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Colon Cancer Survivor

Todd Lovern

Todd Lovern is a hard-working, athletic, 48-year-old guy with a wife and kids living the good life.  In November 2010, he went to his doctor to talk about some strange symptoms he’d been experiencing, like the increase in bowel movements, especially when he was on his training runs. His doctor told him to see a gastroenterologist and get a colonoscopy…yes he was a little young, but he would be recommended to have one routinely at the age of 50 anyway.

“I got a pit in my stomach when they wanted to talk to me and my wife after the procedure,” Todd recalls.

Diagnosis

Todd’s colonoscopy revealed a couple of polyps and a tumor—cancer—located at the lower end of his colon near the rectum.

“I was totally surprised,” Todd says. “It was shocking because I have no family history of any cancer at all.”

Todd then went to get a CT scan. Cancer was also found in multiple spots in his liver. Todd’s colon cancer was now officially a stage IV. 

A few years prior to this, Todd’s wife Lisa had recognized a school friend on TV — a commercial for Seattle Cancer Care Alliance. The friend was Anita Mitchell, a stage IV colon cancer survivor. They recalled this memory, got online, and watched Anita tell her story in a video posted on the SCCA website. She talked about her doctor at SCCA who had saved her life. That November day, Todd and his wife decided Seattle Cancer Care Alliance is where he needed to go.

Treatment

Todd called SCCA and made an appointment to see Dr. Whiting right away. There were more scans to do and then in the first week of January 2011, Todd began an aggressive chemotherapy regimen—six sessions within three months. “It all went well,” Todd says. “I didn’t have too many problems.”

“Todd’s cancer was really concerning in its size and extent,” says Whiting. “However, there were no characteristics that absolutely ruled out an attempt to combine multiple treatments to get Todd free of detectable cancer—what we call no evidence of disease. Patients with colon cancer and liver metastases can do remarkably well when the cancer can be approached with more than one method of treatment, like chemotherapy and surgery. Cure of stage IV colon cancer happens in some of these cases.”  

The chemotherapy that Todd received was the toughest regimen used for colon cancer, according to Whiting. It combined nearly all of the drugs available for the disease. 

“Todd did remarkably will with the drugs – from both a toleration and cancer response perspective,” says Whiting. “I believe that his dedication to taking care of himself and maintaining his fitness was a big part of why he did so well.”

After a few months of treatment and repeat imaging it was clear that Todd was responding well to the drugs. His carcinoembryonic antigen (CEA) cancer blood test had dropped down to normal, and his CT scan looked much better. On April 19, Todd had surgery in the experienced hands of Dr. Mika Sinanan, a University of Washington professor of surgery who specializes in gastrointestinal surgical oncology.

Dr. Sinanan successfully removed the cancer from Todd’s body and was able to rejoin the remaining intestine to itself and avoid a permanent colostomy. However, the surgery did require a temporary ileostomy to allow the new bowel connection to heal thoroughly before it was used. An ileostomy is an opening constructed by the surgeon on the surface of the skin on the right-hand side of the abdomen. The end of the small intestine (the ileum) is brought out onto the surface of the skin and intestinal products pass out into a special bag.  

“No patient ever wants a colostomy or ileostomy,” says Whiting. “We understand that fact all too well. The good news is that the majority of patients treated for rectal cancer do not have to have a permanent colostomy, and the ileostomy, like Todd needed, is reversed once the bowel surgery has healed. Also, good news is that dealing with a colostomy or ileostomy is absolutely manageable and can be a part of an active and full and happy life—I see it all the time, every day. So no matter what needs to be done to get the cancer out, I believe that patients are well served by pushing forward with determination and positivity.”

Todd went quickly back on to chemotherapy after recovering from the first surgery.  The whole program had been mapped out ahead of time and he knew that there was more to come. “I recovered in about six to eight weeks and then had to return to more chemo rounds,” Todd says.  

With the primary tumor gone, the next steps in the sequencing of treatment included more chemotherapy to the entire body, then radiation and chemotherapy to sterilize the rectal area where the primary tumor had been removed (called “adjuvant” therapy), and then, if everything went well, surgical resection of the disease in the liver.

Chemoradiotherapy

By July, Todd was beginning to feel really good. He had modified his runs to three to five miles. Dr. Whiting recommended that Todd transition from chemotherapy to chemoradiotherapy focused upon the rectal area. For this important step, Todd was treated by Dr. Wui-Jin Koh, professor of Radiation Oncology at the University of Washington School of Medicine and an SCCA radiation oncologist. In August Todd began five weeks of daily radiation. 

“I told my doctors that I wanted to take a trip to Hawaii in September after radiation was finished,” Todd says. “We took my daughter who started her senior year when we got back. The three of us even ran a five-mile race together while we were there.”

Last big step – Liver surgery

In September Todd’s studies looked good and it was decided that he would push forward with the last big step – surgery on the liver to remove the metastatic disease.

On September 16, Todd went to surgery with Dr. Raymond Yeung, professor of Surgery at the University of Washington and a specialist in operations for cancer involving the liver. Todd and Drs. Whiting, Yeung, and Sinanan talked about the timing of chemotherapy, liver surgery, and reversal of the ileostomy that Todd had had since April. It was decided to perform the two operations together.

“It’s incredible how the doctors work together so well,” says Todd. “I’ve heard about other places and that doesn’t always happen. The timing of everything was so systematic. To do the ileostomy reversal and have the liver surgery while I was still having chemotherarpy… it was amazing how they kept it all going. I ended up getting the reversal surgery while I was under for the liver surgery!”

Recovery and Outlook

Todd heals well. He’s athletic and strong. He started walking right after surgery and was told to wait 30 days before doing any strenuous exercise. So Todd walked more and more each day. “By the time 30 days was up, I was walking five miles,” Todd says.

On Oct. 21, 2011, Todd had another CT scan and MRI and blood tests. Dr. Whiting told him the numbers were good. There was no sign of disease! “That was a very emotional day for me,” Todd recalls.

All has been well since then. Todd ran in a half marathon in Las Vegas in early December. He has big plans to run in several half-marathons in 2012, including the region’s first marathon of the year, the Mercer Island Half for colon cancer prevention, and at least one full marathon, the Seattle Rock n Roll Marathon. Last year he had a team of 70 people that ran and raised $4,000 for Seattle Cancer Care Alliance colon cancer research.

“Every patient with cancer is a hero,” says Whiting, “and every patient demonstrates in his or her own way the miraculous things that human beings can accomplish. Looking at Todd, the thing he brought to the table was a supreme determination to stay strong and fit and take care of himself. I can’t overestimate how important that strategy was (and is) to the success of a program like this. He has undergone two major surgeries, many, many months of aggressive chemotherapy, and radiation therapy.  His dedication to fitness helped get him here.”       

Maintenance Chemo

The next step for Todd is to keep any errant cancer cells away. He could have opted to discontinue any more treatment, “but it made perfect sense to me to do the maintenance therapy,” Todd says. So every three weeks he comes to SCCA and receives an infusion of Avastin and he takes Xeloda twice a day. Avastin is a drug that inhibits the formation of new blood vessels that feed cancer, and Xeloda is an oral chemotherapy that is taken in pill form.

“Cancer changed my life in that I don’t take the time with my four kids for granted. It changed how I look at things and how I decide to spend my time,” Todd says.

“I hope people can be more aware of their bodies and not be too proud, especially men. I was naïve about colon cancer,” he says, “but it can happen to anyone.”

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