Colon Cancer Survivor
“The kids got on the internet and began to look for colon cancer doctors. Seattle Cancer Care Alliance popped up and we went for a second opinion. We liked what we saw and heard. We developed a relationship.” Les Dorsing, Othello, Wash.
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In 2005 Les Dorsing was being treated for hemorrhoids. After about six weeks, his doctor thought he should see a specialist. The specialist wanted a biopsy of the area. The next thing Les knew, he was in an oncologist’s office in Spokane with his wife and children.
“The doctor’s surgical plan was very vague; he didn’t know really what stage the cancer was in and it seemed like the doctor wanted to remove some parts that maybe didn’t need to be removed,” Les recalls. “He didn’t have a lot of patience with our questions and the kids got on the internet to find someone better.”
Diagnosis and Treatment
Within just a few days, Les and his family headed out of the state to the Mayo Clinic where he heard the difficult news of his formal diagnosis – of stage III rectal cancer. Cancer had moved into his lymph nodes. He was treated with surgery, and had a section of his colon removed as well as his entire rectum and several lymph nodes, half of which were malignant.
Les was encouraged to stay there to have chemotherapy and radiation treatment. But he was far from his home in Othello, Washington, and opted to get radiation treatment locally where he could be closer to home.
“In February, I had several consultations with doctors to plan out my chemotherapy schedule and radiation techniques. Although I started my first chemotherapy treatments locally, I didn’t like the radiation options,” Les said. “The kids got on the internet and began to look for colon cancer doctors in Washington. Seattle Cancer Care Alliance popped up and we went for a second opinion.
Les and his family saw Dr. Wui-Jin Koh, radiation oncologist at SCCA.
“Dr. Koh told me there was no reason to radiate from the sides. He came up with a very precise computer plan for random angles and times,” Les explains.
Because rectal cancer is normally treated with radiation therapy and chemotherapy together, Les continued chemotherapy prescribed by his oncologist close to home. Les stayed with his sister, who lived in the Seattle area, while he received his radiation treatment. “I got through 26 of 28 treatments in five weeks, but couldn’t get to all 28,” he says.
Rectal cancer that has been treated first with surgery, as Les’s was, is managed with a “sandwich” program of chemotherapy followed by radiation with chemotherapy followed by chemotherapy again. Les wasn’t yet done with chemotherapy. Because Les wanted to stay at the Seattle Cancer Care Alliance, Dr. Koh directed him to Dr. Sam Whiting to discuss the last part of his chemotherapy treatment.
“I love that man,” Les says of Dr. Whiting. “What a blessing it was to meet him. I love his bedside manner and the treatment he prescribed.”
Les was happy and cancer-free for over a year and a half, until his cancer came back in both lungs in 2008.
Dr. Whiting recommended a program founded upon chemotherapy, but also wanted Les to see Dr. Michael Mulligan at University of Washington Medical Center to discuss whether the new cancer spots in the lungs could be removed surgically. “Dr. Whiting said it was time to get radical in the treatment,” Les says.
“I don’t remember using those precise words,” Dr. Whiting now chuckles, “But the sentiment is accurate. We know without question in the field of colorectal cancer oncology that a subset of patients with metastases to the liver, or the lungs, or even both organs, can be cured by combining and sequencing systemic and local therapy,” he explains. “Changing the natural history of an incurable cancer to a curable one is not always possible, but it is wonderful when it happens.”
Dr. Mulligan felt that he could safely and effectively operate on Les, and Les went to the surgery for removal of the entire upper lobe of the right lung as well as an additional metastasis in the left lung. The left lung surgery was performed using a special technology called a VATS surgery, standing for Video Assisted Thoracoscopic Surgery, where the surgery takes place through three small holes in the chest rather than through a large open incision.
Chemotherapy was not halted during this time, only scheduled around and in sequence with the surgical procedure. Eight months later it was clear that there was still cancer present in the lungs – now in the left upper lung. “That recurrence was scary,” Les recalls. But because he was still healthy and active, Dr. Whiting felt that another try at going after the cancer could be tolerated. Dr. Mulligan agreed, and in late summer of 2008 he went in again with the video camera surgery and removed the left upper lobe and an additional cancer spot from the left lung.”
Les still wasn’t done with treatment, though. “It sounds trite, but it is true,” Dr. Whiting says, “Cancer is very hard to get rid of. There are few short cuts. The more cancer someone has, or the more times a cancer is recurrent, the less eager I am to stop chemotherapy quickly. In Les’s case we slowly stepped down from multi-agent chemo to single agent chemo over the course of a bit less than two years before stopping everything in May of 2010 when the cancer remained undetectable.”
The radical attack seems to have worked so far. Les has been free of detectable cancer since August of 2008. “I will be 68 in 2012,” Les says, noting that he was “very surprised” by his initial diagnosis, despite having a family history of colon polyps.
“I’d had a routine colonoscopy about two years prior to my diagnosis,” Les says. “At that time they told me not to come back for five years. But the doctors I saw back east said that was a misdiagnosis.
“I’m a lucky guy,” he says. “I have a very supportive family… wife and kids who pushed for a second opinion. And because of that, I got super treatment and super care.”
Life After Cancer
Les and his family own several orchards in eastern Washington, raising tart and sweet cherries, and apples. His sons began transitioning to taking over the farm when he was diagnosed so he could focus on his health.
“I’ve been back to farming in the last two years, but I’m a little slower now. I get to pick the jobs I want to do and my own hours,” he says. “It still gives me a sense of worth.”
“Les is adorable,” Dr. Whiting says, “If I’m allowed to say that about a man who is bigger than me, stronger than me, tougher than me, more stoic than me, used to working 15 hours in the apple orchard, and of the right age to be my father.”
Everyone in the GI cancer program at the Seattle Cancer Care Alliance loves Les and loves his family. During treatment he was always in a good mood, always strong, always gentle and polite - no matter what we were doing with treatment and no matter how he must really have felt. The fact that his apples are exceptionally delicious is just icing on the cake.”
Les used to visit SCCA every three months. Now he comes in every six months. They used to watch his entire body for recurrence, and now they focus on just his lungs.
“I have so appreciated what SCCA has done for me,” Les says. “They even offered a Saturday clinic where all the docs came in and they talked about colon cancer and nutrition, and follow-up, exercise… all facets. It was so above and beyond.
I want to help give hope to others, just like SCCA has done for me.”