does?” she admitted. This cultural silence can delay recognition of serious issues and, in some cases, reduce survival chances.
By speaking openly about her experience, Susan challenges this stigma. She emphasizes that subtle symptoms — persistent fatigue, mild constipation, or intermittent abdominal discomfort — can indicate colorectal cancer, even in the absence of more obvious signs such as blood in the stool. Her advocacy encourages individuals to trust their instincts and seek medical attention promptly.
For Susan Schmidt, receiving a diagnosis of stage 4 bowel cancer was not only a medical shock but an emotional upheaval. Like many patients confronted with metastatic disease, the psychological impact can be overwhelming. Shock, denial, fear, and grief are common initial reactions, and Susan’s experience was no exception.
“When the doctors told me the cancer had spread, I felt like the ground had been pulled from under me,” she shared. “It’s one thing to hear the word ‘cancer,’ but it’s another to realize it’s already moved beyond the colon. You immediately think about mortality, about missing moments with your children, about everything you might not get to do.”
Stage 4 colorectal cancer requires patients to confront not only the progression of a life-threatening disease but also the uncertainty of how long they have. This uncertainty can create anxiety, depression, and stress, making mental health support as essential as physical treatment. Susan emphasized the importance of acknowledging these emotions rather than suppressing them. “You have to face it head-on. It’s terrifying, but it’s the first step in taking control,” she said.
Treatment: Balancing Survival with Quality of Life
Following her diagnosis, Susan’s treatment plan was carefully tailored to her individual situation. Modern management of metastatic colorectal cancer is highly personalized, considering tumor location, genetic mutations, organ involvement, and patient preferences. Susan’s doctors recommended systemic chemotherapy to target cancer cells throughout the body, complemented by targeted therapy to attack specific molecular pathways in the tumor.
“I’ll probably resume chemotherapy after my next overseas trip,” she noted, reflecting a mindset focused on living fully, even while undergoing rigorous treatment. For many patients, chemotherapy can be exhausting, causing fatigue, nausea, hair loss, and other side effects. Susan, drawing on her physiotherapy background, approached these challenges with resilience, incorporating gentle exercise, proper nutrition, and structured rest into her routine to maintain strength and mobility.
Targeted therapies, increasingly available for colorectal cancer, aim to reduce side effects compared to traditional chemotherapy. These drugs are designed to interfere with specific genetic or molecular pathways in cancer cells, potentially slowing tumor growth without severely impacting healthy tissue. In combination, these approaches help extend survival while prioritizing quality of life — a critical consideration for patients with advanced disease.
Palliative care, often misunderstood as “end-of-life care,” plays a central role in Susan’s treatment. Its focus is on symptom management: controlling pain, minimizing digestive discomfort, improving sleep, and addressing fatigue. For Susan, palliative care allowed her to focus on daily life — traveling, attending family events, and maintaining meaningful connections — even while living with a serious diagnosis.
Turning Pain Into Purpose: Advocacy and Awareness
Despite the physical and emotional challenges of treatment, Susan has channeled her experiences into a mission to help others. Recognizing the gaps in public understanding about colorectal cancer, she became a vocal advocate for early detection and patient empowerment.
“I want people to push for answers if something feels off,” Susan says. “Even if blood tests are normal, even if doctors say it’s stress, hormones, or diet — listen to your body.”
In 2024, Susan founded The Floozie Foundation, a nonprofit organization dedicated to supporting adult cancer patients and their families in hospital wards across Australia. The foundation focuses on several key initiatives:
Emotional Support: Volunteers provide companionship and counseling to patients facing the emotional burdens of serious illness.
Comfort Care: Practical assistance such as hospital care packages, relaxation aids, and mobility support is offered to ease daily challenges.
Education and Awareness: The foundation runs public workshops and campaigns to educate adults about early signs of colorectal cancer, risk factors, and the importance of screening.
Patient Advocacy: The organization encourages patients to speak up, ask questions, and advocate for thorough testing and treatment options.
