Interviewed by: Taylor Scheib Edited by: Katrina Villareal
Paula initially experienced painful gas, irregular bowel movements, and eventually blood in her stool. She was often dismissed by doctors who attributed her symptoms to stomach flu, hemorrhoids, or irritable bowel syndrome. As her condition worsened, she became anemic and experienced severe pain, weight loss, and fainting spells.
After years of being misdiagnosed, Paula was finally diagnosed with colorectal cancer in 2014 after a series of urgent care visits and a failed colonoscopy. The tumor had been encapsulated in her colon and despite initial fears, it had not spread to other organs or lymph nodes.
Paula underwent emergency surgery to remove the tumor. Although doctors anticipated the need for chemotherapy or radiation, they were able to successfully remove the tumor and 34 lymph nodes. Paula’s cancer was found to be stage 3, but it had not spread to her lymph nodes.
Throughout her journey, Paula faced multiple challenges, including medical bias due to her race and sexual orientation. She experienced homophobia, racism, and misogyny, which contributed to delays in her diagnosis and treatment. Despite these challenges, she found strength in her community and in sharing her story.
Paula emphasizes the importance of early screening, particularly for those with a family history of colorectal cancer and for marginalized communities. She advocates for self-advocacy in healthcare, urging others to push for fair and humane treatment. Paula believes in the power of survival and thriving with cancer, encouraging others to know their family history, get screened, and not be afraid of a cancer diagnosis. She stresses the importance of treating everyone with dignity and respect in healthcare and encourages individuals to take control of their health.
Thank you to Johnson & Johnson for its support of our patient education program! The Patient Story retains full editorial control over all content.
This interview has been edited for clarity and length. This is not medical advice. Please consult with your healthcare provider for treatment decisions.
I had all the signs and symptoms that they tell you to look out for when it comes to colorectal cancer, but at the time, I didn’t know what they were.
Introduction
I’m in love with my best friend and partner, Lara. We have been together for 38 years and married for 10 years. I’m a cat mom to a little cat named Trixie.
I enjoy dancing and singing. I’m a Duran Duran fan and that’s how I met my wife. For our 38th anniversary, we went to their 40-year celebration in Birmingham, England.
I’m also a great cook and I have a collection of amazing cookbooks. I’m trying to make my way to some of the best restaurants in the world.
Pre-diagnosis
Initial Symptoms
I had all the signs and symptoms that they tell you to look out for when it comes to colorectal cancer, but at the time, I didn’t know what they were.
In the early days, I always had painful gas and weird poop. When I experienced them, I would automatically blame what I ate and drank, so I would dismiss them a lot of times.
But then I started to have more painful symptoms, especially with the gas. I told my wife that I felt like I had gas going up and it was getting trapped. There were times when it hurt so bad that I wanted to scream.
I started seeing more blood. I went to see a doctor who said I probably had hemorrhoids.
PCP Appointment
I started going to the doctor by the end of 2012. I went to my primary care physician, but he didn’t think much of it at the time. When the pain was bad, I would get told that I probably had stomach flu.
Symptoms Worsen
I started to see signs of blood in late 2013. Sometimes I would be straining to poop. Other times, I would have diarrhea. I didn’t have my regular PCP at the time, so I would see whoever was available and they told me to change my diet. When I told one doctor that I saw some blood, he thought I might have stomach flu, so he gave me antibiotics.
By 2014, I started seeing more blood. I went to see a doctor who said I probably had hemorrhoids, so whenever I saw blood, I assumed it was that. I also started having bad pain and being anemic, but I didn’t know it then. I was cold all the time.
Being Dismissed
They said things that a lot of people under the age of 50 would be told because they were too young. “You probably have IBS.” “It’s probably hemorrhoids.” “You just have gas.” “I’m sure it’s nothing. You’re too young.” I heard a lot of that over the year.
By the time 2014 came around, I had been on antibiotics for nine months from different doctors I had seen since 2013.
There were times when the pain would be worse and I would have to go to urgent care. I went at least six times. The first few times, they would say I had gastritis or something stomach-related and send me home with antibiotics and painkillers. The last few times, I was bent over and freezing because I was anemic. I started to lose weight and ended up losing 45 lbs.
I have experienced a lot of bias and straight-up racism with medical care.
The doctor came into the room and before he even said his name or mine, he said, “I don’t give drugs in this room.” My wife took the doctor out and started yelling at him in the hallway while I sat there, thinking, Don’t yell. They will not help me if you yell.
I have experienced a lot of bias and straight-up racism with medical care. In 2014, I had doctors ask, “Did you tell me you were gay? Listen, it doesn’t matter what’s wrong with you because you’re going to hell.”
Losing Her Job
I got a job that year, but I was having such a hard time because I couldn’t keep up. Then I started to see my hands turn white and thought I was working too hard and planning for our wedding was too much. But the doctors kept telling me that I was okay.
I started getting depressed because I didn’t feel good. I felt that I wasn’t pulling my weight or helping my wife like I should. I was telling people I couldn’t do things, but the doctor said I was okay so it was starting to mess with my head. I didn’t want to tell people when it was bad, so I was hiding it, which made it worse.
I ended up losing my job because I kept calling in sick.
I was so sick and dizzy that I could barely see and stand up.
Diagnosis
Turning Point
The day after we got married, we went to a Broadway play, but while we were there, I felt terrible. My colon was becoming completely blocked and I was starting to have serious complications. By the time the play was over, I was so sick and dizzy that I could barely see and stand up. I was shaking, my body was red, and my skin was hot.
When we got back to my best friend’s house, I ran past the door and barely made it to the bathroom. I had the most humiliating accident. I was lying on his bathroom floor and knew that this was bad. I knew something was wrong.
Around January, I started to have fainting spells. I went to an urgent care on a Thursday and said, “Ma’am, I don’t care what you say. Nothing is coming out of me but blood. Nothing!” The person behind the counter got a nurse, who came out and said, “I’ve seen some of your records. Has anybody given you a FIT test?”
I didn’t know what a FIT test was. She was a bit worried. She said, “You probably ate something red, but I’m going to give you this test. Unfortunately, we don’t have a lab here, so I will not have the results until next week.”
I was in agony and stayed in bed all weekend. I was going back and forth to the bathroom and blacking out. I called my wife and we went back to the ER. This time, I must have looked bad enough because they kept me. I still had a 13-hour wait, but they said, “Get her a room. Get some scans. We’re going to do a colonoscopy.”
I don’t remember much after that. I was so sick that they started to medicate me and put me out. When I woke up the next morning, it was time for rounds and the doctors were going to come and talk to me. They did scans, blood work, EKGs, and all these tests, and they tried to do a colonoscopy.
They tried doing a colonoscopy, but they couldn’t get through.
Getting the Official Diagnosis
Around eight doctors came in. My heart started pounding. One doctor said they tried doing a colonoscopy, but they couldn’t get through. I didn’t know what to say after. It was a devastating way to find out I had colorectal cancer.
Reaction to the Diagnosis
What did that man say to me? What did those people tell me? Why did all those people ignore me? How long does this cancer take to grow? Black people have a higher risk of this? I was pissed and it was messing with me as much as the cancer was messing with me. I was mad and when I’m mad, I keep it in because I don’t want to hurt other people. Doubt, depression, and misery set in, and I needed to find a way to turn it around.
Treatment
Surgery to Remove the Tumor
They said, “We’re going to do emergency surgery. Based on what we see, it looks bad. We believe the tumor has broken outside of the colon wall. It might have some interference with your liverand other organs. We’re not sure what we’re going to find. We’re possibly going to do radiation and chemo because it looks massive. We might have to shrink it first or we might have to go in, do surgery, clean it up, and fix what we can. We need to decide. We’re going to keep you here because you are completely dehydrated.” I was skin and bones, and an absolute mess.
The tumor board said it looked bad, so we weren’t going to do chemotherapy or radiation, but we were going to do surgery. They brought me back to the hospital and prepped me for surgery. I was there for about four days prior and then a week and a half after.
The tumor was encapsulated in the colon and has not broken outside of the colon wall.
I went in early morning to prep and they told us that surgery would take 12 to 14 hours. They said, “We believe you are stage 3. When we go in, we might have to take out your uterus. We will take out whatever the tumor has affected. We will take out part or most of your colon. You will probably have a permanent ostomy. We may have to take out part of your liver. If it has gone deeper into the stomach, we will decide from there. We will do what we must do and that’s all we can tell you right now.”
When I woke up, the nurses came over and said, “Ms. Chambers, your doctor will explain everything.” He came in and said, “When we got in, it wasn’t what we thought.” Lara said the doctors came to her about four hours into surgery. They found that the tumor was encapsulated in the colon and has not broken outside of the colon wall. My body was completely swollen. I was blocked. They took out 34 lymph nodes. The whole surgery took 5 ½ hours. When they got the pathology back, there was no cancer in any of the lymph nodes.
Genetic Testing & Family History
Once my doctors knew that I had colorectal cancer, they did all the right things. They asked all the questions, especially my family history. They asked me repeatedly.
I decided to stay at the county hospital because they saved my life. I found my team, so I continued my care with the oncology and GI staff. In conjunction with UTHealth, they were able to offer genetic testing, which I qualified for and was able to do through my wife’s insurance. They suggested that because they think I have a genetic component. They tested me for Lynch, but it was negative.
That same year, my father-in-law and I did a DNA test and the results said I had another brother. A cousin contacted me and we talked about what was going on and I found out about David. He allowed me to share part of his story. He is an ostomate and was diagnosed with stage 3 colorectal cancer two years before me. He didn’t know about our family because he was adopted when he was a kid. We then found out that there’s a family history of not only colorectal cancer but GI cancers, and it runs deep in the family.
Look at your own biases. Think about when you are at the doctor yourself and how you would like to be treated. Keep it professional but bring in that real spirit of caring.
Experiencing Bias
I experienced homophobia, racial bias, bigotry, and a lot of misogyny, which I think went into some of my diagnoses. A couple of people told me I was hysterical and that it was in my head. It was so freeing to tell my story for the first time. It brought people into my life who had a similar story.
Meeting them and finding that community made me realize that it wasn’t just me and that I wasn’t too young. It wasn’t because I was Black. It wasn’t any one of these things. There’s a way that we look at cancer and at diagnosis, treatment, and preventative medicine that needs to be changed. I had whole conversations about this cancer that has stigmas around it that I did not even know I was supposed to be ashamed of.
I’m a nine-year survivor and in those nine years, I’ve seen things change. Things take time. It’s like pulling a bandage off a wound and having the wound heal. We have to treat it and give it light. We have to uncover some of the issues with which we are dealing. Because we all have our own biases, it’s important for anybody in the healthcare field, especially here in the United States, to look at things within us that we need to look at.
Innately, I think most people who go into healthcare do it because they want to. It’s their calling. It’s also their decision to be in healthcare, a space where they care for people who show up in their rawest moments. It’s important to have grace and a little bit of humility. If someone’s coming to you, they’re putting their trust in you.
Treat people with respect and dignity. Ask them, “Who are you? What happened to you? How did you get here? How can I help you? How did you get to me? Thank you for coming here.” Listen to them and meet people where they are.
The calling in healthcare is not for everyone. We still have laws, rules, and regulations, and we are to treat everyone with dignity and respect. Look at your own biases. Think about when you are at the doctor yourself and how you would like to be treated. Keep it professional but bring in that real spirit of caring.
I want people to not be afraid to go to the doctor. I don’t want what happened to me to happen to anybody.
People need to get screened, especially those in the Black and LGBTQIA+ community. You need to feel comfortable and know that there are more and more places with affirming care and who show it. They want you to know that you are welcome. Look for the rainbows.
Let us know that we are welcome. Ask me what my pronoun is. Is that my partner or my wife? Do not assume. Ask us what we need and be in partnership with us.
I want people to not be afraid to go to the doctor. I don’t want what happened to me to happen to anybody. Know your family history. A lot of gay kids are kicked out of the house when they are young, but a lot of them stay in touch with their family members.
Words of Advice
We need to get screened for colorectal cancer. The screening age now is 45, but if you have a family history of colorectal cancer like me, especially if you have beautiful melanated skin, you want to make sure that you’re talking to your doctors early.
Cancer affects the family and not just the individual. If there’s cancer in the family, it needs to be openly discussed. We need to be tested. We need to know our family history.
Nobody is going to care for you the way you do. Always put yourself first.
Cancer is a scary word, but it’s a word. People survive, thrive, and live with cancer. We’re called survivors from the day that we are diagnosed, so from that day, I had a choice. Am I going to live with this or am I going to let it take me? I needed to find a way to live with it and I did.
But I didn’t want to just live—I wanted to thrive. If cancer’s something that you’re afraid of and it’s the reason you’re not getting screened, you’re doing yourself a disservice.
Advocate for yourself. You have the right to advocate for fair treatment and humane treatment. Nobody is going to care for you the way you do. Always put yourself first. Put the mask on first and take care of yourself first. Nothing can be healthy and whole until you are healthy and whole. If you’re not comfortable, say so.
Special thanks again to Johnson & Johnson for its support of our independent patient education content. The Patient Story retains full editorial control.
Interviewed by: Taylor Scheib Edited by: Chris Sanchez
Steve, a 51-year-old resident of Ontario, Canada, was diagnosed with Stage 4 colorectal cancer 3 years ago, and he shares his story with us.
Steve’s diagnosis frightened and angered him. He had been suffering the symptoms of colorectal cancer for years before diagnosis, but they were shrugged off as food sensitivities. When the tumor in his colon was finally discovered, it was so large that his doctors could not get the scope past it to perform the colonoscopy. Moreover, the doctors also found 23 metastatic tumors on his liver. He was told that based on stage 4 colon cancer survival rates, he would likely live for just 3 more years. (hint, that was 3 years ago)
Instead of succumbing to his initial anger and bitterness, Steve chose to fight. He decided that he didn’t want to be remembered as “the angry guy”—and the realization that if he didn’t fight, his cancer would take him away from his family, was all the motivation he needed to do so. He was also determined to model resiliency for his family, especially his sons.
Steve immediately underwent surgery to deal with his blocked bowel, and ended up having a foot of his colon removed along with the primary tumor. He then had to recover for a few weeks before he could start with Folfiri chemotherapy. He also took the antibody therapy medicine panitumumab along with the chemotherapy. Steve ended up taking 27 rounds of chemotherapy, with some breaks, over the succeeding 3 years.
Steve’s cancer journey was far from easy. For one, he had to endure significant side effects from the panitumumab, including unsightly bleeding rashes that covered almost his entire body. But he continued to fight so he could stay with his family. Moreover, he also discovered that he could “fight cancer in the streets” and help other cancer patients, too, and so he got involved with fundraising campaigns for his local hospital foundation and regional cancer center. He also started serving as a volunteer cancer coach at CCRAN, the Colorectal Cancer Resource and Action Network.
