Wednesday, December 5, 2007 10:32 PM CST
Face to face with mortality: Local resident gives first-person account of colon cancer battle
By JOHN RYAN
Nov. 3, 2006. That’s the day I came face to face with my mortality. I learned I had colon cancer.I had just undergone what I thought would be a routine colonoscopy. It turned out far from routine. I had a “cancerous mass” in the right side of my colon that had been there for “some time” and it had to come out, I was told.
Nov. 3 was a Monday. On Wednesday, I had a CAT Scan to see if the cancer had spread. On Thursday, I met with a surgeon to schedule surgery.
It all seemed surreal.
But unfortunately it was very real.
Of all the cancers, colon cancer is the second leading killer in America, and just my luck, I had it.
I was 54 at the time. I had put off having a colonoscopy for four years. Doctors recommend that everyone have their first colonoscopy at 50. Half of the people 50 or older have a colonoscopy, half don’t, doctors say.
Wouldn’t you know it, I was in the wrong half. I figured I had always been healthy. I jogged and worked out regularly, watched my diet. I did all the things a person is supposed to do to stay in shape.
Looking back, I experienced many of the signs of cancer the year before. I had constipation for about a month in the summer of 2005. I began passing blood but thought it must be hemorrhoids caused by the constipation. I also had severe fatigue, but I worked through it, thinking it was caused by age or lack of sleep.
I should have had a colonoscopy right away, but all the symptoms went away.
Later that summer during my physical, I told my doctor about the constipation and the bleeding. He encouraged me to have a colonoscopy. I agreed, but then got busy and forgot all about it until the next summer.
This is pretty typical.
My friend Keith Lynch had a similar experience. Having just retired in 2006 as purchasing manager from Justrite Manufacturing in Mattoon, Keith went on a vacation to Europe. When he got back, he began experiencing stomach cramping in the morning.
He figured he had just picked up something while abroad.
“When I got through it I’d go out and play 18 holes of golf and feel fine,” he told me.
He eventually went to the doctor and was put on antibiotics for two weeks. At first it went away. Then it came back.
He went back to his doctor for more antibiotics and his doctor said no, something else must be wrong.
His doctor ordered an MRI and they found something was blocking the left side of his colon. He immediately had a colonoscopy. Two days later he had surgery.
Keith, of Charleston, was 62 at the time. He had never had a colonoscopy.
“If there’s one message I have to give, it’s get the colonoscopy,” he said. “Even if your insurance doesn’t cover it, get the colonoscopy.”
Of course, you don’t have to be over 50 to get colon cancer. Kelli Taylor was 37 when she found out she had colorectal cancer. A Mattoon housewife and mother of two boys, Kelli had constipation for eight months. She also had blood in her stool and her stool was very narrow. But she didn’t think it was any big deal.
Fortunately she mentioned it to her mother and her mother told her to go see a doctor.
She had a colonoscopy in February and doctors found a tumor in her rectum.
“I was shocked because we have no history of cancer in our family,” she said.
Doctors say cancer isn’t necessarily genetic, especially colon cancer, which is more likely caused by diet.
“In some patients (5 percent), there is a genetic predisposition to develop cancer, perhaps precipitated by a causative factor such as smoking,” said Dr. Edward Hoppin, head of oncology at Sarah Bush Lincoln Health Center. “Colon cancer is most common in developed countries. Although a small percentage may be genetically predisposed, the majority is probably mediated via dietary factors.”
Americans are more likely to develop colon cancer than other nationalities because of our fatty diets.
“Orientals who live in the Far East have a high incidence of gastric cancer and a low incidence of colon cancer,” Hoppin said. “Whereas Oriental-Americans who live in Hawaii or the mainland USA have the reverse, suggesting an influence of the western diet.”
The American Cancer Society and federal health agencies announced recently that cancer deaths are declining in the United States, but one of the main reasons behind the declining numbers is prevention, which includes colonoscopies for colon cancer.
A colonoscopy isn’t as bad as it sounds. The hardest part comes the day before the actual procedure, when you have to drink a gallon of solution over a few hours to flush out your digestive track. The actual procedure is painless.
You go to a room, strip down to a gown and then lie on a cart as they wheel you into the room where the colonoscopy is performed. You are given a drug and are almost immediately put under. The colonoscopy takes about 20 minutes.
The next thing you know, the doctor wakes you and tells you the results. I remember Dr. James Van Popering telling me that cancer was found in my colon. I asked him if it was benign or malignant. He said malignant and then told my wife that she better remember everything that was said because I wouldn’t because of the drug I had taken. He was right. I didn’t remember a thing after that.
My wife drove me home. I had lunch and took a nap. Three hours later, it was like nothing had happened. I wondered why I hadn’t had a colonoscopy sooner.