Through The Floozie Foundation, Susan has not only provided direct support to patients but has also contributed to broader cultural change, helping normalize discussions about bowel health — a topic often shrouded in embarrassment and social taboo.
Raising Awareness About Early Symptoms
Susan’s personal experience demonstrates that early warning signs of colorectal cancer are not always obvious. While symptoms such as blood in the stool or significant weight loss are commonly recognized red flags, early-stage or even metastatic disease can present subtly.
Some of the early symptoms Susan experienced included:
Persistent fatigue despite adequate rest
Minor but noticeable changes in bowel habits, including occasional constipation
Intermittent abdominal pain or cramping
A feeling that the bowel is not fully emptied after a visit to the toilet
These nonspecific symptoms are frequently misattributed to stress, diet, or aging, highlighting the critical importance of self-advocacy and timely medical consultation. Susan stresses that persistent changes in bowel habits, unexplained fatigue, or digestive discomfort lasting more than a few weeks warrant medical attention, even if initial blood tests or imaging appear normal.
Empowering Others Through Personal Storytelling
Susan uses her own journey to encourage proactive health management. By sharing her experiences openly on social media and in interviews, she reaches thousands of people who may be ignoring subtle warning signs. Her transparency not only educates but also reduces fear and stigma associated with discussing bowel health.
“People often feel embarrassed to talk about their bowels, but those conversations can save lives,” she explained. “If I can inspire even one person to see a doctor sooner, it makes everything I’ve gone through worth it.”
Her story also serves as a reminder that life with a serious illness can still be rich and meaningful. Despite ongoing treatment, Susan continues to travel, attend family milestones, and engage in activities she loves. Her approach emphasizes that living with purpose — whether through advocacy, hobbies, or family time — is as important as medical care.
For Susan Schmidt, life after a stage 4 diagnosis is a delicate balance of treatment, self-care, and family priorities. Stage 4 colorectal cancer is not curable in most cases, but modern therapies allow patients to live meaningful lives while managing disease progression.
Susan’s treatment involves a combination of chemotherapy and targeted therapy, with regular imaging to monitor tumor response.
Each therapy cycle brings both hope and challenge. Chemotherapy helps slow cancer growth but comes with side effects such as fatigue, nausea, and hair loss. Targeted therapies, meanwhile, are designed to attack cancer cells with specific genetic markers, reducing collateral damage to healthy tissues and potentially improving quality of life.
Yet, Susan emphasizes that surviving cancer is not only about medical intervention. “Treatment is important, but so is how you live day to day,” she explains. She integrates gentle exercise, balanced nutrition, meditation, and quality family time into her routine. This holistic approach allows her to maintain strength, emotional resilience, and a sense of normalcy amid uncertainty.
Palliative Care and Symptom Management
Palliative care is often misunderstood as solely end-of-life care, but for Susan, it is a critical component of her treatment plan. Palliative services focus on managing pain, fatigue, digestive discomfort, and emotional well-being, ensuring patients can maintain dignity and quality of life.
Through her treatment, Susan has learned the value of advocating for comprehensive symptom management. “Pain and fatigue are not something you have to just accept,” she said. “Doctors can help, but you have to speak up.”
This aspect of care also highlights the importance of early intervention. Even when the disease cannot be cured, managing symptoms effectively allows patients to remain engaged in daily activities, pursue hobbies, travel, and maintain meaningful relationships.
Susan’s Advocacy: Raising Awareness and Saving Lives
A defining element of Susan’s journey is her dedication to advocacy. By openly discussing her diagnosis, treatment, and day-to-day experiences, she breaks the silence surrounding colorectal cancer. She wants the public to understand that bowel cancer can affect anyone, regardless of age, gender, or lifestyle.
Her foundation, The Floozie Foundation, continues to expand its reach. In addition to hospital support programs, the foundation conducts public workshops, social media campaigns, and community events focused on:
Early Detection: Educating adults on subtle symptoms such as fatigue, intermittent constipation, or abdominal discomfort.