After 3 years of chemotherapy and a liver transplant, at his last checkup, Steve’s doctors were unable to find any evidence of his cancer.
Steve shares his story with us to grow awareness of the risks of cancer, especially colorectal cancer, and to encourage other cancer patients to remain positive and continue fighting, no matter how severe or hopeless their situations may seem.
Interviewed by: Taylor Scheib Edited by: Chris Sanchez
Andrea, a nurse practitioner from Spokane, WA, got through stage 3 colorectal cancer.
Andrea’s symptoms began when she was about 7 months pregnant with her son—bloody stool and lower back pain and pressure, progressing to more serious symptoms like rectal pain during childbirth and as many as 20 bloody bowel movements daily—but she was consistently told that they were due to her pregnancy. A colonoscopy, done after the symptoms progressed significantly and her husband was able to get some help, finally diagnosed her stage 3 colorectal cancer.
Treatment–chemotherapy, radiation and surgery–as well as a lot of support, a can-do attitude, and self-advocating, eventually helped Andrea get better. Her story isn’t without some twists and complications, though, most especially an agonizing period during which she thought her colorectal cancer might have progressed to stage 4. Thankfully, this was a false alarm: she was actually already cancer-free, and she remains so to this day.
In addition to Andrea’s narrative, The Patient Story offers a diverse collection of stories about colorectal cancer. These empowering stories provide real-life experiences, valuable insights, and perspectives on symptoms, diagnosis, and treatment options for cancer.
Name: Andrea P.
Diagnosis:
Colorectal cancer
Staging:
Stage 3
Initial Symptoms:
Frequent bloody stool
Lower back pain and pressure
Rectal pain
Severe stomach cramps
Treatment:
Chemotherapy: 5-FU
Radiation treatment
Surgery
This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.
… I was chosen to go through this fight so I could help bring awareness to other people.
We were chosen for a reason, and we need to be strong through this fight.
Introduction
I’m Andrea, I’m from Spokane, WA. I’m 34 years old.
I am a nurse practitioner. I was a nurse for a long time, going on about ten years. And then I went to nurse practitioner school, and now I’m a nurse practitioner in the emergency department. I also was a nurse educator for some time, so I taught nursing students.
I’m married; my husband is a nurse anesthetist who works at one of the local hospitals. We have two beautiful kids: our daughter is going on 5, and our son who’ll be 3 this year.
If I’m not working, I love working out, going to one of our local gyms. We do CrossFit, and that’s like my hobby. It is like my home away from home. Working out, doing those things and spending time with my family and spending time with my friends. I have a really close group of girlfriends, and we tend to do a lot of our little girl’s nights.
I think I’ve been much more outgoing since I’ve been diagnosed and not holed up in my house; I used to be such an introvert. Like, I just want to stay home. I don’t want to go do anything. But after this I’m like, no, I want to go do all the things.
Initial symptoms
My colorectal cancer story starts when I was about 7 months pregnant with my son in June 2021. That’s when I started noticing blood in my stool.
The doctors shrugged it off. Because of my pregnancy, they said it was normal. You can have hemorrhoids, they said. So I didn’t think anything of it.
But it just kept getting worse. I started to have a lot of lower back pain, as well as this feeling of back pressure. I always felt like I needed to go to the bathroom.
Even then, I was told that it was because my baby was sitting really low. He’s sitting posterior, they shrugged. Just pregnancy stuff.
I gave birth to my son on August 9. While I was in labor, I was having an incredible amount of rectal pain. I remember telling my husband, gosh, this hurts so bad—there’s no way this is just a hemorrhoid. I was having contractions back to back, but they paled in comparison to the pain.
Give me the epidural to take the pain away, I said to my husband. Again I was told that it was because the baby’s just sitting very low. But I had had a daughter before, and I knew that this was completely different.
Come October and November, I started to have even worse symptoms. Each and every bowel movement was bloody—worse, sometimes all I would be excreting would be blood. I was having 15, 20 bowel movements a day that were just blood.
I asked my OB to refer me to a GI doctor in Spokane. While they did get me in relatively quickly, in November, once again, my symptoms were only chalked up to pregnancy.
I was told: you’re way too young. You just had a baby. You have a bunch of hormones going through you. You’ve had hemorrhoids. Basically just dismissing my concerns. But at least I did get them to commit to a colonoscopy at the end of December or the start of January.
But something happened in December that sped things up. I was at my cousin’s basketball game, and I had a sudden really severe stomach cramp. And I went to the bathroom and it was all blood clots, the worst one I’ve had. It was just bright red blood with dark red clots.
My husband contacted one of the GI docs that he works with and was like, listen, no one’s taking my wife seriously. Can we please get her in? And the GI doctor went, bring her in next week. I’ll scope her right away.
And December 20th is when I got my colonoscopy and colorectal cancer diagnosis.
Diagnosis and Reaction
I was 32 years old when I was diagnosed with stage 3 colorectal cancer.
Going into the colonoscopy, I knew it would be cancer deep down. But my husband was so reassuring and supportive; he told me I shouldn’t think like that. So when I went in for the colonoscopy, I actually wasn’t terrified or even anxious.
But when I woke up from the anesthesia, the doctor came over to me. He said: there’s a really big mass there. I’m so sorry.
And I think in that moment, I was like: there’s no way this is my real life. You think it will never happen to you, but it does. The thought in my head was: is it everywhere?
My son was 4 months old at that point in time. My daughter was about to be 3 or 4 years old. I was like, am I even going to see my son turn 1? I was in the middle of nurse practitioner school. Why even finish school? Shouldn’t I just spend as much time as I can with my kids?
I remember the first thing we did was call my mom, who was watching my kids, and I couldn’t even tell her. My husband had to tell her. I got on the phone to my best friend, and I told her. And then I had to FaceTime four of my best friends who knew that I was going in for the colonoscopy.
I could die next month, I remember thinking. It is the most terrifying, sickening feeling. The diagnosis really put things in perspective.
I’m thankful that when my diagnosis came out, my doctor really took charge. The doctor came over and said, we’re getting this looked at today. I’ve already scheduled you for an MRI. I’m getting you a CT scan today. I’ve already talked to an oncologist, a surgeon, a radiation oncologist. I’m not letting you leave until we have a plan for you today.
It was a really long day that day because my colonoscopy was in the morning, and then I had to go through the CT, go through the MRI. Luckily, the doctor fixed it up so that the radiologist would read those scans when I was there.
So I was able to find out quickly via my CT scan that there were no other masses anywhere at that point. The MRI did show the tumor and some lymph nodes, but it didn’t show any masses anywhere else. So I felt some relief that, okay, so far it hasn’t spread.
I went home and all I wanted to do was be around my kids, but at the same time, I didn’t want them to see how upset I was. My mom was trying to hold it together and she was having a hard time.
I tried to be normal, but I hadn’t eaten or drank in that day, so I ended up getting so sick that I ended up having to go to the ER for fluids because I couldn’t keep anything down and kept vomiting profusely. I also think I cried every ounce of water that I had in my body out.
So I ended up calling one of the girls I worked with, and she actually snuck me into the E.R. One of the doctors who is a good friend also knew, as well as the provider who took care of me. That level of support was really nice.
Treatment
Chemotherapy and radiation
My colorectal cancer treatment was a whirlwind of “let’s get your appointments going”.
So I actually got called by the radiation oncologist the very next day and they were like, we want to get you in today. We’re going to map everything out for your radiation.
And then I got called from the oncology office and they said, we want to see you today to go over what your plan is going to look like. And so I ended up going to the oncologist that next day, and, he mapped everything out for me.
He said, we’re going to start with radiation, where you’re going to go under 28 treatments of radiation. And while you’re going radiation, you’re going to have a chemo pump. So you’re going to have continuous chemotherapy infusing. And then once you complete those treatments, then you take a week break from the chemo.
Then you do eight intensive treatments of chemotherapy where you come in and get the four hour infusions. After that, you have surgery.
And after your chemo, we rescan you, we remap and see what your tumor is doing. There is a possibility that if your tumor is gone, you don’t have to have surgery.
But I was like, absolutely not. You’re taking that thing out. We’re not watching and waiting for anything. I had already made my mind up that I was going to have surgery.
So I went to the radiation oncologist later that day and got mapped. So he tattooed my back, my abdomen, mapped where they were going to do the radiation treatments. And then I think the day or two after Christmas, I went and got a port placed for all of my treatment.
And I started treatment January 3rd. So really very quickly, I started my first radiation treatment, and then they hooked me up to the pump that I had to wear 24 -7.
Initially the GI doc said, surgery first. But then when I talked to the oncologist he said, typically if it’s stage one, if it’s just this isolated tumor that hasn’t gone into the lymph nodes, we would do surgery where we cut the tumor out and then we do like a clean up chemo. But mine was very eroded. If I would have waited a couple more months, I probably would have had a perforated colon, that’s how bad it was.
And because I had lymph node involvement, we needed to get the chemo in there and kill what we can. The radiation was to kill the tumor, and the chemo was to stop the tumor cells that were floating around from duplicating and so on. That’s why I had to do the chemo and radiation before the surgery.
Surgery
I underwent a pretty major surgical procedure. They basically went in and dissected the entire tumor, plus did a few things on one side of the tumor and then the other side to make sure that it gets all taken out.
Then they did a temporary ileostomy, where they basically take my colon and bring it out through my stomach to let my surgery site heal. I had to have that for 8 to 10 weeks.
I had to be in the hospital for a couple days, just to make sure that everything was working, and that was the first surgery. And then I had that ileostomy for about 8 to 10 weeks, and then I had to go in and have it reversed.
So they go in and they just basically put my colon back together without that tumor in it. And that surgery was actually a little bit more intense. It was much more painful, even though it was a shorter surgery, and I was in the hospital for about two nights with that one too.
When I got told about the ileostomy, you know, my initial thoughts were like, I don’t care. Do it. I just was in that mindset. Do what you need to do to get me better, I don’t care.
But when I actually came home with the ileostomy, it was a very big mental block for me. I felt like I didn’t want to go out in public since I found it disgusting. I never minded taking care of them on other people, but I never thought that I would have to have one.
And I remember the first day that the home health nurse came over to help me figure out how to change the bag and stuff. I couldn’t do it. My husband had to do it because I was so emotionally distraught from it. And my husband actually just said, you don’t ever have to look at this. I will take care of it for as long as you have it. It took me a couple of weeks to finally get used to it.
And actually one of my preceptors for school has an ileostomy and he and I actually became really good friends. And I remember when I found out I was going to have one, he was like, hey, I got your back. I’m going to walk you through this whole thing. I’ve had mine for years. And he was such a big supporter.
He would talk me through it. He’s like, this is just part of our lives now. He was a big reason why I think I did so well with it, because I had him just there, supporting me through it.
And he knew what it was like to have one knowing that it wasn’t permanent. There is an end in sight.
And when I got it reversed, I just remember the doctor being like, okay, it’s getting reversed, but I’m just telling you right now, it’s not going to be a walk in the park. We have removed a lot of your nerve endings, your colon has basically been asleep for weeks. Basically, you might have to potty train yourself again. And I was like, maybe I don’t want it reversed, maybe I just want to keep it.
And so when I had the second surgery, I remember I was in so much pain, I can’t even remember being like, oh, it’s gone. I just was like, get this pain taken care of. Definitely having it reversed was worse than having it placed. And that took a mental toll on me for sure.
Side effects
So the side effects of the radiation, I didn’t have too many. The most significant was fatigue from the radiation, which was insane. More fatigue than I had when I was pregnant with my son, when I was 12 weeks pregnant and I got Covid. The fatigue from the radiation felt maybe 20 times more than that.
I also had a lot of back pain, aches in my pelvis.
They also had said that we’re radiating your uterus, your ovaries, you’re not going to be able to have any more children. They did give me a chance: we can do what’s called an ovarian transposition, where they pull the ovaries out of the radiation field to try and salvage if you want to have kids. And I was like, listen, I have two healthy babies. I need to be there for them. I can’t delay this any longer.
As for side effects from the initial chemo pump, I didn’t have any other than my fingertips turned different colors, like I dipped my fingertips in self-tanner. And everyone would be like, whoa, your fingertips are brown. My oncologist said that the chemo regimen I had to do was called 5-FU, and he was like, oh, it’s the 5-FU fingers. It’s totally normal to have that.
But later on, the side effects from the chemotherapy got way more intense. I went into the first treatment and after the treatment, I felt fine, just a little tired. I was told, though, that the side effects would really hit me—and they did.
Tuesday night after my very first infusion, I ended up so violently ill that I passed out. I got rushed to the emergency room at one in the morning because I was so sick.
When I got to the E.R., my blood pressure was in the 70s. My heart rate was super high. They were like, she is so severely dehydrated, we might need to admit her to the hospital. I can’t even tell you how many liters of fluids they gave me. Every antiemetic possible. I was still so sick.
They called my oncologist. They were like, what do we need to give her? And he was like, you need to give her this specific type of antiemetic. That’s for chemo. That’s really expensive. And hospitals don’t usually carry it. But he’s like, that’s what’s going to keep her out of the hospital.
So after that I went to my follow up appointment. He’s like, we need to do pre-meds on you because that obviously can’t happen again.
And I remember after when I was laying in the hospital after my first treatment, I said, I will not do this anymore. I’m done. I’m done with chemo. I can’t do this for seven more times.
And my mom’s like, you don’t have a choice. You have two children at home. You’re doing this. So we need to figure out what we need to do to make it so you can do this.
So I would pre-medicate, I would get this infusion of this antiemetic that was supposedly only for like chemo patients, before I got my chemo. And then on Wednesday when I got my pump disconnected, I would get fluids and that I did pretty well with that. I really didn’t have any other side effects from the chemo from that point on other than fatigue.
Aside from that, I would usually have to take a nap. I got a little bit of neuropathy towards the end where my feet were really numb and it felt like my feet were asleep, just chronically asleep. Which was pretty common for this type of chemo.
I didn’t lose my hair.
I had so much support and I will always be grateful for it.
Support
I had so much support and I will always be grateful for it.
I’m originally from Portland, Oregon. I have a really close friend group in Portland. I have a really good friend who contacted all my friends in Portland when she heard about my colorectal cancer.
She contacted all my family, all my friends in Spokane, like friends that I have in Arizona. She just went above and beyond, and she basically had them send her a letter of everything they love about me and basically wishes for me and then send pictures. And she put together this book. And so each page was like a friend who wrote a letter to me. I took that with me to my treatments because it was just like seeing how much love and support I had.
My best friend put together a bunch of stickers that said Support Squad Blue for Andrea, and people throughout the hospital were putting them on their water bottles, people I didn’t even know, but worked with her on in her unit and knew how much I meant to her were like wearing, buying these stickers to support me. And so just seeing that was like, so helpful.
I think when you’re literally fighting for your life, I didn’t hold grudges; didn’t get upset or anxious over really little things. I actually had a way better outlook on life when I was going through that because I was like, hey, I don’t know what next week looks like. I’m just going to enjoy everything I can right now, like my children and school.
