When Kelly Spill was eight months pregnant, she experienced some constipation and noticed blood in her stool. Her OBGYN wasn’t worried.
Credit for all photos: Kelly Spill
“She said, ‘You’re about to have a baby in a month,’” Spill said to The Cancer Letter. “She’s like, ‘Things are moving around. It sounds pretty normal. Basically, there’s nothing to worry about.”
At the postpartum checkup, Kelly didn’t mention her lingering symptoms, and the doctors said everything looked good.
But as time went on, Spill’s symptoms worsened.
“I was still constipated,” Spill said. “I was still seeing blood in my stool. At that time, I started to have abdominal pain as well. And I was taking ibuprofen almost every day. And that’s when I was like, ‘This doesn’t seem right. I feel like I shouldn’t be taking anything every day at this point, whether it’s Advil or anything else.’”
Spill went back to her obstetrician, who said he was “99.9% sure” Spill had internal hemorrhoids. If symptoms continue, Spill should go see a primary doctor, he said.
A month went by, and Spill’s symptoms persisted. So, she took her OB’s advice and went to her primary doctor.
“I’m walking in with a newborn, so it’s clear that I’m a new mom. Just seeing that, too, I think is big, because she quickly jumped to, ‘I’m pretty sure you have internal hemorrhoids. Let’s do some blood work.’”
Everything came back normal.
“So, I went home that day and I didn’t really think much of it. At the time, I’m trusting the doctors,” Spill said. “Especially at 28 years old, I’m just going with the flow.”
Despite persistent symptoms, Spill had to put her concerns on pause. She was preparing to move back to her childhood home of New Jersey—a cross-country move from where she was living in San Diego—to be closer to family.
“I put my health aside, not knowing that I was dealing with something big,” Spill said. “And I thought, ‘I have more to focus on. I have to focus on my baby. We have to focus on moving our stuff and getting from A to B. I’ll worry about whatever I have to worry about once I get to New Jersey.’”
A few months went by, and Spill’s symptoms continued to worsen. She lost her appetite, and quickly was down eight pounds. She had lost enough weight on her 5’4” frame that she was “looking very tiny.”
“Every single day, I was waking up in the morning and like, ‘I just don’t feel good. I don’t know what it is, but I don’t feel good.’ I couldn’t explain it,” Spill said.
Spill wanted to get these symptoms checked out, but she struggled to find a primary doctor who would take her health insurance.
Then, one morning, Spill went to the bathroom and was shocked by the amount of blood she found in the toilet.
“You would’ve thought it was that time of month, and it was not,” Spill said. “Seeing that amount of blood in the toilet was very alarming. And that’s when I called my mom and I said, ‘This is not good.’”
Spill and her mother decided to go to the emergency room.
“We went to the ER, and it was the same thing,” Spill said. “He told me, ‘You’re a first time mom, I’m pretty sure you have internal hemorrhoids. Lay off the spicy foods.’
“That’s when I started to feel pretty defeated, because I’ve now had three doctors tell me the same thing, and nothing further was happening. I didn’t know where to turn at that point. And then I started questioning myself on how I was feeling, what I was going through.”
The ER doc was able to get Spill into a family clinic.
He was able to make a call and said, ‘This is where I can send you, have him take a look at you.’ So, that was our next step. So, that’s what I did.
“And nothing really came from that appointment as well.”
A few days later, she had another bout of excessive rectal bleeding. Her appetite, at this point, was basically gone.
“At this point, I’m not really able to eat anything,” Spill said. “I’m sitting at a restaurant. I would take a bite of something, I wouldn’t feel well, I would be in the bathroom. It was really hard for me at work. I just never really felt good.”
Spill was open about her symptoms with her friends. Eventually one friend was able to connect Spill to a primary doctor who took her insurance.
“I went to that doctor,” Spill said. “I was taking pictures along my whole journey since San Diego on my phone, and thank God, because her just seeing those pictures—she looked at me and she was like, “You need a colonoscopy, don’t you?’ And I was like, ‘Yeah, I 100% do.’”
That physician referred Spill to a GI specialist.
That week, Spill saw the GI specialist. The next day, she had a colonoscopy. When she woke up, she was told she had a tumor one centimeter away from her anal opening.
