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Geraldine Levano was 26 and pregnant with her second child when she began experiencing severe acid reflux. Having dealt with similar symptoms during her first pregnancy, she initially dismissed the discomfort as another unpleasant part of expecting a baby.
But the pain kept getting worse.
“It was really bad to the point where I had to have my husband lift my stomach because the pain was unbearable,” Levano recalled.
She visited the emergency room three times during her pregnancy. Each time, doctors found no abnormalities, and her baby was determined to be healthy. According to her account, no additional testing was performed to investigate the underlying cause of her pain.
“Throughout my pregnancy, I kept on saying, ‘Something’s wrong, I don’t feel good,’” she said.
What Levano didn’t know was that she had Stage 3 colon cancer.
Her experience highlights a challenge for nurses and other healthcare professionals: recognizing when symptoms commonly associated with pregnancy may signal something more serious, particularly when patients repeatedly seek care for worsening pain.
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Three ER Visits Before a Cancer Diagnosis
In March 2022, Levano gave birth to a healthy baby boy named Mateo. She and her family hoped the painful symptoms she had endured throughout pregnancy would finally disappear.
Instead, the acid reflux returned just days after she was discharged from the hospital.
During her fourth emergency room visit, doctors discovered a large mass near her stomach and colon.
Further testing at a local hospital revealed a tumor in her colon approximately the size of a grapefruit. The mass had extended toward her stomach and was touching part of her pancreas.
Levano was diagnosed with Stage 3 colon cancer and referred to Amit Agarwal, MD, an associate professor at McGovern Medical School at UTHealth Houston and a colorectal surgeon at UT Physicians and Memorial Hermann-Texas Medical Center.
“If the cancer wasn’t identified, her symptoms could have worsened and progressed to Stage 4 colon cancer. Aside from acid reflux, she could have also developed significant anemia, fatigue, shortness of breath, and changes in bowel habits,” Agarwal said.
Surgery Reveals an Obstructing Tumor
The size and location of Levano’s cancer complicated her treatment.
Before surgery, Agarwal explained that she faced a 50% chance of waking up with a colostomy bag.
“I didn’t have time to say no. Everything happened so fast,” Levano said.
During the operation, Agarwal discovered that the tumor was causing a partial obstruction. He removed portions of her colon and stomach.
Given the extent of the surgery and the possibility that Levano would need chemotherapy, he determined that a temporary colostomy was the safest approach.
“Due to the size of the tumor causing partial obstruction, the size of the colon, the need to take a portion of the stomach, and potential need for chemotherapy after surgery, these factors all led me to the safest thing–giving her a temporary colostomy,” Agarwal said.
Levano underwent chemotherapy while adjusting to life with a colostomy and caring for her two young children.
“I had moments where I didn’t want to do it anymore. It was very, very hard, all while trying to be a mother. It was difficult for me because I couldn’t even carry my 5-pound baby. He was so tiny, and even then, I couldn’t hold him because the pain was unbearable,” she said.
Approximately six months after her initial surgery, Levano underwent a colostomy reversal, marking an important milestone in her recovery.
Lynch Syndrome Helps Explain Her Diagnosis at 26
During her cancer journey, Levano learned that she has Lynch syndrome, an inherited genetic condition that increases the risk of colorectal, uterine, and other cancers, often before age 50.
The condition most likely contributed to her unusually young age at diagnosis.
Today, Levano continues to see Agarwal for annual colonoscopies and endoscopies as part of her ongoing surveillance.
She is now three years cancer-free.
When Pregnancy Symptoms Warrant a Closer Look
Levano’s case illustrates the importance of evaluating persistent or worsening symptoms, even when they resemble common pregnancy complaints.
Severe acid reflux during pregnancy may not initially suggest colorectal cancer. However, her repeated emergency room visits, escalating pain, and continued concerns about her health underscore the importance of considering other possible causes when symptoms remain unexplained.
For nurses, the case reinforces the importance of recognizing changes in symptom severity, documenting patient concerns, and advocating for further evaluation when symptoms persist despite previous assessments.
From Cancer Patient to Healthcare Advocate
Levano now works as a medical assistant at a Houston-area clinic.
Her experience as a cancer patient has shaped how she approaches her work, bringing a firsthand understanding of what it means to feel unheard when something is wrong.
She also believes her pregnancy may have played an unexpected role in saving her life.
“I feel like if it wasn’t for him, I probably would have never even suspected something was wrong,” Levano said.
Her message to other women is to keep seeking answers when their symptoms don’t improve.
“I always tell everybody, if you feel like something’s off—even if you have to go to two different doctors, three different doctors—always get your point across because at the end of the day, you never know when your health could change in an instant.”