Keeping Busy
My oncologist was like, you can’t work. You need to just rest. And I’m like, I’m not just going to sit at home and sulk.
So I actually completed my last semester of nurse practitioner school while I was in chemo. And I used my colorectal cancer treatments as my study time away from my kids. So, keeping myself busy and just continuing to push through, really helped me.
But I had days like there there were absolutely times where it would hit me like, I cannot believe that I have colorectal cancer and that this is what I’m going through.
And I would have to go upstairs. I’d lock myself in my room so my kids didn’t see me, and I would completely break down and just have a moment of hysterically crying, like ugly crying. Why? Why is this happening to me? Like, what did I do? And then I’d pop right out of it.
One of my good friends, she’s always like, okay, have your moment in Pity City and then get yourself out of it and let’s go. So I’d always just tell myself that, get out of Pity City. We had our moment, time to get back.
Stage 4 Scare
I had a bit of a scare during which I thought my colorectal cancer might be stage 4, but it hadn’t after all.
I was just starting my job as a nurse practitioner. Right after I completed treatment. Right before I had my first surgery. They wanted to rescan me and see just how much the tumor had shrunk. So I ended up having another CT and an MRI, and I remember being at my very first day of work at my new job, I was training, and I got the MyChart result.
So I opened it up and the first thing I saw was a new lesion on the liver, and my heart dropped. I remember I got through another hour of work, and then I finally just told my preceptor, I need to go. I’ll be back tomorrow.
And I called my husband, and I’m like, I’m stage four. He’s like, what are you talking about? And I’m like, there’s a lesion on my liver.
That day was the worst. Way worse than the day I got diagnosed. One of the most defeating days ever.
I came home and said, we need to plan my funeral, we need to get our things in order. And my husband, at that point, he’s always tried to be so positive. And at that point he literally goes, I don’t really know what else to say other than, we need to get things in order for you. Because he knew, this isn’t good. That day gives me more anxiety and just makes me cringe more than the day I got diagnosed. Because it felt like I had gone through so much for it just to not work.
The next day I remember messaging my oncology team and I was like, can I please can I have a phone call with my oncologist so we can talk about my CT scan? And she goes, yeah, he’ll like, do a telephone call with you or tell a zoom video. I was like, okay. So I went out to my car. I was again at work.
I went out to my car and got on the call, and he had my CT scan pulled up and he was there. And so I was sitting there and I was just waiting for him to tell me. And he goes, you know, the spot on your liver. He’s like, I am 99% sure it’s not cancer. I actually have a call out to the liver specialist to just look at it.
He said, you know, the chemo you have can really damage your liver. And I had actually had on my last chemo, I had labs done in my liver. Enzymes were elevated. And he said, I think this is a piece of your liver that just died from the chemo and is just trying to regenerate. Doc’s calling me right now. She’s reviewing all your images.
So he talked to her and then he got back on. He’s like, yeah, she is pretty confident.
This is nothing to be worried about. So at that moment I was like, oh my gosh. He said, you know, your tumor is actually shrunk significantly. It’s still there. We still need to do the surgery. But yeah, this spot on your liver, I’m just really not concerned about.
Remission
So technically, my colorectal cancer was in remission on the day of my surgery when they pulled the whole tumor out. June of 2022. And I guess at that point, I didn’t necessarily think I was in remission because I was like, well, they still need to scan to make sure they got everything.
They took the tumor out and they take the test, the margins to make sure there was no tumor cells. And I had negative margins, which they said is really good.
But unfortunately I had like eight lymph nodes that had live cells in it. And that puts you at such a high risk for recurrence.
I remember my oncologist being like, you have a 40% chance of going to stage four even with all of this out. And still it’s like a 60% chance of it not happening. Yeah, but 40% is pretty high. Because of that, they were like, we’re going to have you on a really close scan bloodwork every three months for five years.
So it wasn’t until probably my three month scan after that where they didn’t see anything that I was like, okay, I’m officially in remission. I don’t have the colorectal cancer in me anymore.
To this day, I still don’t think I’ve ever gotten to the point where I don’t feel that I have colorectal cancer. It’s just, I think a part of me feels that someday it probably will come back. And I don’t know how to get out of the mindset that it won’t.
Like, even though, my blood work, I get a CT scan, an MRI every three months, and then I get a tumor DNA test where they actually extract DNA from my tumor, and then they draw my blood every three months, and they compare those so they can actually pick up if there’s like, tumor cells floating. Every single one’s been negative since June of 2022.
But I can’t get in the mindset that it’s gone. I just I think that’s just part of it. I just can’t no matter what, I’m like, okay, well, another month where it hasn’t popped up again, but we’ll just wait till the next month like so.
And I think that’s just part of the process of this. Like you just once have once you have colorectal cancer, you’re never going to feel like you’re fully out of it.
Going during the treatment and everything, I felt less anxiety because I think when you’re going through treatment, you feel like you’re actively doing something to get rid of the cancer. When you’re in remission, you feel like a sitting duck, like you’re not doing anything to actively get rid of it, even though it’s technically gone.
So that has been really hard because when I was in treatment, I’m like, oh, every day I’m going in that’s killing more of those cells, and it’s getting rid of it, and you feel like you’re actively taking care of it. And then sitting in remission for the past two years, I think, okay, is this next scan, the one that’s going to pick something up, is this next bloodwork, the one that’s going to pick something up.
You just kind of feel it’s just like a waiting game. I think it’s because, you know, they say you can’t say you’re cancer-free until five years out.
So statistics show that I was 71% at stage three B, which I was I have a 71% five year survival rate. In hindsight 71% is great, but there’s also that 29% rate, that’s not. And so, I also get to the point where like, okay, yeah, I’m two years out from this. Does that mean I only get three years left? So I just get into a negative headspace and you just have to take a lot to get yourself out of it.
There are going to be dark days. There are going to be days where you feel like you cannot go on any longer. I had plenty of those days where I felt like, I cannot, I don’t want to wake up tomorrow. I cannot move on from this.
Just know that we can. There is a light at the end of the tunnel.
There is a bright side, even though you don’t feel like there is.
Lessons and Learnings
I am a huge advocate now for self-advocating.
I’ve had people reach out to me, on Facebook, on Instagram who’ve seen my story and they’re like, hey, I started to have these symptoms. I went to my doctor and my doctor was like, oh, you know, we’ll just follow up in a couple of months.
Absolutely not. You find yourself a new doctor, you go to an urgent care, you go to an ER and you say, this is what I need, this is what I want. You have to push for it. And, you know, I have told people: exaggerate your symptoms a little bit, like if you had one bloody bowel movement, go and you say I’m having multiple bloody bowel movements.
You get the colonoscopy because right now the colonoscopy age is 45, which is so crazy to me. With the rates of colon cancer showing up in people 18 to 35. I read an article that showed rectal cancer is supposed to increase by 112% in patients 18 to 35 by like 20, 35 or something crazy like that. And then colon cancer is supposed to increase by like 114%, just some outrageous number. Then it’s supposed to be the leading cause of cancer death in people 18 to 35.
And yet the colonoscopy age in the United States is 45. I’ve been in ER medicine for ten years now, but I’m a new provider and I’ve actually had a couple young patients come in who have had similar symptoms and they’re like, yeah, my primary doesn’t take me seriously.
And I’m like, we’re gonna call GI here in the ER today. We are going to try and get this figured out. We need to lower the age. But I also understand that with the increased amount of cancer cases and people needing scopes, they’re overwhelmed too. There isn’t enough providers.
I just think that we need to stop making it an age thing like it is. Colorectal cancer is not a 50 year old man’s disease. Someone who is 19 can get it, someone who is 20. And you can do all the right things and still get it.
I have never smoked a cigarette a day in my life; I do not do drugs; I hardly drink alcohol. I work out and I eat relatively healthy. And I still ended up here. And I had genetic testing. I have no genetic risk factors. I have no family history. So it can happen to anyone, it can literally happen to anybody.
Advice that I’d have for anyone in this situation is that there is a reason for everything. There is a reason that we were chosen to go through this fight.
I look at it as like I was chosen to go through this fight so I could help bring awareness to other people. We were chosen for a reason, and we need to be strong through this fight. We need to be there for our friends.
There are going to be dark days. There are going to be days where you feel like you cannot go on any longer. I had plenty of those days where I felt like, I cannot, I don’t want to wake up tomorrow. I cannot move on from this.
Just know that we can. There is a light at the end of the tunnel. There is a bright side, even though you don’t feel like there is. And know that your feelings are validated.
I had people be like, look at you, you’re still here. It’s like, no, you don’t know. You have no idea how this is feeling. And we are the only ones that will know truly how this feels. Know your feelings are validated, but know that you can get through this. I’m always here to talk to anybody who’s going through that.
My other thing is, stay off of the internet. I was in that support group for a little bit, but then it got to the point where I was seeing so many just negative things, stuff that started to bring me down, and I’m like, I had to remove myself from it. Stay off the internet, stay off of social media, stay off of any of that. That is the best advice I can give, because you will go down a rabbit hole of so many things, and that’s not what your body needs.
And your fight is your own fight, like my colorectal cancer fight isn’t somebody else’s. Like we’re all going to be different. Try not to compare it to other cases. Just know that, like your fight’s your own and you’re going to be different.
Courtney, a high school English teacher from Spokane, experienced symptoms such as fatigue and blood in her stool that led her to suspect she had colon cancer. Despite initial dismissals from multiple doctors due to her age and lack of family history, Courtney persisted in advocating for herself, ultimately undergoing a series of tests, including colonoscopies and scans, which confirmed her suspicions. Diagnosed with stage 3A colorectal cancer, Courtney underwent surgery to remove the tumor and lymph nodes, followed by chemotherapy as a precautionary measure.
Throughout her treatment journey, Courtney faced various challenges, including side effects from chemotherapy such as hand-foot-and-mouth sores and neuropathy. Despite these obstacles, she pushed forward, continuing to teach full-time and engaging in physical therapy to regain her strength. Three years into remission, Courtney emphasizes the importance of self-advocacy, listening to one’s body, and pushing for answers, especially when faced with medical dismissals or ambiguity. She encourages others to trust their instincts, seek support from loved ones, and persevere in navigating the healthcare system to ensure proper diagnosis and treatment.
Name: Courtney H.
Diagnosis (DX):
Colon Cancer
Staging:
3A
Symptoms:
Blood in stool
Fatigue
Treatment:
Surgery
Chemotherapy
Capecitabine
Oxaliplatin
Advocate for yourself, know your body, listen to your body, and keep pushing until you find answers.
Courtney H.
This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.
My name is Courtney. I am a teacher. I teach high school English – specifically honors 9 English and mythology. I am a big lover of reading. I like to play outdoor volleyball, garden, and explore. I live in Spokane, in the Pacific Northwest. It’s so beautiful. We have four seasons and lots of activities and different things to do. I like to spend time with my niece and nephew.
What were your first symptoms?
I took an anatomy and physiology class in college, and one of the only things I remember from that was that the professor said, “Most often when you have internal bleeding of some sort, it is your body’s inability to heal itself, and that usually comes in the form of a tumor.”
What had happened was I had gotten a teaching job in Othello, where I grew up, and I moved down there. This was August of 2020. I was a very busy new teacher. I was the head cheer coach for a cheer program. I worked a lot of jobs in grad school, and so I just was very used to being on the go all the time and having a busy and packed schedule.
I knew I was sick. I knew I had colon cancer, so I just kept pushing.
When I moved to Othello, I started showing one symptom – I had blood in my stool, and I instantly knew. I knew instantly that I had colon cancer. Moving down to Othello, I had to get all of my records and everything transferred down there, including all my medical stuff. So I wasn’t able to go in and see a doctor until October. My symptoms kept progressing, and I just knew when that started happening. I was trying to find somebody that could help me find the exact diagnosis. The answer.
Did you have any additional symptoms?
Just blood in the stool and fatigue. My friend’s mom, who’s a nurse, did a blood test on me and she said I was very anemic. What we ended up finding out when they had taken the tumor out is the blood flow was feeding the tumor, and that’s why I was so anemic.
The first general practitioner doctor I went to, he dismissed all my symptoms and said, “There’s nothing wrong with you. You’re thin, you don’t have a family history. You just need to make some dietary changes.” I was like, “Well, I’m going to keep trying to find answers.” It was in the middle of COVID, so everything was pushed back. Then symptoms kept getting worse. When I came home for Christmas break – home was Spokane – I saw a different doctor and it was the same thing. He spent about an hour with me, ran some tests, dismissed all my symptoms, but I knew I was sick. I knew I had colon cancer, so I just kept pushing.
The first doctor in Richland, he actually had put in a referral for me to see a GI specialist. I was able to see a GI in January of 2021 and [experienced] the same thing. She dismissed all my symptoms. Finally I said, “Listen, this isn’t about you being right or me being right. This is about figuring out what’s wrong. You’re speculating and I’m speculating.” They were all saying, “We think you have Crohn’s or diverticulitis, diverticulosis, or a bleeding hemorrhoid.”
One of the greatest skills that my parents ever taught me was the ability to advocate for myself and to know your body.
I said, “No, I think that I’m sick. What can we do?” She said, “Well, we can give you a colonoscopy. You’re too young and they’re very expensive.” I said, “Well, I’m a teacher. I have great health insurance. We need to do this. I think it’ll give me peace of mind knowing that we have tried everything.”
Receiving a colonoscopy
Months later, she did a colonoscopy and found the tumor. That was February of 2021. That whole month and a half that I went through 9 different tests. I did 3 colonoscopies, a sigmoidoscopy, 2 CAT scans, a PET scan, and an MRI. There’s another one I did but I can’t remember the name of it. All of those tests brought me to the diagnosis. Now what are we going to do? What’s the plan of action going to be? I got a team together.
What tests did the first doctors do?
He did a blood test and some general stuff. He felt my stomach to see if I had any lumps or bumps. Then he went through and looked at family history. Obviously, I don’t have a family history of it. He said, “You’re thin, you’re not pre-diabetic.” I was in Richland, Spokane, and then I went to Kennewick. So three different cities, three different doctors. The doctor in Spokane pretty much did the same thing. They didn’t do anything extensive because you can’t really diagnose it unless you actually get a colonoscopy.
The problem was, neither one of those two doctors could perform that. Then they just dismissed my symptoms. They said, “Well, we’re not going to put in a referral for you to have a colonoscopy because we don’t think, from our experience, that you have it. I really had to beg the GI specialist to give me one.
We did a blood test with the first doctor and he didn’t see anything abnormal. Then the doctor in Spokane didn’t really see anything abnormal. But my friend’s mom, who’s a nurse, knew what to look out for because I told her what was going on. She did her own test and said, “You are severely anemic. Something’s going on.”
Did your insurance cover the cost of the colonoscopy?