Two weeks later, Spill was diagnosed with stage 3 rectal cancer.
For those not keeping count: It took a total of seven doctors to diagnose Spill with rectal cancer. Spill’s symptoms began in March of 2019. She was not diagnosed until January 2020.
The promise of dostarlimab
Spill chose to pursue treatment at Memorial Sloan Kettering Cancer Center.
“[The oncologist] proceeded to tell me that my treatment plan would be oral chemotherapy, radiation, and surgery. And I said, ‘Okay.’ And I’m processing at this point.
“Then he said, ‘Because of this treatment plan, you will most likely never be able to carry another baby again, and you most likely will have a colostomy bag for the rest of your life, because of where the tumor is.’”
For Spill, the news of her looming infertility was the hardest to swallow.
“Hearing that I wouldn’t be able to carry another baby again, that’s what broke me,” Spill said. “I quickly thought about my fiance at the time. We just had a baby. I’ve always dreamed of having a really big family, and now everything is just like a storm at this point. And I just couldn’t bear to even think about how I’m going to tell my fiance these things.”
Spill had a conversation about preserving her fertility with her doctor and ultimately decided to freeze embryos. Spill was lucky—an estimated 70–75% of adolescent and young adult cancer survivors are interested in parenthood, but only half of them report getting oncofertility counseling and preservation options prior to their cancer treatments, according to results of a cross-sectional study: Patient-Reported Discussions on Fertility Preservation Before Early-Onset Cancer Treatment, published in JAMA Network Open(The Cancer Letter, April 11, 2025).
Devastated but ready to move forward, Spill went into the doctor’s office for her first chemotherapy appointment on March 4, 2020. Before they could get started, a research nurse entered the room.
“She said, ‘We have some tests that came back. If you are open to speaking about a possible opportunity to go with a different treatment plan, we would love to speak to you about it.’ And I said, ‘Of course, I have nothing to lose here. So, yeah. Let’s talk about it,’” Spill said.
The tests had defined Spill’s tumor as mismatch-repair deficient, making her eligible for a phase II trial of monotherapy dostarlimab in the neoadjuvant setting.
Dostarlimab, a checkpoint inhibitor, would have much fewer side effects than chemotherapy, the research nurse explained.
“That treatment plan, versus treatment plan A… It just sounded a lot less harsh in my body, and it sounded a little bit ‘easier,’” Spill said. “And I looked at my mom, she looked at me, and I said, ‘What do you think?’ She’s like, ‘Well, I think you should go for it. What do you think?’ And I said, ‘I think whatever you think.’”
Spill’s mom was a pivotal source of support for her through this process.
“At 28 years old, I don’t really know anything about this world,” Spill said. “I don’t have any friends or family who went through this. And I just had no knowledge of really much of anything, and I felt so sick at the time that I couldn’t even think for myself. So, thankfully I had someone with me who could process.”
Hearing that I wouldn’t be able to carry another baby again, that’s what broke me.
Kelly Spill
Spill decided to sign up for the trial. She was told that she would be the only fourth person on the trial, meaning she would be the fourth person in the country to receive dostarlimab monotherapy for the neoadjuvant treatment of locally advanced rectal cancer.
At that time, the possibility that dostarlimab would prevent Spill from undergoing the life-altering standard of care was not on the table. She elected to join the trial simply to avoid the side effects of chemotherapy—even if it was temporary.
“They didn’t really have much to go off of. I didn’t know anything, where this would lead me, at all,” Spill said.
Spill’s radiation oncologist: “I want to say this the nicest way—I hope never speak to you again.”
The next week, Spill had a port put in and began treatment shortly afterwards. She went home from that first infusion feeling “okay,” she said. “I don’t want to say I was great, but I was definitely better than I know going through chemo [would have been].”
I’ll be five years into survivorship in September, and I’m about to give birth to my third baby any day now.
Kelly Spill
After that, Spill rapidly improved.
“After my second treatment, I felt a lot better, which was a little scary, but exciting at the same time. By my fourth treatment, after my checkup, I was told that my tumor was halfway disappeared,” Spill said.
After that fourth checkup, Spill and her mother were told that the three patients who had started on the protocol before Spill had complete clinical response.
