A nurse’s journey in the fight against colon cancer

By Jacqueline Boyle

As a licensed vocational nurse supervisor for University Health, Valerie Gonzalez is used to treating adult and pediatric patients at the Southwest Clinic. But recently, she became the patient. Gonzalez found out she has colon cancer.

She was so busy caring for others that she didn’t notice warning signs regarding her own health. Sometimes, only extreme symptoms get our attention and prompt us to take action. Too often, we explain away the changes in our system – but it’s our body’s way of saying something isn’t right.

“I’m only 33 years old and have no family history of inflammatory bowel disease or any kind of cancer. My diagnosis of stage IV colon cancer came as a complete shock to me,” Gonzalez said.

Eventually, severe and sudden pain in her pelvic area prompted her to go to the emergency room. A CT scan of her stomach revealed colon cancer had metastasized to her liver.

Colon cancer in young people is on the rise

According to the American Cancer Society (ACS), there’s been an increased rate of colon cancer in adults younger than 50. Colorectal cancer is the third most common cancer diagnosed for men and women in the United States. Colorectal cancers include both colon and rectal cancer. Experts predict that more than 104,000 people will be diagnosed this year with colon cancer.

Symptoms of colon cancer

“Each patient presents differently, and some people have few to no symptoms until advanced stages of the disease,” said Dr. Sukeshi Patel Arora, Associate Professor of Medicine and a GI medical oncologist with UT Health San Antonio. She practices at University Hospital and Mays Cancer Center, home to UT Health San Antonio MD Anderson Cancer Center.

Some people do experience signs of colon cancer, but often don’t recognize them as a serious warning. Dr. Arora encourages you to seek medical attention if you have any of these symptoms:

  • Black or dark stools
  • Bleeding from the rectum
  • A change in the shape of your stool or bowel movements
  • A sudden need to have a bowel movement when the bowel is empty
  • Cramping or pain in the lower stomach
  • Ongoing constipation or diarrhea
  • Loss of appetite
  • Unexpected weight loss
  • Gonzalez acknowledges this, saying, “Looking back, I did experience frequent nausea and changes in my stool for months before I sought medical attention for my condition.”

    After getting diagnosed, Gonzalez started getting treatment immediately. Within a week, Gonzalez had an appointment with Dr. Arora, who told her that 95% of her colon was blocked.

    A colostomy was performed to prevent the colon from rupturing. Two weeks later, Gonzalez started chemotherapy treatments. Doctors also performed an ablation procedure to remove four lesions from Gonzalez’s liver.

    “I have a 12-year-old son and husband to take care of. My attitude has been: Let’s hit it as fast as we can and as hard as we can. Dr. Arora put together an aggressive treatment plan for me and said I have an 80% chance of beating this thing. Emotionally, it’s been crazy. But it’s given me a new perspective on life – I appreciate every day,” Gonzalez said.

    People in San Antonio may be at a higher risk for colon cancer

    According to Dr. Arora, people in San Antonio tend to find out they have colon cancer at later stages compared to other parts of the country. “Perhaps it’s due to delayed screenings, diet, or lack of awareness on the part of both doctors and patients to push for early screenings.”

    Recently the ACS has recommended that screenings begin at the age of 45 for the general population. If you have a family member with colon cancer or a history of cancers, screenings should start much earlier and be performed more often compared to the typical recommendations for screenings every 10 years.

    “In San Antonio, there’s a lot of resistance to getting a colonoscopy, especially in Hispanic men,” said Dr. Arora. “Although colonoscopies are the gold standard for screening for this type of cancer, there are a number of other options. Patients should talk to their primary care physician about taking a stool blood test, a stool DNA test or getting a CT colonography.”

    “Often, patients just keep rescheduling their colonoscopy because they don’t want to do it and before you know it, two years have passed. We don’t want to lose that precious time. It’s better to get some kind of screening done instead of doing nothing,” Dr. Arora said.

    What is your risk of developing colorectal cancer?

    According to surveillance research conducted by the ACS from 2012 to 2016, non-hispanic black men and women in Texas are more likely to get colorectal cancer compared to other racial groups.

    Per 100,000 people in Texas, incidence rates were as follows:

    Women Incidences (per 100,000 people)
    Non-Hispanic White 32.1
    Non-Hispanic Black 40.9
    Hispanic 28.0
    Men Incidences (per 100,000 people)
    Non-Hispanic White 44.5
    Non-Hispanic Black 56.4
    Hispanic 46.0

    How to reduce your risk of getting colon cancer

    You can manage your risk factors for colon cancer, which include:

    • Being overweight
    • Lack of physical activity
    • Diet high in red meats and processed meats
    • Moderate to heavy alcohol consumption

    Be aware of risks factors you can’t control. Your risk is higher if you:

    • Are 50 or older
    • Have had colorectal polyps or colorectal cancer
    • Have or had inflammatory bowel disease
    • Have a family history of colorectal cancer or adenomatous polyps
    • Have inherited genes which cause mutations leading to family cancer syndromes
    • Have been diagnosed with type 2 diabetes
    • Have a specific racial or ethnic background where colorectal cancer is more prevalent

    Detecting colon cancer early gives you more treatment options for a better outcome. Gonzalez encourages everyone to see a doctor on a regular basis. “The threat of cancer is still there whether we think it will happen to us or not,” Gonzalez said.

    “Experiencing this first-hand pushes your awareness to the highest level. Getting this cancer diagnosis has enabled me to see things more clearly from the patients’ perspective. Now, I’m a better nurse. I know my patients need their treatments and supplies quickly and they need them delivered with compassion,” Gonzalez said.

    Dr. Arora says it’s important to keep in mind that colon cancer is one of the few cancers that is preventable. Healthcare providers and patients should be encouraged to talk about it more.

    “Everyone talks about breast cancer, but when it comes to colons, nobody wants to talk about that part of the body,” Dr. Arora said. “We need to get people in society to be more comfortable talking about the need for colonoscopies. It saves lives.”

    With two chemo treatments remaining, Gonzalez continues to serve others at the Southwest Clinic. She marches forward in her journey back to health. She has been deeply touched by the support of her staff and co-workers during this challenging time. She said, “I’ve been working as much as possible to keep my mind busy. I still have a lot of patients who depend on me. I don’t want to let anybody down.”

    University Health has a number of gastroenterology specialists who can perform a colonoscopy to screen for colon cancer or to begin treatments for colorectal cancer. Our online assessment can help you determine if you or a family member may be at risk for colorectal cancer.

    SUBSCRIBE TO OUR HEALTH FOCUS SA E-NEWSLETTER
    Get health living and wellness information, recipes, and patient stories from University Health.
    Tell us your patient story
    Share your inspiring personal story of hope and healing at University Health.