I paid a little bit out of pocket, but it was mostly covered. The problem was, and this is something that I think a lot of people run into when they’re getting tests done, especially a colonoscopy or sigmoidoscopy. My insurance company did not want to pay for the right type of drugs. I didn’t know that. I didn’t hear the confirmation. They actually had to tell my parents, and it took 8 hours for the drugs that they gave me to wear off. So I actually didn’t find out about the tumor until the next day. My parents waited to call because they tried to talk to me after the procedure and I was just bonkers.
Surgery
The importance of advocating for yourself
They dismissed the symptoms because I didn’t fit the profile, but one of the greatest skills that my parents ever taught me was the ability to advocate for myself and to know your body. I just knew I was sick. I had that feeling in my stomach. Sometimes science can only go so far, and sometimes you have to put it in your own hands and keep pushing for it. It was a unique set of circumstances, because when I did my colonoscopy, COVID cases were very light, so I was able to go in and get a colonoscopy. When I had my surgery, COVID cases were really light, so they didn’t push my surgery back. These were just perfect little windows where things ended up really working out in my favor.
Formulating a treatment plan
Because I didn’t have the right drugs, she couldn’t finish the colonoscopy. I would have to come back 4 days later and do another one. I came back that Friday. I had [the first one] done on a Monday, came back that Friday, and everything else looked clear. She said, “I’m 98% sure that this is a cancerous tumor. We’re going to send it off to have it biopsied.”
It took two weeks to get back. The next conversation, I said, “I know a surgeon who saved my dad’s best friend’s life. He had stage 4 rectal cancer and he’s been in remission for 20 years. I want that guy.” She was going to put in a referral for somebody else. I said, “No, I want this guy.” Then everything started to move, all the tests.
After all of the tests came back – because the original plan was to do some radiation, 6 weeks of chemo, and then do surgery after the MRI, – the radiologist called me and said, “This is miraculous, but your tumor is a lot smaller than we thought, so we’re going to operate. Nothing else is lining up in your body, so we’re just going to go for it and operate.” So they did.
Describe your surgery
Dr. Holbrook went in and did a lower anterior resection and took out part of my colon, 21 lymph nodes, and my appendix. He said, “I had a stage 4 appendectomy patient who’s 17 years old last week. I just thought I’d take your appendix out.” He spent about 4 hours in surgery. He just retired last year, but he’s one of the best in Spokane. I trusted him.
The prep work was I had to go onto a liquid diet about 48 hours before. They gave me some things that they wanted me to take prior. After I was in the hospital for about 4 days, I had a series of things that I had to go through to get out of there. I had round the clock bloodwork. They would come in at 2 a.m., they’d come in at 6 a.m.. They were checking fluids and different things like that.
As far as the procedure, he just went in. He didn’t tell me how much of my colon he took out, but he took out the sigmoid region of the colon. That’s the end. He took that part out and did the lymph node pluck. After that, I was on a liquid diet for about 3 weeks, giving my bowels a break and allowing things to heal. He was able to go in and do it minimally. The incision where he went in was about this big. He was able to go in right underneath my stomach and do it.
Chemotherapy
What stage were you in?
We got a really good prognosis back. I had a stage one tumor. There were just a few little cancer cells that had broken off and gone into one lymph node, so I had a really good prognosis.
Preserving fertility before starting chemo
I had my 3 week clearance from surgery, and then I actually harvested my eggs, and then I did chemo. It was boom, boom, boom. My body had been through some things. Harvesting your eggs is quite an interesting process. I didn’t know this. When you go through and you do all the things, they monitor you, they take your temperature, they do all the things.
The day before my procedure, they did a COVID test on me and it came back positive. I didn’t know I was asymptomatic. Seattle Reproductive had to fight with Seattle to advocate to harvest my eggs because it’s a $15,000 procedure. They ended up saying, we’re going to suck it up, risk it, and do her procedure. Then I started chemo right after I was cleared from COVID.
I didn’t have to do chemo because of my prognosis, but my surgeon and team recommended that I do it as an insurance policy. I was prescribed 2 different types. I had an infusion chemo which entered through a port and a pill chemo. I would do one infusion every 3 weeks. Then I was on pill chemo for 2 weeks at a time and I’d get a break at the end of it.
Which chemos were you on and did you have side effects?
Capecitabine. The infusion chemo was called oxaliplatin. I had side effects with each. With capecitabine, I had hand-foot-and-mouth, where you get really bad sores everywhere. The other chemo was oxaliplatin. It’s a platinum chemo. It had some really strange side effects. You couldn’t touch anything cold. You couldn’t ingest anything cold. I couldn’t drive in my car with the AC on or it could close my throat. Everything had to be room temperature or hot.
It was in the middle of the summer, so one of the biggest issues I ran into was I was dehydrated a lot. I was hospitalized 2 different times for dehydration which was scary. I lost a lot of weight. I think I lost about 25 pounds. I tried to eat when I wasn’t hungry. I had to watch what I ate. They tell you you can’t have raw fruits and vegetables while you’re on chemo, which is so weird because you should be eating healthy foods, and they said to eat what I could.
The first two days after infusion chemo and pill chemo, you’re the sickest, you’re nauseous. It’s really, really hard to get up and move around. With oxaliplatin, like I said, it’s a platinum chemo so it causes neuropathy. You have a lot of tingling going on in your body. It got to the point where my eyes were affected by it. I could taste it in my mouth. It was very all-consuming throughout my body.
Stopping oxaliplatin
I did my own research about my particular prognosis and I decided to stop oxaliplatin after 4 rounds. That’s the infusion chemo. A lot of patients push past that, and there are some patients that end up disabled from doing that chemo. I did not want to do that. I didn’t want to risk that. It was making me so sick that I could barely eat.
Did anything help alleviate your chemo symptoms?
When I was dehydrated, I would go in and get pumped with fluids. That helped. I did take Zofran to help with the nausea. You can’t be in the sun either when you’re on chemo. You have all these things that you can’t do.
The best thing that helped with the side effects was to get my mind off of it.
I think for me, the best thing that helped with the side effects was to get my mind off of it. I taught full time while I was on it. That was my choice. I didn’t want to lay in bed every day and dwell on it. That’s just my personality so I decided that I was going to work and let that be the thing that would help get my mind off of it. I did oxaliplatin for 3 months and capecitabine for 6 months.
When I went back to school to teach, I did physical therapy and that helped a lot. It helped me build up strength because I had lost so much muscle mass and lost so much weight and it helped with getting through those days.
Reflections
How long have you been in remission?
I am almost at the 3 year mark of being in remission. I count it as April. My oncologist counts it as November because that’s when I finished chemo, but I think that the surgeon got everything.
How often do you get scans and do you experience scanxiety?
I don’t think that it ever really leaves you. I think that it stays with you.
I just hit the 2.5 year mark, so now I go every 6 months. I think that’s one of the hardest parts. I was joking with a friend that I’m a part of an exclusive club now because it doesn’t really ever leave you. With scanxiety, I just do my best to just try and stay positive. It’s always quite exhausting because it’s a 4-day process – blood work, scan, and meet with your doctor.
My aunt is a phlebotomist, so she’s always encouraging, giving me tips on how to stay positive and hydrate, make sure you’re ready to go. But it is a real thing, and I honestly don’t think that it ever gets any better. I think that you learn how to manage, how to live with it. The farther out that you get, you feel better. But I don’t think that it ever really leaves you. I think that it stays with you.
What advice do you want to share with cancer patients?
Advocate for yourself, know your body, listen to your body, and keep pushing until you find answers.
You need to advocate for yourself and you need to be able to listen to your own body. Science only goes so far. Knowing, understanding, and listening to your body is really important. Because if you’re sitting in front of this doctor that doesn’t know you, you’re just a statistic. They’re trying to see where you fit, and if you don’t fit the category, you don’t fit the profile, of course they’re not going to suspect anything.
I also think that you have to hold on to your faith and keep pushing through roadblocks and things that are in your way. You just have to keep going until you find the answers that you really desire to have. For me, that was, I’m sick of hanging out in ambiguity. I know I have it. You are speculating, but that’s why we have science. That’s why we have these things. We shouldn’t be profiling people based on their age or the way that they look. We should be listening to the patient and to their concerns.
Advocate for yourself, know your body, listen to your body, and keep pushing until you find answers. That’s why I’m alive and well today, because I advocated, and I continued to push until I got the answers that I needed. I don’t blame any of them. They’re doctors, they’re human, but I do think that they need to listen to patients better. I think that they need to listen to their patients, listen to the concerns that they have, and really do a better job of putting something in place that is going to help. Help eliminate this ambiguity. For people that may not feel as comfortable to advocate, you just have to remember that you know your body. So even if it’s something that’s totally foreign, talk to somebody about it and try and find those answers that you are desiring to look for.
Raquel first noticed symptoms in 2019, like pencil-thin stools, pain, bloating, and blood in her stool. She then started getting full quickly after eating.
When she finally went to the doctor after developing severe pain, she was dismissed and told, “It was just anxiety.” She then ended up in the emergency room and was later diagnosed with stage 4 colorectal cancer, which had spread to her liver, ovaries, and lungs.
In sharing her story, she aims to raise awareness about rising colorectal cancer rates in young people and the importance of listening to your body.
In addition to Raquel’s narrative, The Patient Story offers a diverse collection of colorectal cancer stories. These empowering stories provide real-life experiences, valuable insights, and perspectives on symptoms, diagnosis, and treatment options for cancer.
This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.
Name: Raquel A.
Diagnosis:
Colorectal cancer
Staging:
4
Initial Symptoms:
Frequent bowel movements
Pin-thin stools
Mild red blood in stool
Treatment:
Chemotherapy: oxaliplatin, 5-FU (5-fluorouracil), and irinotecan
I feel so confident that whether I can heal from this or not, I’m going to be able to handle it well. It’ll be okay. I’ve overcome other things in life and I hope that I can be an inspiration to people who are struggling.
I’m 33 years old with terminal colorectal cancer. It has been such a huge part of my life that I have to remind myself that there are other parts outside of that.
I currently work in the tech industry and I’m very blessed to be able to do so.
In my spare time, I like reading and drawing. I’m very artistic and very recently, I’ve been posting more. I’ve been finding great connections on social media with other people who are going through the same thing as me.
I didn’t take my symptoms more seriously because they would come and go.
Pre-diagnosis
Initial Symptoms
I first started noticing symptoms in 2019. I was roommates with my best friend and she started to notice how often I was going to the bathroom. At the time, I was working in restaurant management so I figured I was probably eating too much of the food at work or eating too many processed foods.
I started changing my diet, trying to eat healthier and more protein but also using fiber supplements. I figured I wasn’t eating enough fiber and that’s one of the first things you read online about how to resolve diarrhea or bowel issues. That did help. The symptoms went away, but they would come back to plague me again.
Symptoms Worsened
In 2022, I was working as a contractor in the tech industry. I made really good friends with people on my team. One of them noticed how often I was going to the bathroom and she said, “Raquel, are you okay?” I said, “Yeah, I’m fine. Maybe it’s the dairy in my coffee. Maybe I have a gluten sensitivity.”
At the time, I wasn’t concerned and wrote myself off. I dismissed my symptoms. But knowing what I know now, I was having classic colorectal cancer symptoms.
I experienced frequent bowel movements and pin-thin stools. In addition, any kind of blood in your stool is a huge red flag. It means something is wrong. The color, whether it’s dark or mild red, pinpoints where exactly that bleed is located. Mine was mild red. I didn’t have heavy bleeding, which is why I thought there wasn’t something wrong.
But another classic sign is getting full quickly after eating and that was a huge red flag that something was wrong. That happened from 2022 until when I got diagnosed in May 2023. Every time I took a couple of bites of something, I immediately felt so bloated.
I was actively dieting before my diagnosis, but despite how healthy I was eating, I could not lose weight, which I thought was strange. My stomach was so round and hard. I would later find out that the cause of some of my bloating was ascites. When you have cancer that is as advanced as mine, especially with colorectal cancer, the tumors start secreting free fluid. I had about a gallon of fluid in my stomach that they had to drain. That immediately relieved so many symptoms I was having with eating.
I didn’t take my symptoms more seriously because they would come and go.
They’re not going to think of cancer when they see somebody who visually looks very healthy and young so I don’t necessarily blame her. At the same time, this dismissal of people who are like me is widespread because I know I’m not alone.
Symptoms Dismissed by Primary Care Doctor
It’s important to note that as a millennial—and I have statistically looked into this—half of us don’t have a primary care provider. That was the story of my 20s. I was blessed to land a permanent role in the tech industry where I had good healthcare and was able to schedule my first physical in 10 years back in May of 2023.
When you don’t go to the doctor for that long, there is a lot to talk about. I let my primary care physician know all of my symptoms, especially my bowel symptoms, and that I had severe abdominal pain somewhat recently. It wasn’t in one spot and felt very abnormal.
When I was talking to her about this, I could tell that she thought it was in my head. She scheduled me for a psychiatric appointment after my physical because she thought I had anxiety.
But now that I know so much about my disease, I know that they were classic colorectal cancer symptoms. Because I was so young, a woman, and a minority, statistically speaking, even just one of those categories is going to make you more likely to be dismissed in a medical setting and that is absolutely what I experienced.
It was maybe three weeks after that physical when my cancer was found to be completely metastatic and had spread all over. I know that she probably felt some guilt because, after my diagnosis, they sent the information to my primary care provider before I was assigned to an oncologist.
I’m sure once she saw how bad it was, she felt guilty at the same time. She’s not the only doctor who has done that, especially when you’re young. Medical doctors are taught these statistics of colorectal cancer being an older person’s disease. They’re not going to think of cancer when they see somebody who visually looks very healthy and young so I don’t necessarily blame her. At the same time, this dismissal of people who are like me is widespread because I know I’m not alone.
It wouldn’t be until I had a liver biopsy that they would find the primary source of my cancer, which was colorectal, and I wouldn’t find out until later how incredibly it had advanced.
Diagnosis
Getting the Cancer Diagnosis in the Emergency Room
I finally went to the ER. I remember that day so clearly.
I had severe abdominal pain that was migrating to my lower back and I almost fainted in my apartment. My intuition was saying that something was wrong so I went to the ER.
They did a full blood panel on me, which included the cancer markers CEA, CA 125, and CA 19. Mine were elevated. My CEA alone was in the 700s and anything above 30 is already a sign of cancer activity in your body. For mine to be that high means that my cancer was so advanced.
When I was in the ER, I felt that they took me seriously that’s why my cancer was found. The doctor knew something was wrong so she did that blood panel. I had an MRI, a CT scan, and an ultrasound. They did all those tests immediately.
The ER doctor told me that I had ovarian cancer because that’s where they found it initially. Based on the CT scan, the cancer was pretty advanced in my ovaries and my liver. It wouldn’t be until I had a liver biopsy that they would find the primary source of my cancer, which was colorectal, and I wouldn’t find out until later how incredibly it had advanced.