“We were told, ‘There are three people ahead of you, and they did not have to get radiation or surgery, and their tumor had completely disappeared.’” Spill said. “So, that was when we really found out that, ‘Oh my goodness, there’s actual hope that I might not have to get radiation or surgery.’ And that’s when things really started to bloom for us.
“It was also scary, because I’m only the fourth one, so what if that doesn’t happen for me?”
By her ninth treatment, Spill’s tumor had completely disappeared.
“It was unreal, and it was hard to even think that this was actually happening to me,” Spill said.
The response was so unexpected, in fact, that despite being declared disease-free, a radiation oncologist called her to set up an appointment.
“I’m thinking to myself—and I’m a pretty quiet person, I don’t really like to be outspoken—but after realizing how much I need to advocate for myself, I was like, ‘What do you mean? Why do we have to go with the radiation? I thought I didn’t have cancer anymore. I thought I was cancer free. I thought my tumor was gone. What’s going on?’” Spill said. “And he was like, ‘Oh.’ It sounded like it was news to him, and he wasn’t aware of it yet.”
The radiation oncologist hung up and called Spill back 10 minutes later.
“He said, ‘Kelly, there was an amendment in the protocol. I want to say this the nicest way—I hope never speak to you again. You do not need radiation,’” Spill said.
That was a pivotal moment for Spill. Her top priority—growing her family—was now presenting itself as a possibility once again.
“That was the real, real, real big moment for me, because that’s when I knew that there was a possibility that I could have another baby,” Spill said. “That’s all I was thinking about my whole entire journey. And my doctors were probably blue in the face over how many times I asked, ‘Can I have another baby? Can I have another baby? Is this going to happen for me?’”
Despite Spill’s eagerness, her oncologist strongly suggested that Spill wait two years before trying to get pregnant.
“She said, ‘I know you really want to, but I really advise you waiting at least two years, because if anything is going to happen, the tumor will most likely come back within two years, and we want to just make sure that everything is okay,” Spill said. “That broke me, because I really thought it was time for me to be able to progress in my life at this point.”
As much as the recommendation crushed Spill, those next two years proved vital for Spill’s mental as well as physical health.
“Little did I know, I really needed those two years,” Spill said. “Because survivorship—I had no idea—was extremely hard. I realized that my mindset did not catch up to my physical body yet. I didn’t know, really, what had happened, because I was fighting so hard. Everything had to catch up with each other. So, it took me those two years to figure myself out. I had a lot of anxiety attacks, panic attacks. Survivorship is not easy.”
Finally, almost three years after her diagnosis, Spill and her husband got the green light to try having another child. They decided to pursue IVF, using the embryos Spill had frozen years earlier.
Her second child, Mya, was born July 14, 2023. Her third child is due May 14.
“I’ll be five years into survivorship in September, and I’m about to give birth to my third baby any day now,” Spill said.
Spill has not received any cancer treatment since her last dostarlimab infusion in on August 19, 2020.
Life with three children
When Spill was diagnosed, her son, Jace, was eight months old. Jace is now six.
Jace, it turns out, adores being an older brother.
We were told, ‘There are three people ahead of you, and they did not have to get radiation or surgery, and their tumor had completely disappeared.’ So, that was when we really found out that, ‘Oh my goodness, there’s actual hope that I might not have to get radiation or surgery.’ And that’s when things really started to bloom for us.
Kelly Spill
“He has, as you can imagine, no idea the journey that we went on as a family and how much he’s played a part in it,” Spill said. “But I can’t imagine him not being able to experience having a sister, because he’s such a loving little boy with so much energy, and he gives her so much love.”
Spill said Jace will fake cry at home, because he knows that Mya will come over and hug him.
“He is a lover of babies,” Spill said. “He probably gives this baby that’s on the way the most love out of everyone. He is just so excited. He kisses my belly every day. I just can’t imagine him not having siblings.”
Mya is “just a ball of fun,” Spill said.
“She’s so cute. She is really starting to grow into herself right now. She just loves to babble. She’s talking all the time. She has no idea baby’s about to come and rock her world,” Spill said.
Spill is excited to be growing her family.
“Even today, I look at her and I’m like, ‘I can’t believe you’re here,’” Spill said.
