Colon cancer diagnosis right before wedding leaves bride-to-be fearful

Like any excited bride, Miranda Brown of Goose Creek had all the details nailed down. The dress; the location in her hometown of Grand Rapids, Michigan; and the grand European honeymoon.

What the then 34-year-old bride didn’t expect were all the stomach issues she would have right before the wedding. She suffered from stomach cramping and diarrhea and felt very fatigued. Attributing it to the stress of planning a wedding, she went to the doctor in April 2019 to seek medications that would help her digestive issues. She eventually was referred to a gastrointestinal specialist who performed a colonoscopy in May 2019—just to be on the safe side.

Coming out of anesthesia, Brown remembers the doctor coming in, sitting down and telling her she had colon cancer.

“It was a little tough to swallow because that was not at all what I was expecting. The travel plans were already made. I had just made all my final deposits, so definitely one of my first thoughts was, ‘I don’t really have time for all of this.’’’

She knew to take the news seriously, though. Brown had lost her grandmother to colon cancer several years before, and her uncle, too, was battling it. Her mother survived cervical cancer. Even with a strong familial history, it never occurred to her that her upset stomach might be related to cancer, given how young she was. Her relatives all had been older at the time of their diagnoses, and she was not old enough to start the screenings.

The next step was for Brown to visit Hollings Cancer Center at the Medical University of South Carolina, where she consulted oncologist Paul O’Brien, M.D., and surgeon Virgilio George, M.D., who wanted to do surgery as soon as possible.

With her wedding just weeks away, Brown began to panic and have second thoughts. She recalled her fiance’s romantic proposal at Brookgreen Gardens at its annual Night of a Thousand Candles event.

“Because we like Christmas stuff and lights and all of that, we wanted to go. He had everything planned perfectly. We were just walking around, and we found this random courtyard with all the candles floating in their little ponds. Nobody was in there. ‘This is perfect,’ he said, ‘Hold still.’ He got down on one knee and proposed with all these candles floating around us.”

While she knew Andrew loved her, she also knew he hadn’t signed up for this. She decided to give him an out if he wanted it.

When she broached the subject, he shook his head. He was all in. “He was very supportive. He definitely helped me take things one day at a time because it's not something I've been very good at. I’m the type of person to plan in advance, and I'm not good at taking things as they come. He’s helped me a lot with that.” 

George, who is chief of colorectal surgery at MUSC Health, said he wishes patients as young as Brown were unusual, but that he has seen a rise in young patients with colon cancer in the last five years. He’s had patients as young as 19. Colorectal cancer is the third most common cancer diagnosed in men and women in the nation. It's expected to cause about 53,200 deaths during 2020.

George and colleagues are concerned about the rise that’s happening among people younger than age 55. He’s pushing for more awareness campaigns so patients know the current trends and screening guidelines.

“If people at any age have symptoms,” George said, “they need to check with their doctors to see about screenings.”

The general screening guidelines recommend screenings begin at age 45, but that age drops to 35 for people who have a family history and to 40 for African Americans, who have a higher incidence rate, he said.

 

With March being Colorectal Cancer Awareness Month, George is thankful for patients like Brown who share their stories to let other people know the value of screening and paying attention to symptoms.

George, who worked with Brown so she didn’t have to cancel her wedding, asked her to postpone the honeymoon. Brown agreed to the compromise, adding that the wedding day turned out to be perfect and everything went just as planned. She got married in the same chapel her parents had and her sister had the year before.

“It was a gorgeous day. There was a little rain, but it seemed to stop every time we happened to be outside for pictures and stuff. I don't think we could have asked for a better day.”

Everyone agreed not to mention her upcoming surgery, but it was in the back of her mind all weekend. Though disappointed about her honeymoon, she’s glad she returned home from Michigan sooner to get treatment.

Exploratory surgery found she had a seven-centimeter mass that was touching other organs. George didn’t want her to lose her ovaries or uterus, so he didn’t remove the mass. Brown recalls being confused when she awoke from surgery; she didn’t understand why the mass hadn’t been removed.

George explained how serious this situation was and why he wanted to try another approach to see if they could preserve her fertility. Receiving that news just 10 days after her wedding was hard, she said.

George brought Brown’s case before Hollings Cancer Center’s tumor board, a multidisciplinary group of medical professionals who analyze scenarios from all angles to determine the best course of treatment for a patient. Given that the Browns hoped to have children one day, the team made the decision to do a fertility consult with an OB-GYN specialist, set up a course of chemotherapy to shrink the tumor and then to do surgery.

 

Brown recalls it being a whirlwind, seeing a round of doctors from fertility specialists to oncologists. “It was a lot, but it was really nice that they all seemed to work well and communicate well. I never felt like somebody didn't know what was going on. Everybody seemed to be on the same page.”

She responded well to chemotherapy, her tumor shrinking substantially. That meant during surgery, George was able to spare her ovaries and uterus and remove the tumor. As an added bit of good news, all her lymph nodes tested negative. Given that hers was an advanced stage III cancer, George said he was very pleased with the results and wished all patients could have similar results.

Brown said she’s thankful for the way her case was handled and the support she’s gotten from her medical team and family. She’s loving married life and grateful to have her husband by her side.

“He's been very supportive and helpful getting me what I need and keeping me grounded. Sometimes I need a day to just whine and vent and cry, but for the most part, I’ve been trying to stay positive. I try not to get too bogged down in the diagnosis and everything because being upset about it wasn't going to change anything. He’s helped me stay positive.”

She wants other people her age to know her story too. “This was something I hadn’t even thought about,” she said, adding how important it is to talk to family members about their health histories.

“I feel like colon cancer, especially, tends to be a harder topic. It's like if somebody has breast cancer or leukemia or something like that, it’s fine to talk about. But people don't like to talk about colon cancer. I just want people to be aware this can happen even if they are young. Screening can save lives, and for me, I still have a chance to have kids.”

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