The metastases are in my colon, ovaries, liver, lungs, peritoneal cavity, and omentum. They found them through those tests within a week.
Everything happened so fast. I feel truly blessed that when I went to the ER, my cancer and the type of cancer was diagnosed so quickly. They ran all these tests, found my cancer, and immediately referred me to an oncologist. The next day, I was talking to an oncologist who then referred me to have a liver biopsy. A couple of days later, they found the primary source of my cancer.
Even though it’s very, very unfortunate how late my cancer was found, what an incredible experience for them to take me so seriously and find out what was going on. Kudos to the hospital that I went to. They took me very seriously.
Reaction to the Diagnosis
I don’t think I reacted like a normal person would have and that’s because I’ve had a lot of things happen in my life. I have a very calm demeanor. When things go wrong, I’m your go-to person to think logically and that’s how I processed my cancer diagnosis.
Even the doctor seemed really surprised that she said, “Raquel, you’re not even crying. I’m so sorry I’m not telling you good news.” I said, “You know what? It’s okay because no matter what happens, I’m going to get through it.”
I feel so confident that whether I can heal from this or not, I’m going to be able to handle it well. It’ll be okay. I’ve overcome other things in life and I hope that I can be an inspiration to people who are struggling. I feel like everything’s going to be okay. I told myself that even at the beginning of my diagnosis.
My liver and lung metastases aren’t responding to chemo, but the metastases in my ovaries and colon are responding moderately well. My oncologist and I are trying to see what combination could help with wherever else my cancer is.
Treatment
The treatment protocol and how they’re going to approach your diagnosis depends on your hospital. When I first got diagnosed, I was at a different hospital but for insurance purposes, I had to switch to a different one.
My treatments would have been a little bit different if I stayed with the first hospital because they wanted to start surgeries right away. They said, “You’re going to have a full hysterectomy. I’m going to be doing this in collaboration with one of our very renowned liver surgeons and we’re going to do this at the same time.”
But then when I switched to a different hospital, they told me, “We’re going to focus on chemotherapy. Let’s see how you react, shrink what we can, and then talk about surgery.” I understand the reasoning for that because they want to shrink as much as they can to lessen things going wrong during surgery or make it a little bit less risky.
Because I ended up switching hospitals, I’ve just been primarily I’ve been chemotherapy.
Being on Chemotherapy for Life
I first started with oxaliplatin. The side effects are not pleasant. It causes neuropathy. Fortunately for me, we stopped that in December. I was on it for six months until the side effects started affecting my quality of life too much.
I have switched to 5-FU (5-fluorouracil) and irinotecan. They introduced irinotecan to see if that’s going to help my liver metastases because so far, I’m having a mixed response to chemotherapy.
My liver and lung metastases aren’t responding to chemo, but the metastases in my ovaries and colon are responding moderately well. My oncologist and I are trying to see what combination could help with wherever else my cancer is.
I have chemotherapy bi-weekly and for Christmas, I pushed back my chemotherapy because I didn’t want to be sick during the holidays. My CEA, one of my cancer markers, jumped when I wasn’t strictly on my bi-weekly regimen. If I ever stopped chemotherapy, decided I didn’t want to continue, or changed my protocol at all, my cancer would jump at that opportunity to be aggressive.
I don’t have a choice as of right now. Chemotherapy is keeping me alive so I’m going to continue being on it bi-weekly. Fifty percent of people who have chemotherapy might need what’s called GRANIX shots.
The white blood cell count gets so low with chemotherapy that medications are needed to boost the white blood cell count to continue treatment. I, unfortunately, fall under that category so not only do I have my chemotherapy, but I have to have those shots to even have chemotherapy because my white blood cells get too low.
I’m very actively looking to find and get second opinions from hospitals that are willing to touch me and get some of this out because I know it would help me in the long run.
Looking for Other Opinions
As of now, they’re telling me that they don’t want to do surgery because of how incredibly advanced my cancer is. They’re saying that it might not be worth it.
However, I’ve read and seen from other people with colorectal cancer that they have better survivability with surgery because the more cancer is in your body, the more opportunities it has to spread and be aggressive.
I’m very actively looking to find and get second opinions from hospitals that are willing to touch me and get some of this out because I know it would help me in the long run. I will be traveling to MD Anderson and Memorial Sloan Kettering, hoping that they can do surgery on me, which will help extend my life. Even though I know it’s risky, I’m willing to do it because the alternative is being on chemo forever.
Getting Help & Support as a Cancer Patient
Having the support of family and friends has been such a huge help and I give so much thanks to the incredible people in my life who have helped me through this.
Some things have personally made it a little bit easier, like trying to buy foods that are pre-cut or pre-chopped. I like getting frozen oatmeal because I can just microwave it.
I’m sicker some days than others and I have found that it helps to have plastic utensils so that I’m not thinking about washing the dishes. To alleviate some of the guilt of buying disposables, I buy the biodegradable kind. You never think about how much something like that would make your life a little bit easier, but it does.
Give yourself grace and find the little things that you deserve to make your life easier.
If I had advocated for myself sooner, my cancer would have been found sooner… Listen to your intuition. You know your body more than anybody else.
Importance of Self-Advocacy
Self-advocacy has been such a big part of my cancer journey because if I had advocated for myself sooner, my cancer would have been found sooner. A lot of people who are as young as me or even younger don’t have a primary care provider.
Maybe they don’t have health insurance and I understand that there is a money barrier to getting treatment for a lot of people. That’s why I’ve been speaking to people who are younger than me and are getting diagnosed with advanced colorectal cancer because of those barriers.
One of the reasons why I started to be so outspoken about my diagnosis is to encourage people to go to the doctor. It’s never normal to have blood in your stool, even if it’s a little bit. Something’s wrong.
Unfortunately, if you’re young, a woman, or a person of color, you have to advocate for yourself so much more than people in different demographics. I hope to inspire people to get the medical help that they need for their symptoms because I was invalidating myself.
I went to my primary care provider and had my physical. I told her all of my digestive issues and bowel symptoms, and she said it was all in my head and that it was anxiety.
Other young people say in the comments on my social media, “This happened to me, too.” That’s one of the reasons why I’m trying to be so outspoken and raise awareness. I want people who have had the same experience to hear my story and say, “I need to take this seriously. Even if a medical professional says that I have nothing to worry about, I need a second opinion. I need to go to a GI specialist.” That is my goal in sharing my story. Don’t let anybody write you off. Get seen. Go to a GI specialist.
All it takes is one who will listen to you and help you. They’re out there. We just have to find them.
Words of Advice
Listen to your intuition. You know your body more than anybody else. A medical professional is diagnosing you based on generalities, but you know yourself better than anybody so if you are having these problems, you deserve to see a specialist and get a second opinion. Don’t listen to the first doctor. Get opinions from a second or a third, especially if your symptoms are persistent.
If your symptoms are persistent and aren’t going away, then something is wrong, especially if you have blood in your stool. That should never be written off. Any kind of blood in your stool is a huge red flag. Pay attention to it.
You deserve to be listened to and taken seriously in a medical setting. If the first doctor isn’t taking you seriously, all it takes is one who will listen to you and help you. They’re out there. We just have to find them.
If you have been invalidated about your bowel health or your symptoms, follow your intuition. As much as we want to completely trust that they have our best interests, that they went to medical school and they’re knowledgeable, that doesn’t mean that they aren’t sometimes wrong and don’t make mistakes or misdiagnoses.
Go out there and fight for yourself. Fight for your health. I hope everybody who hears my story feels very validated to go and seek help.
Shortly after gallbladder removal, Keith developed what felt like gallbladder pain. His wife encouraged him to go to the ER where he received a CT scan that revealed a mass in his colon. After removing the mass and some lymph nodes, a biopsy showed Keith had stage 4 colorectal cancer.
As a husband and a father of two boys, Keith discusses the impact his diagnosis has had on his outlook and life and how he stopped working to prioritize time spent with his sons.
Now on his third line of treatment, Keith discusses cancer support groups, chemotherapy, treatment side effects, mental health, how he is considering a double lung transplant, the importance of being a patient advocate, and his advice for others on their own cancer journeys.
I’m Keith. I’m 43 years old. My hobby is that I love to be outside kayaking, hiking, and walking. I’m a Corvette enthusiast who’s working on my car and hanging out with my dogs. Those are usually the 2 that hang out with me while my kids are at school and one might poke his head in. He’s a very large Great Dane. My wife, kids, and I like to travel. We like to do a lot of international travel and domestic as well.
When did your symptoms first occur?
Early in the year 2021, I had my gallbladder removed. Then in May, I started to have abdominal pain again, very similar to when I had gallbladder issues.
I was coaching Little League baseball the night of May 4th, 2021. As the night progressed, the abdominal pain continued to get a little worse, so much so that my wife forced me to the hospital in the middle of the night.
Getting emergency surgery
I went to the emergency room, and they did a quick CT scan and found a mass in my colon. They did a couple of other tests like blood work and stuff, and they said that they were going to be prepping me for emergency surgery because they wanted to get that mass out.
As they did more digging and research, they also found several lymph nodes that were impacted as well as 4 lesions on my liver at that time. So that’s a whirlwind of how we got started.
I went through that emergency surgery that night and was in the hospital for about 11 days. A couple of days after my surgery, I became septic so I had a lot of issues health-wise. We weren’t sure how that was going to play out, but I was actually able to make it out of the hospital the day before my wedding anniversary, which was nice. I started chemo shortly thereafter.
I went to the emergency room, and they did a quick CT scan and found a mass in my colon.
Did you have other symptoms besides abdominal pain?
No, nothing. Even what would have been 6 months before that, I did a triathlon. No issues. I’m not necessarily saying I’m the most healthy person in the world, but I definitely didn’t consider myself unhealthy by any stretch of the imagination.
What did doctors say about your minimal symptoms?
I was told that 41 was very young to be diagnosed with this. They mentioned that they’re seeing more and more of this in younger patients being diagnosed very late stage. Some of the traditional symptoms are rectal bleeding and abdominal discomfort. But for me, I really didn’t have any of that, other than the gallbladder pain that came back.
I thought it was strange because you shouldn’t have pain in an organ that was removed. I thought initially it was maybe some type of surgery complication that turned out to not be a surgery complication at all. It was a whole other issue.
I was told that 41 was very young to be diagnosed with this. They mentioned that they’re seeing more and more of this in younger patients being diagnosed very late stage.
It was tough. I went to the hospital during COVID times, so nobody else could come with me. I went by myself. I was in the emergency room by myself and had to make a call to my wife that they found a mass. Even at that point, I still really didn’t comprehend or grasp what the situation was. I was thinking, okay, they found something, they got to get it out and then I can go home and move on with life. That wasn’t the case.
It was very shocking initially and I was almost numb. It wasn’t until after the surgery when I started to recover in the hospital that my situation and the diagnosis became real.
The more doctors that I spoke to while I was in the hospital didn’t necessarily paint a real great picture of the survivability, how long I would be around, and all those things. Luckily, I have a great oncologist I met several weeks after all that, which helped put things into perspective a little bit, and while obviously still serious, there’s at least hope.
I still really didn’t comprehend or grasp what the situation was. I was thinking, okay, they found something, they got to get it out and then I can go home and move on with life. That wasn’t the case.
What cancer treatment options were you given?
After surgery recovery, I met with my oncologist about 4 weeks after my initial diagnosis and surgery. We walked through traditional first-line chemotherapy FOLFOX, which is a pretty aggressive first-line treatment and pretty standard care for most of these patients. We did add Avastin into the mix as well to hit it harder, which is probably the best way to describe it.
We talked through side effects and what to expect over these 6 months. The intent was curative intent and to get me to a position where I could be surgical in regards to the liver situation.
Undergoing liver surgery and chemo
We went through 4 months of FOLFOX before I was able to have my liver surgery. They did a liver resection in October of 2021 and took out about 30% of my liver. The good news is most of the lesions that were in the liver were necrotic. Chemotherapy, knock on wood, had done its job, and then I recovered from that surgery.
They did ask me to complete 4 additional rounds of clean-up chemo just to make sure there wasn’t anything lingering out there that didn’t show up on scans. I left the hospital in October extremely excited. You get this diagnosis 4 months before and it’s a pretty dark picture, and to be told that we got it all? In my mind, I beat it and we’re moving on with life. We can go back to normal.
About 2 months after that, a follow-up CT scan showed numerous spots in my lungs. It had hid for a little while and then metastasized further into the lungs which we’re still working on treating today.
About 2 months after that, a follow-up CT scan showed numerous spots in my lungs. It had hid for a little while and then metastasized further into the lungs which we’re still working on treating today.
Of all the chemo that I’ve been on, that first-line treatment was pretty rough. FOLFOX is not for the faint of heart. I had a lot of fatigue and nausea. At one point, I did have a blood clot that they deemed Avastin probably caused. That was a little scary. I had a blood clot that started in my leg and moved into my lungs. We were able to work through that and get that resolved.
Mental Health
The physical and mental toll of cancer
I did seek out some professional help from a therapist’s standpoint, and that helped me tremendously.
I looked at it as 2 things. There’s the physical piece – there’s a lot of medications and vitamin supplements and things like that I was taking to help. But I think the first year of this was more challenging on the mental side if I’m being honest. It was pretty dark for a while because the first thing most people do is grab their cell phone and computer and start searching for your disease and they want to learn more about it.
The prognosis for stage 4 colon cancer patients is not really great. I’ve got 2 young boys and my wife, we have a great family. To think about losing all that in a very short window is very humbling. I went through a pretty dark depression phase where I lost hope. This was before treatment really started and things started to actually show some progress.
I did seek out some professional help from a therapist’s standpoint, and that helped me tremendously. Not only to be able to take the feelings that I’m having at different points throughout the day or the week or whatever and work through and process those but to get me centered and present instead of sheltering away.
Breaking the stigma of men expressing their emotions
I think that the traditional model of men don’t cry, keep your feelings in, walk it off, and rub some dirt on it is just culture. My wife and I had a lot of conversations about depression and the diagnosis. It’s great to be able to talk to friends and family, but there’s a note that a professional can bring to those conversations that friends and family can’t.
Friends and family will tell you, “You got this, you’re going to be okay, we’re going to get through all those things,” and it’s all with good intentions. But the professional side will actually take you through how to deal with the dark stuff, how to work through those feelings, how to deal with anxiety, and how to deal with depression so you can actually enjoy life instead of just living secluded and isolated.
I did find a couple of groups shortly after my diagnosis that really helped me with peer-to-peer, patient-to-patient, sharing stories, hope, avoiding isolation, and being able to talk to people who truly understood what I was going through.