Screening Promotion: Encouraging adults over 45, or those with a family history of colorectal cancer, to participate in colonoscopies, fecal immunochemical tests (FIT), or other recommended screenings.
Patient Empowerment: Providing guidance for patients to ask questions, seek second opinions, and make informed decisions about treatment.
Support Networks: Connecting patients with counseling, peer groups, and online communities to reduce isolation and foster resilience.
Through these efforts, Susan transforms her personal challenges into a mission to save lives and reduce preventable late-stage diagnoses.
The Importance of Screening and Prevention
Medical research consistently shows that early detection dramatically improves colorectal cancer outcomes. While stage 4 disease has lower survival rates, catching cancer in stages 1 or 2 can result in curative treatment in most cases. Screening methods include:
Colonoscopy: Visualizes the entire colon and rectum, allowing for polyp detection and removal before they become malignant.
Fecal Immunochemical Test (FIT): Non-invasive and detects hidden blood in stool, often an early sign of cancer.
Flexible Sigmoidoscopy: Examines the lower colon for polyps or lesions.
CT Colonography (Virtual Colonoscopy): Uses imaging to visualize the colon structure without invasive surgery.
Experts recommend adults begin routine screening at age 45, or earlier if they have a family history of colorectal cancer or known genetic risk factors. Lifestyle measures can also reduce risk, including a diet high in fiber, regular exercise, limiting alcohol, avoiding tobacco, and maintaining a healthy weight.
Raising Public Consciousness
Susan’s story also highlights a societal challenge: cultural discomfort in discussing bowel health. Many adults delay seeking care due to embarrassment, even when experiencing persistent symptoms. By openly sharing her experiences, Susan encourages a cultural shift, helping normalize conversations about digestion, bowel habits, and colorectal health.
She stresses that early attention can be lifesaving. “Even subtle signs like unusual tiredness, constipation, or minor abdominal pain should not be ignored. Listen to your instincts and push for answers,” she said.
A Message of Hope and Resilience
Despite the seriousness of her diagnosis, Susan demonstrates that life with metastatic cancer can still be purposeful and joyful. She continues to travel, attend her children’s events, and advocate for others. Her approach combines realistic acceptance of medical realities with optimism and proactive living.
Through social media, interviews, and foundation initiatives, Susan connects with thousands of people worldwide. Her transparency offers both education and reassurance: serious illness is frightening, but patients are not alone, and meaningful life is possible even while undergoing treatment.
Lessons for Everyone
Susan Schmidt’s journey offers several critical lessons:
Trust Your Body: Persistent symptoms, even subtle ones, are worth investigating. Don’t dismiss fatigue, digestive changes, or abdominal discomfort.
Advocate for Yourself: Ask questions, seek second opinions, and insist on thorough testing if something feels wrong.
Normalize Conversations About Bowel Health: Reducing stigma around digestive health encourages early detection and can save lives.
Support Patients and Families: Emotional support, counseling, and practical assistance improve quality of life and resilience for those affected.
Screening Saves Lives: Routine colorectal cancer screening dramatically improves outcomes and should be a priority for adults over 45 or those at elevated risk.
Conclusion: Turning Tragedy Into Purpose
Susan Schmidt’s journey from subtle, ignored symptoms to stage 4 bowel cancer diagnosis is a powerful reminder of the importance of vigilance, early detection, and self-advocacy. By transforming her personal challenge into advocacy and support for others, she is making a tangible difference in the lives of cancer patients and their families.
Her foundation, public presence, and candid storytelling demonstrate that even amidst serious illness, individuals can lead purposeful, impactful lives. Susan’s resilience and compassion inspire not only those with colorectal cancer but anyone facing health challenges to take action, speak up, and prioritize their well-being.
“I want people to know they’re allowed to speak up,” she says. “Your health is worth it. Listen to your body, push for answers, and don’t wait until it’s too late.”
Susan Schmidt’s story is a lifeline for others — a vivid illustration that awareness, early intervention, and proactive healthcare can literally save lives, while courage, advocacy, and resilience can transform personal hardship into hope for countless others.
