To her 77,000 TikTok followers, the videos show a bright, energetic young woman seemingly making the most of life.
In clips that have drawn hundreds of thousands of views, teacher-turned-influencer Sam Jackson tries on new outfits, soaks up the European sun and shares classroom tips with fellow teachers planning lessons for sharp-witted pre-teens.
Yet amid the polished snapshots of influencer life are a small number of posts that lay bare the devastating reality the 32-year-old has faced this year.
In one video posted in early July, which has now been watched more than 800,000 times, Bolton-born Sam quietly tells her followers “the news no one wanted”: she has stage four bowel cancer.
At first, she believed it was an illness she could at least understand — one with a treatment path she might be able to anticipate. What she found online suggested some people live for several years with advanced bowel cancer.
She was also aware that cases of the condition are increasing among people in her generation.
But within weeks, everything changed again when an internal scan exposed a far more alarming diagnosis.
The cancer was not bowel cancer after all, but appendix cancer — affecting the small, tube-shaped organ connected to the large intestine that contains part of the body’s gut bacteria.
Sam Jackson, 32, has been hit with a lethal cancer that’s rising in young people
While it developed there, it’s now approaching her stomach lining.
Experts say the disease, known medically as appendiceal cancer, is often tougher to treat than bowel cancer, and far more likely to spread after treatment.
And, curiously, it is also on the rise – particularly among young, fit and healthy Britons.
Incidence of the deadly condition has jumped five-fold over the last 20 years, according to data for England. The largest increase has been seen in those aged between 20 and 39.
Cancer specialists say it was ‘very rare’ to see a young person with this disease a decade ago. Today, one in three appendix cancer patients are under 50. For bowel cancer, it’s one in 20.
And experts say that appendix cancer is uniquely ‘sneaky’ as, very often, there are virtually no symptoms. There is also no simple, effective test that looks for 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,’ said Professor Justin Stebbing, oncologist and visiting professor of cancer medicine at Imperial College London.
‘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: ‘Treatment tends to be less successful, compared to bowel cancer.’
For the past year, Sam had ‘on and off tummy problems’, including bloating and cramps. Sometimes she’d need to go to the toilet more urgently than normal.
‘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 she struggled to stick to the restricted eating pattern as it resulted in weight loss and exhaustion.
In March, she visited her GP who advised her to keep a food diary to track common triggers. The symptoms came and went, having little impact on her day-to-day life.
But on Saturday, July 18, she was hit by an almighty ache in her belly, which felt a little like ‘a strong period pain that wouldn’t go away’.
The sensation was still there on the Monday morning, so she made a plan to ‘dip out of work’ that day to visit her GP.
‘She had a feel of my stomach and said that, because of the severity of the pain I’d been in, it could be appendicitis, so she told me to go to my local A&E.’
Hospital doctors conducted blood tests, CT scans and an ultrasound, and provided an infusion of painkillers.
At 7pm, after several hours of waiting, nurses brought her into a side room with a sofa and low lighting, and gestured for her to sit beside the doctor.
‘I thought, “This doesn’t seem good”,’ Sam 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.’
Her hunch was right. The scans had detected several suspicious growths in her ovaries and within her digestive system. The signs pointed towards cancer that had spread.
Further tests would need to be conducted to establish the location of the original tumour, but it was likely to be either ovarian or bowel cancer, doctors told her.
‘You never think it’s going to happen to you,’ said Sam, 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 follow-up colonoscopy – whereby a camera is inserted into the back passage to look for bowel tumours – along with a biopsy and yet more scans were conducted over the following week.
The results were confusing. Her bowel and ovaries were clear of cancer but doctors had 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 phoned and asked her to come in to see the specialist with her parents, who had travelled down from Bolton to London, where Sam now lives.
Another family room, another stern-looking chaperone.
The doctors had finally got to the root of the problem; a tumour in her appendix which had spread upwards to the lining of her stomach.
She’d need major surgery and chemotherapy, although doctors weren’t yet sure which would come first.
‘My mum 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.’
Sam has been documenting snippets of her medical journey on her social media platforms
Sam Jackson, who hails from Bolton, is ‘carrying on as normal’, enjoying festivals and weddings
Between 14 and 50 per cent of patients with advanced appendix cancer survive longer than five years, depending on the exact location of the tumour.
At the time of writing, Sam is awaiting confirmation from the hospital about when she’ll begin her treatment plan.
Scientists remain perplexed about the rise in young people getting appendix cancer, which is still rare, affecting just a few hundred people a year.
It’s likely that the same factors at play in the rising tide of bowel cancer are to blame.
‘I suspect it’s a mixture of factors like ultraprocessed foods in our diet, antibiotic use, perhaps changes to the gut microbiome,’ Professor Stebbing explained.
‘It could be related to events that happen in childhood because these cancers tend to take a very long time to develop.’
While the appendix is often thought of as a ‘redundant’ organ, it plays a role in digestion, and is therefore affected by the food we eat.
‘Food passes through it and can get trapped in it,’ Professor Stebbing says. ‘It’s exposed to the contents of our gut, just like the bowel is.’
Sam, meantime, is ‘carrying on as normal’ – as the upbeat clips on her social media can attest to.
She began documenting snippets of her medical journey in July, and found the supportive feedback from followers was often the only thing that kept her going.
‘I’ve had thousands of messages and gained around 30,000 followers – and I really didn’t expect that type of support. 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.’
But mostly, she’s sharing clips of her sunny coffee walks and evenings out at friends’ weddings. She’s preparing to go back to work this week.
‘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? 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.’