Talking to children about a cancer diagnosis
Honestly, as a father, that was the hardest conversation I’ve ever had. My wife and I talked a lot about this before and what approach we wanted to take. At the time, 2.5 years ago, they would have been 9 and 11. You think 9 and 11-year-olds are pretty young, but kids are smart, especially with technology at their fingertips. They’re able to find the answers if you don’t provide them, so we made the decision that we were going to be age-appropriate, open, and honest with my diagnosis, my condition, and how life is going to look for a while.
I look back on that and I’m really glad we made that decision because I’ve met other folks that are going through similar things that chose a different option. Every family is different and everybody’s decision on how they include their family in these conversations is something very personal. But I’ve also seen a lot of family and friends be torn apart simply because they felt things were hidden from them.
We made the decision that we were going to be age-appropriate, open, and honest with my diagnosis, my condition, and how life is going to look for a while.
I wanted that to be the voice, I wanted them to feel like they’re a part of this story and what we’re going through, and not dismissed. Even 2.5 years into this, I still double down and think that was the right decision for us.
As for my parents and in-laws, we needed a lot of help right in the beginning. This was right at the beginning of summer break when all this happened. My kids are extremely active in sports and activities. Being out of the mix for a while, recovering from surgery, we needed a lot of help shuttling kids here and there and just dealing with life. It doesn’t stop just because somebody gets sick.
We were able to have a lot of conversations and tough conversations, but at the same time, as family does, there’s a lot of hope, positivity, and support that comes with those conversations.
Metastasis
Blood work is pretty traditional and then we also used ctDNA testing to monitor residual disease and that’s actually what gave us the smoke alarm…It posted positive.
How long after your diagnosis did you learn your cancer metastasized?
About 2 months. It would have been January or February 2022 till March or April that I didn’t have residual disease and nothing showed up on the scans. Then we started using a couple of different tools to monitor my disease. Blood work is pretty traditional and then we also used ctDNA testing to monitor residual disease and that’s actually what gave us the smoke alarm. It was a test called Signatera, which is a molecular test for ctDNA. It posted positive.
How did you react to your cancer recurrence?
It sparked a flurry of emotions and feelings that it’s back. Because of that positive test, my medical team ordered scans and so forth. At first, nothing showed up, so we were at this weird place where we knew something was there. We know something’s brewing, but we just can’t see it and we don’t know where it is.
What treatment did you opt for with your recurrence?
I’m really lucky in regard to the medical team that I have. My oncologist and I walked through different options. We could do nothing and wait to see what pops up and deal with it then. Or, what is not very common, is my oncologist actually offered me to go ahead and start back on treatment again knowing that something’s there, it’s going to show up, we just don’t know when. While chemotherapy is not fun, we opted to go ahead and start treatment to be as aggressive as we possibly could. About a month after that, they did a follow-up CT and then found 14 spots on both sides of my lungs.
Not knowing where the recurrence was at first, was chemotherapy the right choice?
I think if anything, it bought me time to process and plan with my team what approach we wanted to take. The treatment that I started then would have been the treatment that I would have started if we waited regardless. I know there’s no real way of knowing, but in my heart, I believe it probably saved it from popping up in other places as well. While 14 spots in your lungs are not great, it could have been worse. I think that some of those tools that we’ve used put us in a position to get ahead of it to try to treat it the best we could.
What chemo were you on post-recurrence?
I know there’s no real way of knowing, but in my heart, I believe it probably saved it from popping up in other places as well.
My second line treatment was called XELIRI, which is Xeloda Irinotecan, and then we kept Avastin in the mix as well. I was on that cocktail for about a year and a half.
There were side effects, so still some fatigue and some nausea, but the ability to bounce back was so much faster. When I was on my first-line treatment with Folfox, after that infusion, I would be out of commission for 4 or 5 days in a row and miserable. The worst flu possible is the best way to describe it.
Then when I moved to the second-line treatment, the day after infusion was pretty rough. Then you started to come out of it pretty quickly and that cycle was every 3 weeks. I actually got an extra week of good feeling into that mix too. While again, no chemo is great, it definitely was good from a quality-of-life perspective.
Staying on a curative path
We had that tougher conversation around curative intent versus palliative care, and I’m still on a curative path. I’m not ready to succumb to this is going to be my life forever. I know that seems kind of silly at times, but I think for me mentally, I need to know that curative is still a path.
I’ve also learned I have to accept stability as positive.
Hearing that was obviously frustrating, it was discouraging. But I feel like we were in the right place to get started when we did. As I said, that cocktail worked for about a year and a half.
What we started to see, and this was just a couple of months ago was that some of those numbers like my Signatera test started to increase, but my scans still showed stability. Again, maybe I’m an oddball, but we’re in this weird situation where we know the chemo that I’m on wasn’t reducing anymore, but it was keeping things stable. I’ve also learned I have to accept stability as positive.
But we had that conversation around if this drug is no longer shrinking but is holding it stable, is it best to stay on this until it stops working altogether or do we want to go ahead and fast forward a little bit and jump on third-line treatment? The path that we’ve always taken is the most aggressive path and the best probable outcome. We made the decision to go ahead and jump ship and start third-line treatment, which started about a month and a half ago.
What cancer treatment are you on currently?
The third line for me is Vectibix, which is an EGFR inhibitor along with Irinotecan. So one of the old drugs and one of the new drugs and that’s where this lovely rash comes from, is from the Vectibix.
How long will you be on your current treatment?
The good news is that I have found options post this line of treatment. Exiting standard of care, there are a couple of clinical trials that I’ve already looked into and tentatively been approved for.
Until it stops working. I love being the oddball. All the spots in my lungs are very small and they’re all under a centimeter. So for me to get into any clinical trials, I don’t qualify because they’re not big enough to biopsy. I’m in that weird situation of, you almost want it to grow to be able to qualify for trials and things like that. But mentally, I just can’t accept that. I’m just going to continue to beat it down until I can’t beat it down anymore, so it’s indefinite right now.
The good news is that I have found options post this line of treatment. Exiting standard of care, there are a couple of clinical trials that I’ve already looked into and tentatively been approved for. It’s a pretty aggressive opportunity that’s being tested in an NCI center close to me, it’s a double lung transplant for metastatic cancer patients. That tumor board has already approved me, but I have to exhaust the traditional standard of care, which is the current treatment that I’m on now.
Reflections
There are plenty more options out there as long as you’re willing to do the research and find them and go wherever it takes to get whatever that treatment may be.
I don’t want to take anything away from my team because they are great, but at the same time, there’s a realization that you’re not their only patient. They’re not going to invest 40 hours a week looking into different options for you.
I’ve learned a lot through a couple of advocacy groups that I’m a part of that have really helped me understand the value of second opinions. For me, second, third, fourth, fifth, sixth, and seventh opinions. I’ve traveled quite a bit to get a better understanding of options that are out there and things that are at different cancer centers I can’t get locally. That has helped me open up some doors and continue to build that hope strategy around, there’s something else after this instead of just saying, this is the last standard of care line. This is it.
There are plenty more options out there as long as you’re willing to do the research and find them and go wherever it takes to get whatever that treatment may be.
Doing your own research to understand your options
I think a big misunderstanding, and it is not the fault of your local oncologists and teams, I think it’s just how the systems are built. You have to be a component of your care and you have to be an advocate of your care. That also comes with education. I had this misunderstanding that I would just go to my oncologist and they would take care of everything and they would prescribe, “Here’s what you need to do to get rid of X, Y, and Z,” and then things would be great.
I can’t stress enough, exhaust your options in regard to opinions. There are never too many opinions and too many places to visit to get ideas.
There are limitations to every cancer center that’s out there. Some specialize in the cancer you have and some don’t. For me, knowing that I’m not going to get a list of trials that are across the United States for me to look into. They provide some that they’re familiar with, but ultimately, a lot of that research lies on the patient along with opinions. I can’t stress enough, exhaust your options in regard to opinions. There are never too many opinions and too many places to visit to get ideas.
How often are your scans?
Because I’m still on active treatment, I see my local team every 2 weeks and we complete scans every 3 months. My next scan will probably be at the end of September. That’ll be the first true telltale sign of how this new line is actually working. My hope is it can get me to a point where surgery would be an option from a lung standpoint, but it’s got to do some good work.
I will say that the positive is that, I just had my third, but after 2 rounds of this, one of the tumor markers in my blood is the second lowest it’s ever been. I’m hoping that correlates in September to good news on a scan, but we’ll see when we get there.
Do you experience scanxiety?
Let yourself be surprised when there’s good news and actually enjoy that.
It was a lot worse in the beginning than it is now, but don’t get me wrong, there’s still scanxiety. I think My Chart is a blessing and a curse at times because you have access to those scans as soon as they’re available. Sometimes I see them before my oncologist. When it’s a good scan, that’s great, because then you can high 5 and move on about the day. It’s when it’s not that the panic sets in – do I need to call, when are they going to see it, what’s our next step?
How I’ve learned to deal with it is you just have to accept it. That sounds really weird, but you have to accept the situation you’re in. You’re going to get good news and you’re going to get bad news, and more than likely, you’re going to get bad news more than good news. With that mindset, you’re not expecting to go in and everything’s going to be great and the scans are going to be clear.
Don’t set yourself up for something that’s not realistic. It helps a ton. Let yourself be surprised when there’s good news and actually enjoy that. When it’s not, learning how to process that, going back to see a professional that can help with tools and tips and tricks to work through some of those things has helped me post-scan to be able to control some of those things.
Do you still work?
I stopped working after my diagnosis. We were lucky enough to be in a situation where I could step away from work and we could live our lives as normally as we had. I know that is not the situation for a lot of folks, so I don’t take that lightly.
What it has allowed me to do is spend my time how I want to spend it and prioritize my time differently than I did in the past. I think with a lot of folks, work is always this big rock that you always have to spend time on. Then, you get home and you got kid’s activities and all these different things. It just consumes the day. With me not having to work, I’ve been able to spend time with my kids that I never would have had the ability to do.
One of the things that I’m most grateful for is the last 2 summers, our kids would go to some type of camp or care when I was working. But since I’ve been home, we didn’t have to do that. I was able to stay with the boys both summers and they coined the term Summer of Dad. What they would do is they would take a plain old calendar, and just start filling it with all these activities that they would want to do throughout the summer break. My job was to find ways to get all those things to happen over the course of 65 days or 80 days or whatever it is.
It has been so much fun and so rewarding to spend that time with my kids. My phone’s not ringing. I don’t have to worry about email. I don’t have to worry about the grind of a traditional job. I’m able to spend my time how I want.
Which cancer support groups do you recommend?
I would be remiss if I didn’t mention a couple of groups that helped me tremendously through this diagnosis. One of those is colon cancer-specific. It’s a group called ColonTown, a nonprofit organization that focuses on patient and caregiver-led support, education, and being able to, share stories and speak to people who are going through things that you’re actually going through.
The other group would be Man Up To Cancer. This is an all-cancer type group, but specifically for men. We touched a little bit earlier on that stigma of male mental health, isolation, and those types of things. That group is phenomenal at helping solve that gap and really providing support and help for men specifically to not isolate during these times and how critical it is to not do that.
As a cancer patient being able to find the people who are going through this with you, it’s amazing. The connections you can make with people, whether it be online or in-person, that are going through things. It’s almost a bond that’s stronger than any relationship I’ve had with people I’ve known for years. I don’t know if it’s a trauma response or what it is, but it’s interesting to be able to surround yourself with like-minded people in similar situations. You just feel that weight gets taken off your shoulders to some extent when you can share and know that people get it.
What advice do you have for others on a cancer journey?
Don’t give up hope, number one. Absolutely educate yourself on your disease and be an advocate for yourself along with your care team. Be a part of those conversations. Don’t just let those conversations be done to you and take your life back.
To say I’m not scared of death is an extreme understatement. I’m actually terrified of that, but can’t control when that’s going to happen. It’s all in science’s hands at this point. What I don’t want to do if I get to that point, is look back and say I’ve wasted the last year, 2 years, 3 years, whatever that is, worrying and not living my life. That will be my biggest regret as a father, a husband, and just as a human.
Everybody has a stopwatch above their head, and some might be shorter than others, but I’m going to maximize every day I can and I’m going to do whatever I can to enjoy it, whether that be enjoying my own hobbies or spending time with my friends and family. I’m not going to let it take that part of my life away.
Symptoms: Found the cancer as a result of family history & early colonoscopy; discovered Lynch Syndrome after genetic testing Treatment: Partial colectomy
Navigating Life with an Ostomy: Tips from Patients and Medical Experts
Written by:
Jenna Jones
Undergoing an ostomy procedure involves major changes. To offer guidance, The Patient Story hosted a live discussion with colorectal cancer patients Amy Hart and Jason Randall, who both have ostomies, along with Dr. Vanessa Wookey, a gastrointestinal oncologist from Fox Chase Cancer Center.
From their real-life expertise, they offer practical advice about living with an ostomy, from diet and clothing tips to cleaning and skincare. Plus, Amy and Jason share how they wear an ostomy with body-positive confidence.
An ostomy is a surgical procedure that brings a section of the intestine or urinary system through an opening (stoma) in the abdomen. Waste passes through the stoma into an external pouch or ostomy bag attached to the skin.
Ostomies allow the bowels or bladder to function after injury, disease, or birth defects. Reasons for getting one include colorectal cancer, Crohn’s disease, bladder issues, and birth abnormalities according to the United Ostomy Associations of America, Inc.
“You can still do everything you could do before. You can swim and go in hot tubs. You can do everything. It’s not limiting like you might think it is. There’s so many different kinds of bags you can use, so figuring out what’s best for you is a process.”
Jason, who has had both an ileostomy and colostomy, highly recommends joining an ostomy support community. “It’s really helpful to ask people questions and dive into the more in-depth stuff,” he says.
Amy, who shares her experiences online, agrees. “Seeing other people, maybe four years down the road, allows you to see what your life could look like after this massive change.”
Dr. Wookey stresses the value of connecting with those living with ostomies day-to-day: “The best thing patients want is someone who can help them figure out some of the troubleshooting.”
Finding the Right Bag System
There are various ostomy pouching systems available. Jason emphasizes trying different products patiently to see what works best.
“What one person may work well for them, may not work for another person,” he explains. He started with a two-piece system but found a one-piece pouch simpler.
Amy switched her ostomy bag based on a friend’s recommendation. “It worked out great,” she says. Reaching out to manufacturers for samples helps find the optimal ostomy bag.
“Any closed system is not a good idea if you have an ileostomy, because you’d be changing it all day long. Whereas with a colostomy, it’s a little more predictable. It’s easier to manage. People tend to go with closed systems for convenience.
I used to be a 2-piece ostomy person for both my ileostomy and my colostomy. I’ve had about 2 years of colostomy and 3 months of ileostomy. With the colostomy, I’ve gone down to a 1-piece system.”
According to Dr. Wookey, there’s no singular best ostomy diet. She advises starting with a low-fiber, low-fat diet after surgery and then slowly reintroducing foods.