For most people that’s the end of the story. Often polyps are found, clipped out and tested. Usually they are not cancerous and you are told to come back in five years. Occasionally they are pre-cancerous, meaning if they continued they would become cancerous. Those people must get a colonoscopy every three years.
The unlucky people — like me, Keith Lynch and Kelli Taylor — have to undergo surgery as soon as possible.
Keith had his surgery two days after his colonoscopy. Because I am a college professor and naïve on top of it, I asked my surgeon, Curt Green, if I could wait until the semester was over to have the surgery. His response: “I wouldn’t. My schedule is two weeks out. You better get on it.” I did.
The surgery isn’t horrible. I can say that now in hindsight. The night before you drink more solution to cleanse your system. The operation takes about two hours.
The good news is we have about four to six feet of colon, or large intestine, as it is also called, and we don’t need all of it. Generally a surgeon cuts out about a third of the colon and reconnects it. There can be complications but there wasn’t in any of our cases.
It takes about three weeks before you are getting around. My doctors told me if I had to I could have gone back to work then. I did go in one day to grade final papers and submit my grades. After six weeks, I was feeling normal and I did go back to work full time.
Kelli had a more difficult time than Keith and me because she had rectal cancer. She had to have radiation treatment on the tumor one week before the operation. The radiation caused her ovaries to cease functioning and she began menopause.
In all three of our cases, cancer spread outside our colons. Cancer was found in one lymph node in Kelli and Keith. It was found in four of my lymph nodes. That meant our cancers were Stage III, meaning we needed to undergo chemotherapy to hopefully make sure that if any cancer cells survived the operation the chemicals would kill them.
Had our cancers been Stage I or II, we probably wouldn’t have had to undergo chemotherapy. I know one woman on our campus who was operated on and didn’t have to have chemotherapy because the cancer was contained in the colon, Stage I.
Chemotherapy isn’t as bad as it sounds but it isn’t as good as you hope it will be either. Each of us had to undergo chemotherapy for six months.
“In the beginning, it’s no problem,” said Keith. Like me, he began chemo treatments every other week beginning in January and he golfed until March.
As the therapy goes on there is a cumulative effect. Each treatment adds to the treatment before and they get harder to take. The chemicals linger longer in the body. For instance, I had treatments on Tuesdays. For the first four treatments, I would feel tired and a bit ill, like I had a cold, from Wednesday to Friday, but then I’d start to feel normal again.
But halfway through, the treatments get harder to get over. As Keith put it: “The fatigue that followed (got intense); it would take a week to get the sense you’re halfway normal.
I took off Tuesdays, my treatment days, and then I would go back to work. At the end, I had a few tough Wednesdays when I’d get really tired and would go home after work and go to bed. But I was able to keep up my routine, although I often felt tired or fatigued.
With chemotherapy for colon cancer, you don’t lose your hair. It stops growing and gets pretty thin, but you don’t go bald like breast cancer patients do.
Keith and I took the same chemotherapy “cocktails” intravenously: Oxaliplatin, fluorouracil and leucovorin. All of the drugs have side effects and they affect people differently. One side effect we both had was sensitivity to cold.
If a cold breeze hit my hands, legs or feet, they would go numb, like they were asleep. Keith experienced the same thing and worse if he breathed in cold air. I couldn’t drink anything cold or it would feel like frost was running down my throat. The first time I did eat something cold, it made me throw up.
One woman at the cancer center warned me about oxaliplatin. She said when she took it she would have to put on gloves to get anything out of the refrigerator. She said she changed her chemotherapy because of that and because oxaliplatin made her sick all the time.
Kelli experienced the same thing. She got dehydrated, nauseous and couldn’t get out of bed after taking oxaliplatin the first week. She stopped taking it but continued on with Xeloda, which she took in pill form. She took six pills a day for two weeks and then had one week off before starting again.
After taking the pills for two weeks, she experienced a metallic taste in her mouth and occasionally a queasy stomach. She also experienced soreness in her hands and feet and her feet often felt blistered.
“It takes me four to five days to feel normal and get my energy back,” she said.
Kelli finished her chemotherapy on Nov. 5. Keith and I finished in June. One other side effect Keith and I experienced was numbness in the hands and feet. The bottoms of my feet still feel like they are asleep, four months after stopping the chemotherapy.
However, it has all been worth it. At our first four-month checkup Keith and I found out we’re cancer free. We will have to have another colonoscopy soon and we will have to undergo checkups every four months for the next five years.
With any luck, we will all stay cancer free. But we will be telling everyone we know to get a regular colonoscopy. It could save your life.
John Ryan of Charleston is a journalism professor and director of student publications at Eastern Illinois University.
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VTucker wrote on Dec 5, 2007 9:47 AM: