39-Year-Old Mom Of Three Diagnosed With Stage 3 Rectal Cancer Five Years After Onset Of Symptoms, Blood In Stool & Urgency To Use Bathroom — The Importance of Colonoscopies

Peters, who claimed her doctors dismissed her symptoms as having to do with childbirth, explained in a recent post shared on her Instagram, “For me, sh*t got real, fast. Literally, there was blood on the toilet paper after I wiped my butt. It was clear things were not normal. For the five years prior, I voiced my symptoms to every medical professional in my life.

How Is Rectal Cancer Treated Differently Than Colon Cancer?

“Dismissed as something that came with giving birth. Told that the hemorrhoids I had were ‘cute’ and that there was nothing to worry about, I remained unheard. As blood became brighter and more prevalent, I knew I needed to be seen. My diagnosis rocked me to the core and the kicker is that it never had to happen – colorectal cancers are 100% preventable.”

Peters continued, “Throughout my cancer battle, balancing a full time job and raising three young boys, we learned a whole lot. A harsh reality for all of us in our 20s, 30s and 40s is there is a skyrocketing uptick of younger people like me with colorectal cancer, disproportionately rising in healthy people, women and people of color.

“My story is becoming all too common and many of us don’t live to tell about it. Being fortunate enough to complete the aggressive treatment that left me as a cancer survivor today, it’s clear that this was completely avoidable with earlier intervention.”

She further insisted, “If I had just been seen. Taken seriously. Earlier. I was not crazy, I was right. My story does not need to become yours.”

Recounting her story in a recent interview with TODAY.com, Peters said the first time she noticed blood after a bowel movement was when she was 33 years old in 2015, a symptom her doctor overlooked as something normal that occurs after childbirth.

She told TODAY.com, “Some of my physicians chalked it up to being related to childbirth, which ultimately delayed my diagnosis.”

It wasn’t until she gave birth to two more children, and the third birth causing complications, that she finally underwent a colonoscopy, which led to her diagnosis.

Her first symptom she recalled was blood in her stool, and it later turned to “ribbons of blood in the poop to filling the bowl with blood,” followed by a change in the texture of her stool.

Peters explained, “It was trying to fit past this pomegranate sized, 5-centimeter sized tumor, in my rectum in order to exit my body. I had increased urgency to go to the bathroom where it felt like ‘Oh my gosh am I going to poop my pants right now?’”

Shortly after a Cologuard test read positive for cancer, a colonoscopy revealed her tumor, and a biopsy confirmed it was cancerous.

RELATED: How to Recognize Sneaky Cancer Symptoms — Looking at Cancers That Are Most Often Misdiagnosed

Her treatment consisted of six rounds of chemo, followed by 38 weekly rounds of radiation with oral chemo for five and a hald weeks, as well as surgery to remove the tumor and reconstruct her rectum, Today.com explains. She also had an ileostomy for a couple of months and an additional six rounds of chemo.

In an effort to continuing to make a difference and spread awareness for the disease, she urged, “I’m never going to stop talking about this.

“If I can help humanize and make this more realistic by sharing my own story, as improper or unglamorous… as it might be, I am never going to stop sharing that.”

The Difference Between Colon and Rectal Cancers

Both colon cancers and rectal cancers affect the large intestine, so the symptoms, screening tools, prevention, risk factors, and diagnosis are the same for both. The treatment, however, could be different.

The rectum is the final part of the colon; it is about 6 inches long, and its main function is to store stool until a bowel movement can be made. A cancer of the colon can start anywhere in the colon, which is about five feet long and absorbs water from stool.

If the rectum is removed, a person may no longer have as much an ability to hold bowel movements, resulting in frequent, urgent trips to the bathroom.

“Any cancer of the rectum, we treat a little bit differently than cancer of the colon, for the reason that because it sits in the pelvis, which is essentially a bony ice cream cone, it makes any surgery in this area much more challenging,” Dr. Kyle Cologne, a professor of clinical surgery at the Keck School of Medicine at USC, told SurvivorNet in a previous conversation.

“This is also why for rectal cancer we may use, much more so than colon cancer, things like chemotherapy, potentially even before surgery, radiation, and these all are part of your diagnosis that your surgeon should talk to you about.”

Dr. Daniel Labow explains the different types of colon cancer surgery.

When you have a colonoscopy, the gastroenterologist performing the procedure is looking at the inside of your colon and rectum to detect growths and to pinpoint their location in the colon or rectum.

Where the cancer is located (whether it is in the colon or rectum) is important because the rectum does not have the same protective outer layer (called the serosa) as the colon, so it may be easier for a tumor to break through and begin to spread locally in the body. This also means that rectal cancer is more likely to recur after treatment compared to colon cancer.  In addition, because of the rectum’s important function as a storage organ for stool, surgery to remove the rectum causes significant changes in quality of life when compared to surgery to remove part of the colon. This changes the considerations to select tools such as chemotherapy and radiation in addition to, or sometimes even instead of, surgery.