Amy adds, “I eat everything. I just introduced it in small quantities and with a lot of liquids.” She stresses thoroughly chewing food to aid digestion.
Jason recommends tuning into your body’s signals if certain foods cause discomfort. He takes supplements to relieve symptoms of obstruction when needed.
Preventing Leaks and Skin Irritation
To prevent ostomy pouch leaks, Jason uses special rings around the stoma opening for protection. “Getting a pre-cut bag and not cutting it yourself creates a much better seal,” he says.
For skin irritation, Dr. Wookey advises gentle cleaning around the stoma: “Using just water or a gentle soap is really the most you need.” See your doctor for significant redness or wounds.
Ostomy Clothing Tips
“My life as far as using the bathroom is altered but the only part that’s really impacted by that is the part that happens when I close the door and no one’s in there with me.
[As] life does, it takes a really long time for it to re-settle down, but it does settle back down.”
Amy suggests stretchy, high-waisted clothing styles to accommodate ostomy pouches. She also wears bike shorts under dresses for security.
For men, Jason fuses a belt called Stealth Belt to keep his pouch securely in place during activity. This also helps prevent abdominal hernias.
Life after ostomy surgery involves adjustments. But support groups, finding optimal products, and an adaptable mindset makes thriving with an ostomy completely possible.
Symptoms: Found the cancer as a result of family history & early colonoscopy; discovered Lynch Syndrome after genetic testing Treatment: Partial colectomy
Jason Randall, A Stage 4 Colorectal Cancer Survivor
Jason’s Stage 4 Colorectal Cancer Story
Jason’s cancer journey began in 2005, in the middle of his Navy service. He began experiencing stomach issues and was diagnosed with GERD. Much later, in 2018, he was seen by his doctor when he developed severe abdominal pain and infrequent bowel movements. A scan revealed 80% of his liver was covered with metastatic disease, which led to a stage 4 colorectal cancer diagnosis.
After years of fighting Veterans Affairs to prove his cancer was connected to exposure to cancer-causing chemicals during his Navy service, restitution was granted through the Pact Act – an Act that grants better healthcare and funding to veterans exposed to toxic chemicals.
Jason shares his cancer journey, his work with COLONTOWN – a colorectal cancer support network, and how he overcame liver surgery and chemo after doctors said it couldn’t be done.
Just this year, Jason and his wife launched Kohala House of Healing, a cancer retreat in Hawaii. The lush hideaway is designed for those affected by cancer to find hope, healing, and renewed purpose.
At the Patient Story, we feature the real voices of cancer patients to empower and offer hope. Explore more Colorectal Cancer Stories for further inspiration.
My name is Jason Randall. I live in Eudora, Kansas with my wife and 3 children. We live on a hobby farm. I was in the Navy for 5 years from 2003 to 2008. After that, I went to school.
My wife and I were best friends in high school. After the Navy and college, we reconnected. When I came back from Hawaii for a semester at the University of Kansas, we started dating. My wife has our daughter from a previous relationship, who I’ve adopted.
We’ve lived on this hobby farm for 10 years. I’m a cartographer by profession. Technically, a GIS analyst. We like to fish as a family. We go to the gym and swim quite a bit.
When did you first notice something wasn’t right?
In about 2005, right in the middle of my Navy service, I had some stomach issues that they tested. They came to the conclusion that I had GERD reflux disease, so they put me on omeprazole and Zantac-type medications. It was fine for years after that.
About 2018, I was diagnosed with stage 4 colorectal cancer. It blindsided us. I say us as in my family because I always include caregivers. They are often overlooked in this process.
They saw that about 80% of my liver was covered in what appeared to be metastatic lesions…It started me in this world of advanced-stage colorectal cancer.
Two weeks before, I had some severe abdominal pain that I’d never had before and 2 weeks before that, I’d noticed that I wasn’t going to the bathroom at a regular frequency. Then it just stopped and I started getting abdominal pain. That’s when I thought something was wrong. I need to go get this checked out.
My mom had diverticulitis quite a bit over the last couple of decades and they said, “It’s probably that. Let’s get a CT scan just to make sure so we can put you on antibiotics for it.”
I had that scan on July 16th. They saw that about 80% of my liver was covered in what appeared to be metastatic lesions. That prompted a PET scan on the 17th which confirmed it. My liver, the large majority of it, was covered in metastatic disease. It started me in this world of advanced-stage or stage 4 colorectal cancer.
Was there any connection between your GERD and colorectal cancer?
I brought that up along the way many times after I was diagnosed. The doctors never put them together because they generally think, anything in the upper esophagus or upper GI tract is Barrett’s disease or esophageal cancer instead of colorectal cancer.
My colon, where we found the tumor was at the sigmoid part of my colon, right before the rectum. So there really wasn’t a tie to it.
Ironically, after I had surgery to remove 30 cm of my colon, my GERD completely went away. It cued me to ask, what’s going on here?
If you look at the history all the way back to 2005, I was on ranitidine, which is Zantac. Then when I got out of the military into the Veteran Affairs (VA) system, I was on omeprazole for 10 years. My doctor mentioned that the advanced stage of my disease and the extent of it [means] it had been in me for about 10 to 15 years at a minimum. That squarely placed it right in my military service.
Did the VA take responsibility for your diagnosis after your exposure to cancer-causing chemicals?
Not definitively. Presumptively, yes. I was fighting the VA for about 3 years, trying to tell them that everything lines up with the exposures I had while I was in the Newport News Shipyard.
After I got out of my basic and my school training, I reported to the USS Eisenhower in 2004, in what they call an RCOH overhaul, where they take an aircraft carrier in the middle of its life and completely redo everything. They take it down to bare steel. They replace the reactor rods. I was in that environment for about 2 years.
We had all sorts of chemical and toxic exposures. You can use PPE and try to protect yourself, but you still inhale it once you take the equipment off. I was also within the burn pit zones in the Persian Gulf from 2006 to 2007.
Finding help through the Pact Act
They said you need to prove to us and provide a nexus that caused this, which is impossible. Even though statistically, 25-35% of all veterans of any service have an increased risk of multiple cancer types.
Jon Stewart was one of the biggest promoters of this law called the Pact Act for Toxic Exposures and Burn Pits. It finally connected my service to my cancer diagnosis.
Because of the way the laws were written before, the burden of proof was on the person having cancer. They said you need to prove to us and provide a nexus that caused this, which is impossible. Even though statistically, 25-35% of all veterans of any service have an increased risk of multiple cancer types, like prostate, breast cancer, colorectal cancer, and all sorts of different things.
The law was really good to help veterans who have been struggling to get this care and to have the military take responsibility for that within their service.
Did you have any other symptoms before your stage 4 colorectal cancerdiagnosis?
The only other symptom was, before diagnosis, I had something in my belly button that would appear every 4 to 5 months. By the time I could get in [to the doctor’s office], it would go away. They’d say, come back when you can. By the time I could get scheduled, it would go away.
It only lasted for a couple of days and it was like a little bit of discharge from my belly button and a little bit of hair follicles. It seemed like there were hair follicles that would come out. It’s hard to explain, but something wasn’t right.
It turns out that’s right where my primary tumor was, along the sigmoid colon. It was like, this could be a correlation to that.
What happens, happens but I wish I could have got in when they could have examined that a little bit better.
Did you have bleeding?
They say the number one symptom of colorectal cancer is no symptoms at all.
You hear a lot of people with colorectal cancer say they had blood in their stool. I think I’ve only had it at one point and it’s because I ended up having an emergency stent placed shortly after diagnosis because of the situation at hand. Even then, it was a couple of times.
They say the number one symptom of colorectal cancer is no symptoms at all.
How did you react to receiving your stage 4 colorectal cancer diagnosis?
No matter how much you think you know about cancer, unless you’ve experienced it firsthand or been a primary caregiver or even a secondary caregiver to someone, there are so many misconceptions about it.
It’s very vivid, even though in July, it’ll be 5 years now on this journey. I was diagnosed on July 17th, 2018. It was 2 days after my son’s second birthday, and my wife was pregnant with our third child.
I remember walking into the doctor’s office after the CT scan. They called about 15 minutes later and said, we need to see you tomorrow first thing. I go in and the doctor casually says, “I don’t know another way to put this, but you’ve got cancer and it spread to your liver.” I said, okay, took a minute, and then as soon as I walked through the doors leaving the place, it was like a rush of holy crap. I’m a dead man.
No matter how much you think you know about cancer, unless you’ve experienced it firsthand or been a primary caregiver or even a secondary caregiver to someone, there are so many misconceptions about it. I thought I was dead.
I come from a large breast cancer family. I carry a BRCA1 germline mutation. The women in my family, if they’re a carrier, they’re almost guaranteed to get breast cancer. It’s not as prominent in men. My mom had cancer, and her mother passed from cancer. I have had exposure to this, but it was emotionally devastating.
My wife was at the bowling alley with the kids and a friend. When I called her, she completely lost it. It was a bad, very dark time. We ended up coming home that night, my wife and I. We had my parents watch the kids, and we just held each other thinking, how much time do I have?
With 80% of my liver covered, that’s not a good situation. And I had a fully blocked sigmoid colon so they couldn’t go in and remove the primary tumor. I had to have that stent open me up before I could pass stool. Everything from there was a whirlwind getting into doctors, and getting the stent placed. It was emotionally devastating.
Treatment
What were the next steps in your treatment?
That’s a little more vague to me. I do remember [the doctor] saying, we’re going to have to get you in for a PET scan, which happened the next day to confirm it was stage 4 colorectal cancer. After that, I was at my local hospital system near Lawrence.
If you’re not used to it, it’s a lot to process, to listen to everything they’re telling you, and to absorb it.
Luckily, I have a doctor cousin who took me with his training. We called him and asked, “Do you have any advice?” He said, “I want you to go see Dr. Miranda at KU Medical Center,” which is the National Cancer Institute (NCI) here in the Kansas City area. It’s the only one in the Kansas City area.
He came with me to the appointment. That was a very pivotal moment in this. Going to one of the top centers in the area with that NCI rating, it’s important to have.
I work in the colorectal cancer support community and advocacy, and I heard the average time for people going from symptoms to starting chemotherapy is above 200 days, which is insane. I got in within 2 weeks. I was diagnosed on July 17th and I had my first chemo on August 1st, about 2 weeks later. I’m very blessed to have that team move that quickly.
A lot of it is very vague. It was just, go see this doctor, see this, get this scope. If you’re not used to it, it’s a lot to process, to listen to everything they’re telling you, and to absorb it.
I’m very grateful my oncologist never told me an expiration date. They did say, “You have a terminal prognosis of chemo for life and are inoperable due to your extended disease. You’ll never get off chemo and you’ll never be operated on for a curative intent. Palliative reasons, possibly, but we’ll do everything we can to extend your life.” That was a big pill to swallow
How did you come to terms with a terminal prognosis?
I don’t know if I ever fully digested it. I never believed I had cancer. It was all very surreal. I thought, is this happening? Did I get phase-shifted into some weird parallel universe? This has to be a bad dream. When am I going to wake up?
It was a lot to process. Every time I heard it, I would sigh and griff and say, “No, I don’t want to hear this. This is not my fate. I don’t foresee this being me.” It was really hard to swallow, especially every time my oncologist said, “We’ll do everything we can to extend your life, but you will be on this forever.”
I was put on what they call FOLFIRINOX. Sometimes they call it FOLFOXIRI. It’s basically how the drug is administered. With colorectal cancer, if you’re not a candidate for immunotherapy, irinotecan, and oxaliplatin are the 2 big drugs [that are given], and 5-FU which has been a standard since the 70s.
I had what’s called the kitchen sink. It was a combo of those 3 drugs. I started on August 1st and I started with what would have been the first of 30 initial cycles. I did 9 of the FOLFIRINOX, then we paused to do Y-90, which is Yttrium-90. It’s a radioactive isotope of the element yttrium.
They go through your hepatic vein and your groin and they send a catheter up into your liver. It’s a liver-directed therapy where they drop millions of radioactive resin beads right into your liver where the tumors generally form based on where the blood flows. I had 2 of those in November and December 2018, then I resumed 11 more treatments of what they call FOLFOX, which is the previous one, minus the irinotecan. They wanted to drop down the irinotecan because of the 2 Y-90. It’s a lot to take on with the radiation.
It’s targeted radiation, so I ended up having 6 of the 5-FU, largely driven by blood numbers – whether my white blood cells were up or my platelets were high enough. My big issue was low platelets, something I still suffer from today, from all those treatments.
Switching treatments due to lung spots
In September of 2019, I had some lung spots show up so we switched the drug oxaliplatin. A lot of the time, oxaliplatin causes severe neuropathy. Luckily, I never had too bad of that and I ended up taking 20 cycles with that in the mix, which is a lot. Some people dip out after 4. Usually, it’s between 8 and 12 of those.
Then I started back on the irinotecan drug through a combo called FOLFIRI. We added a biological drug called Vectibix or panitumumab, an epidural growth factor inhibitor that prevents blood vessels from growing. I did 4 more treatments through December 2019, and then I stopped to break for Christmas.
Getting a second opinion led to new treatment options
Even though they had my best interests in mind, I still sought that second opinion out at the City of Hope in California. It’s probably the best decision of my life.
My story started to change through COLONTOWN, an online colorectal cancer support community. I learned about Dr. Fong who’s a liver specialist and surgical oncologist. He doesn’t do just the liver, he does a lot of stuff in the abdomen area minus the colon itself.
People kept saying, you need to go see him. I had scans in December at my local center. Even though I had a really good response to chemo, they told me, you’re going to be on chemo for life and inoperable. They were scared that if I did have liver surgery, the liver would grow back. It’s the only organ that does that and the disease would progress with that regrowth.
Even though they had my best interests in mind, I still sought that second opinion out at the City of Hope in California. It’s probably the best decision of my life. It led to a surgery that was 12 hours long in February 2020.
They removed my entire right side and a right hepatectomy and then a lower anterior resection (LAR). They removed 30 cm of colon and a quarter of my rectum with curative intent and also took my gallbladder. I had 5 ablations on my left side at the time. I had lost 110 pounds prior to that surgery.
What inspired you to get a second opinion?
It was the support group COLONTOWN. People kept mentioning it. I was holding out on hope at my current NCI center. I still actually see them to this day, but I was hoping that with that next set of scans, they’d say, we’re going to try. They never did.
Ultimately it was my wife who said, “You need to go do this. Let’s go out to California. What is the worst they’re going to say? No, and you’re still the same?” I said okay, let’s rule it out. If one of the top people in the world says no, then it’s my fate. Thankfully it wasn’t.
Cancer recurrence and COVID caused changes to treatment
That’s not where the treatments ended. I stopped chemo after that because I had 30 cycles and 2 liver embolizations and they said my body needed a break. About 6 months later it returned, but not in my liver or colon. It returned in my tailbone in October 2020.
