Overcoming the Odds

Latest advancements in colorectal cancer treatment offer hope

In March 2016, Stephanie Allen was doubled over from stomach pain and severe constipation. She waited to see if the pain would go away, but within days, it grew worse. Finally, she asked a neighbor to take her to the emergency room.

Stephanie Allen treated for Stage IV colon cancer by Shilen Patel, MD, at Florida Cancer Specialists & Research Institute.

Stephanie takes the time to enjoy her garden.

“I had a friend take me because I was too doubled over to drive,” recalls Stephanie. “The pain was similar to when I had a gallbladder attack. I thought that maybe I had a blockage of some sort.

“At the hospital, they ran a bunch of tests – a lot of lab work, x-rays and then a CT scan – and came back and told me they were going to admit me. They weren’t positive what was going on.”

Stephanie was given a strong IV pain medication to relieve her discomfort and help her rest. “It pretty much knocked me out,” she remembers.

The next morning, she met Shilen Patel, MD, whom the hospital had called in. Holding a box of tissues, in case Stephanie would need one, he sat at the end of her hospital bed and explained what the diagnostic tests had revealed.

“He proceeded to tell me what was going on,” she relates. Dr. Patel explained to Stephanie that she had advanced colorectal cancer. A large mass was in her colon, and the cancer appeared to have spread to her liver and lungs.

“I think my comment to Dr. Patel was, Did somebody just suck the air out of the room? I couldn’t breathe for a couple of seconds. It was terrible,” she shares. “Dr. Patel was very compassionate when he talked to me. I felt good about him from that moment on.”

A board-certified oncologist, Dr. Patel specializes in the treatment of colorectal cancer at Florida Cancer Specialists & Research Institute’s Spring Hill office in Hernando County.

For Stephanie, he became a guardian angel and ally as she entered the toughest challenge of her life.

Treatment Advances

When her cancer was discovered, Stephanie was working as an IT technician and commuting to a job in Tampa from Brooksville. She is 58 and lived in Colorado before moving to Florida to help care for her elderly mother.

Two days after being released from the hospital, Stephanie went to Dr. Patel’s office in Spring Hill. He explained her options for treatment. Although she had advanced cancer, strides in treatment offered her hope. They range from newer surgical techniques to medications that are changing treatment protocols.

The latest advancement arrived in May 2017 when the Food and Drug Administration approved an immunotherapy drug for treating colorectal cancer that has a specific genetic feature. The drug enlists the body’s own immune system to fight the cancer by interfering with how cancer cells mask their presence.

“It’s been a fairly long time since we’ve seen any major changes to the therapies we utilize in colorectal cancer, until just recently,” notes Dr. Patel. “Now, we’re seeing the pace of these breakthroughs really accelerating.”

Colorectal cancer is the third most common cancer in the United States, according to the American Cancer Society. Symptoms range from bleeding to changes in bowel habits, but colon cancer can spread without being noticed. It’s why colonoscopy screenings are recommended for people over age 50.

Stephanie doesn’t recall any symptoms other than constipation that eventually became severe. Dr. Patel estimates her tumor had grown for about a year before it was discovered.

“The symptoms of colon cancer are very nonspecific, and that’s why it’s hard to diagnose early without preventive screening,” educates Dr. Patel.

“Colorectal cancers aren’t the fastest-growing tumors, but they’re certainly not the slowest either,” he adds. “It’s hard to estimate exactly how long a tumor has been growing. For Stephanie, it probably happened within the last nine to twelve months, although she only had symptoms for two months at most.”

Stephanie had to stop working as she underwent cancer treatment. She first began a round of chemotherapy to shrink her cancer. It was a rough road, but she eventually stabilized. The drug Avastin®, known as a targeted therapy, was added to boost the effectiveness of her treatment.

“They are waiting for the tumor to shrink before they can do surgery to remove it,” states Stephanie.

A challenge arose when she began having uncontrollable headaches and high blood pressure. An imaging study revealed a single lesion of the cancer had spread to her brain, where colon cancer rarely metastasizes.

Stephanie was airlifted to a hospital to have the tumor removed. She then received advanced radiation therapy called CyberKnife® at the Florida Cancer Specialists office in Brooksville.

“Treating her brain in a very precise way was quite successful. It led to a remission of the cancer in her brain,” describes Dr. Patel. “She’s currently still on chemotherapy to keep her cancer stable and is doing well. She has had a significant reduction in all sites of her cancer.”

Dr. Patel will continue to guide her therapy according to how her symptoms change and whether the cancer progresses or remains stable.

Testing of her cancer cells shows she could benefit from another target therapy medication, if needed in the future. Tests also determined her cancer has the genetic feature that makes her a candidate for immunotherapy, another future option.

In addition, doctors at Florida Cancer Specialists & Research Institute participate in clinical trials, which give patients further access to leading-edge therapies. If needed, that could be another treatment avenue for Stephanie, says Dr. Patel.

Caring for the Whole Person

Stephanie has returned to life-affirming personal routines. She likes to putter in her garden and take her dogs to the dog park.

A large part of her recovery has been the quality of care she has received from Dr. Patel and the staff at Florida Cancer Specialists & Research Institute. Not only did they take care of her physical symptoms, they took care of her as a whole person, she says.

Stephanie has nothing but praise for the entire staff, from those at the front desk to nurses in the infusion room.

“You really feel like you’re part of an extended family,” she observes. “Everyone there is equally wonderful. They’re all compassionate. They’re honest. They’re caring. They are there for you for whatever you need. If they don’t have the answer, they’ll find out for you.

“Dr. Patel is the same way. He’s a wonderful man. I was blessed when he came into my life. Dr. Patel has been there for me; everybody’s been there for me.”

In the future, Stephanie hopes to return to work. She already has a job prospect in sight.

“I try to keep my life as normal as possible,” she says. “I feel good. I have my days when I’m tired, and I just rest. But I tell you – you might not think you have courage or strength when facing a situation like this, but you can find it and work with it.

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