The Least Discussed Cancer

Nothing about colon cancer is remotely appealing, and it seems to be the least discussed type of cancer simply because it involves the organs of waste elimination- and nobody wants to talk about that! However, in an effort to edify and raise awareness of this disease, I feel it's best to just tell it like it is. The truth is I'm sick right now and so I'm beyond feeling "embarrassed" about any of this, because this is my life we're talking about. I've said that I've lost some sense of modesty in medical situations after having two kids, so I've just about abandoned any qualms about discussing my body and my bowel movements at this point, although I try not to force the information on anyone. But when anyone expresses curiosity or concern, I welcome and even encourage questions because it gives me an outlet as well. I can be quite candid and frank in my discussions about it because there's no way around it anyway. A friend once told me that once you have kids, 90% of your conversations are going to be about poop. Well, that seems to be the case with colon cancer as well, go figure. The following post may be a bit grisly at times but it is what it is, so continue reading at your own risk.

Everyone wants to know what happens now that my chemoradiation treatment has concluded. At the time of diagnosis back in May, the colorectal surgeon discovered a 4cm tumor in my lower colon, which was confirmed by the subsequent CAT scan. The scan also revealed that there did not appear to be any visible metastasis to my other organs at this time, so that was a bit of good news. It made radiation treatment much easier to devise since most of the radiation beams would be extremely localized and focused on the single tumor. However, the location of the tumor is a bit problematic since surgical removal of it and the surrounding tissue could result in having to remove part of the rectum as well. That would necessitate my having to wear a colostomy bag for the rest of my life. For those of you who don't know, a colostomy is a surgical procedure that involves connecting a part of the large intestine onto the anterior abdominal wall, resulting in a stoma or opening on the abdomen to which a bag would be attached to collect any waste. Due to my relatively young age, the medical team wanted to try a treatment regimen that would increase my chances at a better quality of life by first attempting to shrink the tumor via chemoradiation before surgically removing what's left of it.

After 6 full weeks of radiation treatment and daily 5FU chemotherapy, we can only hope that the tumor has shrunk to a point where it would allow the surgeon to remove the tumor growth area without sacrificing any part of the rectum. At the time of the surgery, the doctor will be able to see if, and by how much, the tumor has shrunk after chemoradiation. He intends to cut out the cancerous section of my colon and about 2cm on each side of the tumor location, as well as taking out any proximate lymph nodes and the watershed area that feeds it. If successful, the surgery will prevent the cancer from spreading to other organs and save the rectum, therefore evading a permanent colostomy. The doctor will also be able to more accurately "stage" my cancer, which means that a descriptor (usually a number between 1 and 4) is assigned to indicate how much the cancer has spread. It takes into account the size of the tumor, the depth of penetration into the tissue, the involvement of lymph nodes, the spread to adjacent or distant organs (called metastasis). Accurate staging is the best predictor of survival after treatment, or it may even determine the plan for further treatment. If there is any chance of recurrence or if it is evident that the cancer has spread, then an executive decision will be made to remove the rectum as well and I will have to live with a colostomy for the rest of my life. But it will be a small price to pay in exchange for years of life with my children.

I am not going to lie, I really suffered through chemoradiation and I would never wish such an affliction on my worst enemy. The pain and discomfort were excruciating at times. I was literally burned inside out, and the pain of making a bowel movement through raw, burned and damaged tissue was enough to leave me breathless, shaking and bleeding each time. I was psychologically afraid to eat because I feared the inevitable bowel movement that would follow, so I went hungry for days and it made me even weaker. That is why I had to be admitted to the hospital after 6 full weeks of getting burned by powerful rays that are meant to kill the cancer cells and enduring the 5FU chemo that coursed through my veins daily like a poison. Both of these treatments caused collateral damage to healthy cells and tissue as well, which means that my ovaries and my uterus were fried in the process. The doctor told me that such damage could not be avoided, and the result is that I will never again be able to have children and that I will subsequently experience all the symptoms typical of menopause at age 35. The news was not particularly devastating to me because I already have my twins. The fact that I had children very recently, and that I was lucky enough to have had two at once, was a blessing and comfort to me in the face of such terrible news.

But now that the treatment is done, my body needs the time to rest and rejuvenate before surgery. The doctor explained that he usually requires 8 weeks of recovery from chemoradiation before surgery since operating before the body has had a chance to heal tends to result in extra bleeding and leakage at the surgical site. So my surgery is scheduled for September 22nd. Post-surgery, I can expect about 5 - 10 days in the hospital to heal and wait for my colon to "wake up" again. Not only is he cutting out the cancer, he is simultaneously installing an ileostomy, which is a stoma for the small intestine instead. Having the ileostomy for 3 months will allow the surgical site to heal by bypassing the colon altogether. Although I am a little bit frightened by the prospect of major abdominal surgery, I remind myself that I made it through an emergency C-section for my twins, and I should be able to weather this as well. The incision will be perpendicular to my C-section scar and will run from my bellybutton up toward my chest. After 3 months of healing, the doctor will reverse the ileostomy and try to put me back together again. If everything goes well, I will not have to live with a permanent colostomy or get adjuvant chemotherapy and my body can hopefully work the way it used to. With any luck, the cancer will either be eliminated or go into remission.

This is my life right now, and I am just trying to buy some more time so that I can have years ahead with my kids. We are all living on borrowed time anyway, but I'd like to take an advance, and we know the kind of fees that are charged for that. Live well, my friends, and take good care of your health. You will not even begin to know how much you will miss it when it's taken from you.