I started back on the FOLFIRI with the Vectibix for 4 more cycles. On my very last cycle, my 34th chemo, 2 days later I tested positive for COVID. That was a crazy week. COVID delayed my radiation treatment.
In February and March of 2021, I had 28 full pelvic radiation sessions to the entire pelvic region, which destroyed my rectum. For 3 months, it was pretty rough. I was sitting on the toilet for 3-plus hours a day, not really living life, just stuck.
Finding hope after his son’s birth
Throughout January and February 2019, I was on a lot of treatments. My son was still in my wife’s belly at the time. I caught him about 2 hours after my eighth round of heavy chemo. That gave me a lot of motivation, wanting to see my kids grow older.
It’s a very powerful moment in my life. Seeing my son born and being able to catch him. Both my sons were born at this house. My wife did a home birth, bless her soul. I didn’t think it would work out, but it did and it really changed me. It gave me a little bit more hope in October 2018 when that happened.
Then it got dark again. I had surgery in January 2019 because the chemo destroyed my anus and caused a fistula to bore through. It caused a lot of pain.
In early February, I found an integrative medicine doctor through my dentist of all people. I went to see him and he joined my team. That was one of the biggest moments of my stage 4 colorectal cancer experience. Not just diet and exercise, which are important, but he also helped mitigate the side effects, which helped get through it and process it.
I had hope, even though the hope was taken out from underneath me when they said you’re going to be on chemo for life.
One of the biggest things [he taught me] was the mind-body connection and meditation called Psychosomatic Wellness, which has a lot of science behind it. I wasn’t big into that kind of stuff. I thought, “This is heebie jeebie. This isn’t going to work.”
About a month into it, I connected to it. I went somewhere. I still don’t know what to call it. Some people may call it universal energy, God, chi, soul. Whatever you want to call it, I went somewhere and connected with something. It really helped me process things.
I was able to accept life, death, purpose, and what all this means. I was grateful for whatever was to come. I carried that into this second opinion. I had hope, even though the hope was taken out from underneath me when they said you’re going to be on chemo for life. What do I have to lose? I went out to California and sure enough, it happened and here I am still.
Getting an Ostomy
Describe getting an ostomy bag
Back during the big February 2020 surgery, I had a temporary ileostomy placed which is where the small bowel dumps into a bag with a stoma. That was reversed in May 2020.
Fast forward to the radiation. In June 2021, I had an abdominal perineal resection (APR). It’s a surgery that’s known as Ken or Barbie butt. Imagine a Ken doll or a Barbie doll. They just have a straight stitch on the backside. They took my anus, my rectum, and in my case, my tailbone and part of my sacrum to get clear margins. It was successful, and it left me with a permanent colostomy bag but it’s been a blessing in disguise.
Having it removed has been great for me. I don’t sit on the toilet for 3 hours a day. I spend 60-90 seconds messing with bowel function now. I still swim 3 to 4 times a day. I get to play with my kids. I lost 110 pounds and I wasn’t sure if I’d ever gain it back, and now I’m on the other end of it. It’s been so good to me that now I need to lose a few pounds.
What types of ostomy bags are there and which do you use?
There are several types of ostomy:
The ostomy that comes off your small bowel and avoids your large intestine.
A colostomy, which can be placed along your transverse colon all the way down to your sigmoid.
One-piece open bags which have a little cut-off valve that you can drain as needed.
Two-piece drainable bags.
Two-piece closed systems in one-piece closed systems.
I had a temporary ileostomy. At first, they tend to be more of a liquid output. They’re always on because the way the bowel works is your ileo dumps into your cecum and that’s when your stool starts to form. Before that, it’s all liquid as your small intestine absorbs nutrients. [Ileostomy is] common when people have a large surgery over a colostomy.
If you’re removing the lower part, you tend to get a stoma. That’s the medical name for the exit point. The stools tend to be more formed, it’s more predictable. I find that [colostomy] systems are a lot easier to use than the ileostomy systems.
Considerations when choosing an ostomy bag
Any closed system is not a good idea if you have an ileostomy, because you’d be changing it all day long. Whereas with a colostomy, it’s a little more predictable. It’s easier to manage. People tend to go with closed systems for convenience.
I used to be a 2-piece ostomy person for both my ileostomy and my colostomy. I’ve had about 2 years of colostomy and 3 months of ileostomy. With the colostomy, I’ve gone down to a 1-piece system.
There’s usually, a flange that adheres to your stomach. Once that gets on, a lot of people use either pastes, barriers, or protective rings to help hold that on to prevent leaking.
Leaking is the #1 thing that gets people flustered. It’s like crapping your pants and no one wants to crap their pants. It’s one of the big anxiety drivers with an ostomy. Am I going to leak? How am I going to manage this?
Also when you have a peristomal hernia. The creation of a stoma is a hernia in itself. That can cause more herniations so you want to be very careful with your abdominal wall and building your core back. When you get a herniation, you can feel it. It can lead to blockages.
With an ileostomy, you have to watch your diet a lot more than with a colostomy. Things tend to get blocked more with the ileostomy. From my experience and hearing from others’ experiences with a colostomy, people can still get it.
Leaking is the #1 thing that gets people flustered…It’s one of the big anxiety drivers with an ostomy.
If you have an ostomy, make sure you have a good hernia belt. I’ve got several. I have several Stealth belts. I also have one called a Stomaplex, which is like a stoma guard for impact. You don’t want things to hit it because it can bleed. Some people also use a Nu-Hope binder. It’s like a taller binder that goes around with a hole in it to support that and push your abdominal wall together so that you don’t herniate as often.
Is colostomy irrigation an option for some?
You cannot do it with an ileostomy, but with a colostomy, not many people are aware you can do irrigation. Instead of having to worry about having a bag going throughout the day and finding a frequency, people that are more active tend to go the irrigation route.
Imagine an enema but for your stoma. It goes all the way up your bowel track and basically gets behind the stool and you force water through it and then drain it over the next 30 minutes to an hour after that. When it drains, your bowel is empty and you can put a stoma cap on it. A lot of people are able to go hiking for 24 to 48 hours at a time [after irrigation].
Has your ostomy experience always been good?
Go out there and explore, call, get samples if you can, and find the system that works for you.
I’ve had a very good experience with my colostomy and my ileostomy. A lot of people do have struggles though, so if someone’s out there and they’re asking, “Why does this guy have such a good experience?” You’re not alone.
I struggled the first couple of months with mine before I found a nice rhythm and system. Don’t be afraid to call the 3 big companies – Hollister, Convatec, and Coloplast – and request samples. It can be very good to talk to one of their reps to find out what system works for you.
Having an option between a flat bag and a convex bag can be a game changer. A lot of people get stuck and say, “This is what the hospital gave me. How do I deal with this?” Go out there and explore, call, get samples if you can, and find the system that works for you. Because what works well for me may not work well for you.
Post-Treatment Tests & Scans
A circulation tumor DNA (ctDNA) test helped catch cancer recurrence
In June when I had the APR, I got the colostomy, and my Ken butt, I had about a year’s worth of no evidence of disease (NED). Then I had a recurrence in my lung. A spot that had been on CT scans since diagnosis, which they thought was scar tissue, initially never responded to any other thing. After all the chemo I went through, it decided to grow in May 2022.
I didn’t go on treatment because we caught it very early. I’m on a circulating tumor DNA test (ctDNA) called Signatera. Another company, Guardant, has one called the Reveal. It’s the same test, different companies. They sequence the biology of your tumor, specific to the person and no one else. The signature will never pop up in anyone else.
It can detect circulating tumor DNA in your body. It’s not cancer itself, it’s just junk DNA our body puts off, but it has that signature of your disease and they can detect if you have a recurrence. My tailbone recurrence was caught by September or October 2020.
After I went through the radiation, the chemo and more radiation, and the second major surgery, I was about a year clear. Then I had that Signatera test which detected an extremely low amount.
Is a ctDNA test for everybody?
It’s still in the testing phase. Not everyone responds the same. Their bodies aren’t as sensitive to the test.
There are also different areas of the body that put off more ctDNA like the liver, whereas the perineal may not. It’s still in flux, but it can be another tool because the normal marker for me was never above. It was always within range and it still is. It’s never varied more than a point, so it was never really a good indicator. The Signatera test has been really important for that.
COVID delayed a necessary treatment
In May 2022 when I had a spot come back in my lung that grew, COVID struck again. When I went in to get it ablated, I’d had COVID 3 weeks prior. Even though I felt better, my lungs still had some junk in them covering up the spot and they can’t ablate what they can’t see.
Then in August 2022, I had a biopsy that confirmed it was colorectal cancer in my lung and I had an ablation the same day. I was in at 6 a.m. and I was out by noon, working at 12:30. It was the least invasive. It allowed me to skip treatments by detecting them so early.
As of Monday, I had a negative Signatera test come back and I had my CT scans showing that I’m 9 months no evidence of disease and I’ve been off chemo for 2.5 years.
How does it feel to be done with chemo?
Surreal. They told me I’d never get off of it, and here I am. 2.5 years off of chemo.
How often do you have scans?
Right now it’s every 3 months until I hit 2 years. Then it should jump up to every 6 months. In 3 to 5 years, they’ll jump it up to either none at all or every year.
I plan on setting records. I’m going to be the longest person NED ever. At least that’s the way I’m setting my mind up for it.
Reflections
Describe the work you’ve done since being diagnosed
I’m blessed to be where I am, and if I can help alleviate someone’s symptoms, give them peace of mind, or just provide some hope, I won’t be quiet.
I do a lot of work within the colorectal cancer support space. I’ve worked for COLONTOWN since July 2020, after I had my Dr. Fong surgery. Dr. Kaiser was my colorectal surgeon.
PALTOWN, which is the nonprofit for COLONTOWN, asked me to be on their leadership cabinet. They were forming a new leadership cabinet, a new model. There are 7 of us. I’ve been there ever since.
I do a lot of support work. I reach out to a lot of people. I do work for Man Up to Cancer. A primary goal is keeping men from isolating during a diagnosis.
I also do early-onset colorectal cancer awareness through the Colon Club. Through that group, I was in their 2023 On the Rise magazine. It lays out where we’re at and our story to raise early-onset awareness. It came with a photo shoot. I never thought I’d become a model but here I am.
I’m blessed to be where I am, and if I can help alleviate someone’s symptoms, give them peace of mind, or just provide some hope, I won’t be quiet.
The importance of expressing your emotions
Meditation, I went somewhere with it and that was my first foray into the emotional side of [my diagnosis]. I learned to accept that it’s okay to be emotional. And we should be emotional because if you push it down, it does nothing but hurt your mental health. Other people are going through this, and at this point in the game, if you have cancer, who cares?
It’s so much easier said than done, but you need to talk. Tell everyone how you feel. Some people are quieter than others. If you need to join a group and listen to other people do it, you don’t have to be active in those communities. Seeing what other people are going through can help your mental and emotional health more than anything. Some of us happen to be a little more vocal about it, but it helps to get people out of that bubble, that survival mode that we get stuck in.
A trip to Hawaii led to new revelations
In 2021, my family was gifted a vacation. During this trip, we realized that we weren’t living. We were stuck in this deep survival mode, which is mental and emotional depression. You’re living between scans. You’re stuck in survival.
It woke something up in us. We asked, what have we been doing? I’m doing all this support work, but we’re just going through the motions. We’re not really living our own lives.
We came up with the idea of going back to the Big Island of Hawaii. Then we said, we should move back there.
We came back [home], I looked at my wife and said, “I have this crazy idea. Would you ever move back, get a secondary house and host people to experience what we did?” I was thinking she was going to say, “You’re nuts, Jason. No.” And she said, “Yeah. I think that would be great.” So we started developing this plan.
I went to school for a semester on Oahu at the University of Hawaii Manoa studying anthropology and geography. It’s a beautiful place. If you’ve never been, I highly suggest going.
We were stuck in this deep survival mode, which is mental and emotional depression. You’re living between scans. You’re stuck in survival.
Connecting with a cancer retreat center
About 6 months into [developing this plan], I was looking for health care on the Big Island or through the VA because I’ll always need to go see doctors. I found this cancer retreat on the north side of Hawaii on the Kohala Crater. We said, “Holy crap. These people are doing what we thought of, except it’s a whole retreat center.” We reached out to them and they agreed to become our mentors.
Life gets busy with 3 kids and I was still worrying about that lung recurrence. Two days before or after my lung ablation, I finally had my VA claim accepted which lifted a huge medical burden off of my back because they’ll cover all my medical expenses. That freed up some resources.
My wife and I flew out in December to visit them as a patient and a caregiver to see what they had to offer. We really bonded with the couple. We shared our story with them. She was a cancer survivor. Her husband was on chemo for 12 years before she got with her current husband. He was a disabled veteran as well, and we really bonded.
We told them our dream and they offered to sell us the place. I went back for 5 weeks in April and March of this year to see what they meant by that, get more details, figure it out, and work on the farm. It’s also a sustainable farm that teaches food as medicine, and it has a temple that aligns with the integrative practices that I was doing, which was so beneficial to me.
After that trip ended, we came back and we now have a purchase agreement with a timeline to make that happen. We’ve got a little more money to raise and we have a timeline to do that.
My wife and I want to move our family out there, live on-site, and host cancer patients. Ultimately, it would be if we can find enough funding where it’s no cost to other people, but we’ll see how it goes once we get the next steps in place. That’s pretty active right now. We’ve formed an LLC and our nonprofit to make that happen.
What’s helped you stay hopeful throughout your cancer journey?
It’s hard to think in terms of hope when you are told you have stage 4 colorectal cancer, you’re not going to have any other options or it’s a grave diagnosis. Sometimes it’s hard to remove yourself from thinking way into the future. You have to just take it day by day. Take every day, even if it’s minute by minute, hour by hour. Do what you can to help yourself get through the day. Join support groups. That’s been such a big, thing.
The first thing you need to do is never look at Dr. Google. It’ll send you down a rabbit hole of despair. I had my first mental breakdown ever because I was looking at Google and looking at different statistics, then I started thinking about my kids. Avoid that.
Find your people. Find people that will lift you up and support you. A lot of people lose their support networks, especially once they’re out of treatment. Everyone thinks, I’m cured or thinks, you’re done. You’re never really done. Whether the physical stuff is over and the treatments are over, there’s going to be mental and emotional damage. Don’t dwell on that. Everyone goes through this with a cancer diagnosis. It’s okay to not be okay.
What advice do you have for someone recently diagnosed with cancer?
If I have any advice for anyone starting a diagnosis is, once you get diagnosed, it’s going to be rough at first. But once you get through that initial despair and anxiety, start setting goals. Future goals.
Something my integrative medicine doctor told me and it’s been my mantra ever since, he said, “Jason, set a goal and reach it. And once you reach that goal, set another one. Always keep your eye on the prize.”
Symptoms: Found the cancer as a result of family history & early colonoscopy; discovered Lynch Syndrome after genetic testing Treatment: Partial colectomy
