In 2009, Delia Wilson assumed that her consistent stomach pain was due to the stress of being in graduate school and working full-time.
When the pain continued, her primary care doctor recommended that she have a colonoscopy, which revealed scar tissue but, she was told, nothing potentially life-threatening.
But when the pain returned in 2021 and she began bleeding, Wilson underwent a biopsy.
The results — and the manner in which the gastroenterologist who did the procedure delivered them — were distressing. “’You have cancer!’ He just blurted it out,” Wilson said. “He wasn’t compassionate in how he talked to me. I had to leave. I left that place in tears and ended up walking all the way home.”
Finding new hope
She wanted a second opinion and needed to find another physician, quickly, before the cancer spread — one who would manage her care with compassion.
From her home in Santa Barbara, an internet search led her to Kevork K. Kazanjian, MD, a colorectal surgeon at UCLA Health. He confirmed her diagnosis and told her of several options to address the cancer.
“He told me I could do radiation, which would shrink the tumor but not cure it. He told me the cancer hadn’t spread anywhere else in my body so I didn’t need chemo,” Wilson said. Surgery would be the most aggressive, and hopefully most definitive, approach to remove the cancer while it was still at an early stage.
Early diagnosis and treatment is imperative
“The prognosis for colorectal cancer very much depends on the stage of the cancer at the time of diagnosis,” Dr. Kazanjian said. “The earlier the disease is diagnosed, the better the chance for cure. Early detection through screenings such as colonoscopy, which is the gold standard, leads to earlier-stage diagnosis, which yields better overall outcomes and survival for most individuals.”
Wilson had a successful surgery and continues her recovery. She advises others to visit their primary care physician regularly and to undergo recommended screening. “If there is a problem, a screening will find it. And if there are polyps, they can be removed before they can develop into a life-threatening disease,” she said.
Risk factors for colorectal cancer
Age and genetics are the primary risk factors for colorectal cancer. Individuals with a first-degree relative — a parent, sibling or child — who had colon cancer or an advanced polyp at age less than 60 should get colonoscopy screening every five years starting 10 years earlier than the age at which the family member was diagnosed or at age 40, whichever is earlier.
Current guidelines recommend screening starting at age 45 for average-risk adults. That is important because there often are no symptoms in the early stages of the disease. “Most patients who are diagnosed from a screening have had no symptoms,” Dr. Kazanjian said. “Those who are not having screenings will go undiagnosed until symptoms develop.”
While colonoscopy is the gold standard, there are other, non-invasive tests to detect colon cancer. There are two kinds of at-home stool-based tests. The FIT (fecal immunochemical test) test looks for blood in the stool and must be repeated annually. The multitarget stool DNA test detects blood and certain DNA alterations in the stool and is recommended every three years. Another option is CT colonography, which involves bowel prep similar to a colonoscopy but is conducted with a CT scan. CT colonography is given every five years.
If findings are positive for the stool-based or CT colonography screens, the individual needs to follow up with a colonoscopy. Someone with a family history of colon cancer or advanced colon polyps in first-degree relatives should have a colonoscopy rather than a stool-based test.
Nutritional lifestyle changes
Diet also can be a factor. Eating red meats and processed meats may increase the risk of developing colon cancer. Other risk factors include a lack of physical exercise, being overweight and consuming alcohol and/or tobacco.
Since her surgery, Wilson has maintained a low-fiber diet, and stayed well hydrated, to head off the possibility of a bowel obstruction, a potential consequence of cancers of the stomach, colon and ovaries.
“With Delia, we want to prioritize consistent meal intake and protein, because that’s important during cancer treatment,” said Emma Veilleux, RDN, senior dietitian for the Simms/Mann-UCLA Center for Integrative Oncology.
As Wilson continues to mend from her surgery, she remains optimistic that she will overcome the disease.
“It feels like an endless journey,” she said. “But I know that there is a light at the end of the tunnel.”