The "Adventure" Begins

Short story…

I have colon cancer…Surgeons remove the cancer on Wednesday, March 25, 2009…I’ll be fine !

Long story…

On Thursday, March 5, I went in for my triennial colonoscopy screening appointment with Dr. Peter Fenton, gastroenterologist. Following the procedure, Dr. Fenton came into my post-procedure cubicle at Intermountain Medical Center in Murray, Utah, to debrief the outcome.

Dr. Fenton explained (with a hint of his native Jamaican accent), “Mistah Hunt, the results of your colonoscopy concern me. We found a 2 centimeter by 4 centimeter lesion in your lower colon. We’ll have you in for a CAT scan today as soon as they can work you in. The CAT scan will tell us if the lesion has gone beyond the colon to other organs, including the liver.”

The look on Dr. Fenton’s face was rather grave, but I told him that the news did not worry me, and even if I keeled over tomorrow, I would go a very happy man, having done everything that my Father in Heaven and I had planned for my life. I explained that since both my father and grandfather died at age 52 from heart failures, that every day I survive beyond age 52, I consider to be “bonus days” in my life. So, I don’t worry about anything, no matter what the outcome of the investigations.

By late afternoon, the CAT scan was complete and my daughter and son-in-law, Kristie and Kevin Moreton drove me home.

Later that evening, Dr. Fenton called me at home, greeting me in his Jamaican accent with, “Mistah Hunt, I have ‘grrreat’ news and I have ‘fnntastic’ news for you…Which would you like to heah fuhst?”

I said, “Well, it already sounds wonderful…go ahead and surprise me.”

“The great news is that the lesion has not affected any organs outside the colon, including the liver. The fnntastic news is that you ah going to live happily for the next thihty to fohty yeahs.

“I’ve made an appointment for you to have an ultrasound this coming Tuesday, March 10th, with one of the two specialists in Utah that do that procedure on the colon. That test will show us how many layers of the colon the lesion has affected. I’ll also make appointments with a grrreat surgeon and an oncologist.”

Tuesday’s ultrasound at LDS Hospital with Dr. Oscar Batista indicated that the lesion had affected all layers of the colon and involved the fat layer just outside the colon. This indicates at least a Stage Two lesion. (We won’t know if the lesion is Stage Three until pathology results of the lymph nodes return following surgical removal of the affected area and the associated lymph nodes.)

A Visit With the Surgeon

On Thursday, March 12, I met with the gastrointestinal surgeon, Dr. Michelle Murday. Dr. Fenton says that he has known Dr. Murday for many years and has total confidence in her abilities. My visit with Dr. Murday reinforced Dr. Fenton’s assessment. She is very professional and took the time to answer all of my questions.

She indicated that the colonoscopy and ultrasound results indicate removal of about a foot of lower colon (sigmoid colon) and the attached lymph nodes to ensure removal of the malignant tissues. Pathology on the lymph nodes will indicate whether or not I will need chemotherapy following ablation of the affected area.

I had several questions that Dr. Murday answered to my complete satisfaction:

Q. What protocol does my case indicate?
A. The protocol, in chronological order includes:
Laparoscopic ablation (surgical removal) of the section of the colon for several centimeters above and below the lesion, including the attached lymph nodes.
Biopsy of the lymph nodes to determine if any malignancy has traveled beyond the colon (Stage 3).
Chemotherapy if the lymph nodes show any malignancy.

Q. Who, among my immediate family members, should have screening for this same issue?
A. Siblings and children should have screenings at least every five years, beginning at age 40.

Q. What is my prognosis?
A. Stage 2 statistics show better than 80% survival beyond five years; Stage 3 survival is 60%-80% beyond five years. (If I had a 60% chance of winning the lottery, I’d certainly buy a ticket. ) Dr. Murday confirmed that my prognosis is excellent.

Q. Since I have no direct-line family history of cancer of any kind, how did I end up with this challenge?
A. Cancer results from some variety of cellular mutation. There is a specific genetic defect called KRAS. If you had that particular gene, then you and your children would have a 100% chance of developing colon cancer by age 40. Since you did not develop this lesion by age 40, then we can rule out that specific genetic defect.

If the mutation is not genetic, then the mutation is environmental. We are finding that typical causes of environment cell mutation seems to occur with incidence of animal protein consumption and not enough consumption of dietary fiber, fruits, and vegetables.

Q. What should I expect immediately following surgery?
A. Perhaps 5 days in the hospital, then a month of home recovery prior to return to work.

Q. What follow-up procedures can I expect?
A. CEA (CarcinoEmbryonic Antigen) blood tests each quarter for two years; semi-annually for the next 3-5 years, then annually after five years. Also, regular colonoscopies are in order.

Q. When and where is my surgery?
A. Surgery is Wednesday, March 25, at St. Mark’s Hospital (1220 E. 3900 South, Salt Lake City).

My Thoughts About this Adventure

First, I have spent not even one moment worrying about these procedures and my future…Worry doesn’t solve a thing, and it can actually have a negative effect on medical outcomes. Wonderful professionals are treating me, and I have total confidence in their skills.

Nearly immediately following the initial findings, I spoke with my MD uncle, Dr. A. Hamer Reiser, Jr. He properly advised me that my first medical procedure should be a Priesthood Blessing from Melchizedek Priesthood holders. I was honored and blessed to have that procedure from dear friends very early on. Participants in that blessing received confirmations of the efficacy of that blessing for my full recovery.

Frankly, my major concern at this point is for the health of my contemporaries. At the time we received this diagnosis, I had no symptoms and there is no direct-line family history of any cancer. We discovered this challenge because I have received regular screenings that people should have at specific ages.

My dear friends and family, have age- and gender-appropriate cancer screenings! Please e-mail me, or call me, if you have any questions or concerns regarding your own screening.

Where We Go From Here…

If you have questions, please feel free to contact me at my e-mail address.

Next installment…Surgery and post-operative outcomes.