Sam Jackson, a 32-year-old teacher-turned-influencer from Bolton in Greater Manchester, has revealed she has appendiceal cancer that spread to her stomach lining, months after doctors first told her she likely had stage four colon or ovarian cancer.
Jackson, who has 77,000 followers on TikTok, disclosed her diagnosis in a video posted in early July that has since been viewed more than 800,000 times, telling followers she had "the news no one wanted": stage four colon cancer. Weeks later, an internal scan revealed the disease had actually started in her appendix, the small tube-like organ attached to the large intestine.
A rare cancer on the rise
Appendiceal cancer, also known as appendix cancer, is far rarer than bowel cancer and often harder to treat, according to experts. Fewer than 1,000 cases are diagnosed in the United States each year, equivalent to one to three people per million.
The disease is most common in people aged 50 to 55, but rates have risen sharply among younger adults in the last two decades, with cases climbing by around 200 percent among Americans under 50 over that period.
Professor Justin Stebbing, an oncologist and visiting professor of cancer medicine at Imperial College London, said appendix cancer is "sneaky" because it rarely produces clear symptoms and there is no simple test to detect it.
"While bowel cancer can cause no symptoms, there are often small traces of blood in the stool, and we can spot this via a simple test," he said. "We don't have that with appendix cancer. And either there's no symptoms, or it's a list of very non-specific digestive complaints that can easily be dismissed for mild period pain, IBS or endometriosis."
He added that "treatment tends to be less successful, compared to bowel cancer."
Months of dismissed symptoms
Jackson had experienced "on and off tummy problems" for about a year, including bloating, cramps and sudden urges to go to the toilet. She initially blamed dairy and gluten.
"I assumed it was food-related because it always seemed to happen when I'd eaten dairy or gluten," she said. "When I cut them out for a bit, it really helped." But sticking to the restricted diet left her exhausted and caused weight loss, so in March she saw her doctor, who told her to keep a food diary to track possible triggers.
The pain returned sharply on Saturday, July 18, feeling like "a strong period pain that wouldn't go away." When it hadn't eased by Monday, she left work to see her doctor, who examined her stomach and warned it could be appendicitis, sending her to the emergency department.
The diagnosis
Hospital staff carried out blood tests, CT scans, an ultrasound and gave her painkillers through a drip. At 7pm, nurses led her into a side room with a sofa and low lighting to sit with a doctor.
"I thought, 'This doesn't seem good,'" Jackson said. "The room they took me to was like one I've seen in a TV show, where they take people to give them bad news." The scans had found suspicious growths in her ovaries and digestive system, and doctors said it was likely either ovarian or bowel cancer, pending further tests.
"You never think it's going to happen to you," said Jackson, who lives alone. "I was, obviously, shocked and upset, but I think I still had this feeling they'd got it wrong and made a terrible mistake, because it all happened so quickly."
A colonoscopy, biopsy and further scans followed over the next week. The results were unexpected: her bowel and ovaries were clear, but doctors found diseased cells in her stomach lining. "The wait for answers was excruciating," she said. "Although there was still a glimmer of hope, at this point I'd accepted that it was probably stage four cancer."
Two days later, the hospital asked her to come in with her parents, who traveled from Bolton to London, where Jackson now lives. Doctors told them a tumour in her appendix had spread to her stomach lining, and that she would need major surgery and chemotherapy, though the order of treatment was still undecided.
"My mom and dad started crying, I started crying, it was horrible," she said. "The doctor said that, although more tests were needed to confirm, the cancer was probably stage four."
Two forms of the disease
Appendiceal cancer comes in two main types. Epithelial appendiceal cancer grows from cells lining the appendix and can cause a buildup of mucin, a jelly-like substance, which may eventually cause the appendix to rupture. Neuroendocrine appendiceal cancer, the more common form, develops from enterochromaffin cells involved in digestion and gut movement.
Between 67 and 97 percent of people diagnosed with neuroendocrine tumours live more than five years, though the rate falls when the cancer is caught later or has spread. Experts say the disease's rarity makes it hard to calculate an overall five-year survival rate.
Why cases are rising
Scientists have not pinned down why more young people are developing appendix cancer, though the disease still affects only a few hundred people a year. Stebbing said the causes are likely similar to those behind rising bowel cancer rates.
"I suspect it's a mixture of factors like ultra-processed foods in our diet, antibiotic use, perhaps changes to the gut microbiome," he said. "It could be related to events that happen in childhood because these cancers tend to take a very long time to develop."
He noted that although the appendix is often seen as a "redundant" organ, it plays a role in digestion. "Food passes through it and can get trapped in it," he said. "It's exposed to the contents of our gut, just like the bowel is."
Living with the diagnosis
Jackson is currently waiting to hear from the hospital about when her treatment will begin. Since July, she has documented parts of her medical journey on social media, gaining around 30,000 new followers and thousands of supportive messages.
"I've had thousands of messages and gained around 30,000 followers, and I really didn't expect that type of support," she said. "I've been in touch with other girls going through the same cancer as me, and it's made me feel like I'm not alone."
She is preparing to return to work this week and has continued going out with friends, attending weddings and even a festival. "I'm going out for dinners, I'm seeing my friends, I even went to a festival the other day," she said. "I'm trying to be as normal as I can for as long as I can because, well, I don't really know any other way to be."
"People say I'm brave, but what choice do I have?" she said. "The other option is to admit defeat and stay in bed every day. I can't do that to myself, so I'll just keep going, day by day."