“With rectal cancers, they come in all shapes and sizes,” says Dr. Cologne. “And what I like to tell patients is, it’s like buying a house. It’s all about location. So, tumors that are in the upper rectum are much easier to treat than tumors in the lower rectum.”

So, what does this mean when it comes to treating rectal cancer? Before making treatment decisions, your medical team will need to stage the disease to determine the extent of the tumor. The staging for rectal cancer involves having chest and abdominal CT scans and an MRI scan of the pelvis. These scans can help determine:

• If cancer has spread to other organs
• The tumor’s size
• The tumor’s relation to nearby organs
• If lymph nodes have been affected

Understanding Colon Cancer

Colorectal cancer happens when polyps are not removed and become cancerous. It can take up to 10 years for a colon polyp to become cancerous, according to SurvivorNet experts.

“We know that colon cancers can be prevented when polyps are found early,” Dr. Heather Yeo, a surgical oncologist who specializes in colorectal cancers at Weill Cornell Medicine, told SurvivorNet.

“Lowering the screening age helps somewhat with this, but access to care is a real problem,” Dr. Yeo added.

Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center, previously explained the colonoscopy procedure to SurvivorNet.

“When we see a polyp, we actually physically take the polyp out through the colonoscope,” he explained.

“What does that mean? That means we basically put a wire through with a little bit of a flange at the end, and we pull the polyp out. Now, note there is no pain with that. Inside the colon, there are no pain fibers. So, there’s no pain,” Dr. Murrell added.

The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on colonoscopy before they develop or when the polyps are small enough to be removed without surgery.

Looking for Polyps During Colonoscopy

The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.

The U.S. Preventive Services Task Force recommends guidelines that state colon cancer screenings should begin at 45 years old. This is in response to the increase we see in colon cancer diagnoses in younger adults.

However, many insurance companies still do not cover the cost of screenings for those under 50. In the past, the disease had predominantly been found in adults 50 years or older, but for those predisposed to getting it at a younger age, these new guidelines could help catch it earlier.

Colon Cancer: A Silent Killer

Dr. Heather Yeo, a colorectal surgeon and surgical oncologist at Weill Cornell Medicine and New York-Presbyterian, previously told SurvivorNet, “Colon cancer is considered a silent and deadly killer.

RELATED: How Does a Colon Polyp Turn Into Cancer?

“What happens is people often don’t know that they have colon cancer. They don’t have any symptoms. That’s why we screen for colon cancer in the United States.”

The Rate of Colon Cancer is Increasing in Those Under 50

“You should be screened for colon cancer, even if you have no family history. Once you have your initial screening colonoscopy, if there are no polyps and you have no high-risk factors, usually once every 10 years is fine,” she advises.

“Colon cancer is a slowly progressing cancer. If you have any family history of colon cancer, you should be screened about 10 years before your family member had colon cancer. So if you have a family member that was 53, you should be screened at 43.”

Coping With an Advanced Diagnosis

Colon cancer is very treatable and curable if caught early. However, treatment may become more intense when the cancer is detected in later stages.

Chemotherapy is known to improve survival in patients with metastatic or stage 4 colon cancer.

“Colon cancer most commonly spreads to the lung and to the liver,” Dr. Heather Yeo, a board-certified in general surgery, colon and rectal surgery, and complex general surgical oncology, explains to SurvivorNet.

“We try not to do surgery right away. If you think about it, we can’t cut out all of the disease, and any time you do surgery, you’re actually compromising a patient’s immune system,” Dr. Yeo explains.

WATCH: Not all stage 4 colon cancer patients are the same.

The most common therapy is called FOLFOX, and your doctor may add medications like irinotecan (FOLFIRI) or cetuximab, depending on how well your tumor shrinks with treatment and other specifics about your particular tumor.

“If you respond really well, then we keep you on that until you stop responding really well. But if after a few cycles, your disease has progressed, that’s when we think about adding other additional chemotherapies,” Dr. Yeo said.

Colon cancer screenings can involve at-home tests such as Cologuard, but a colonoscopy is more effective, according to SurvivorNet experts. A colonoscopy involves examining the colon and rectum with a long, thin tube attached to a camera.

WATCH: Colon cancer symptoms.

The most poignant signature of colon cancer includes a change in bowel habits. This may include constipation or diarrhea due to changes in the size or shape of bowel movements. A change in stool color, particularly black or tarry stools, can indicate bleeding from a tumor that lies deep in the colon.

Other symptoms can be harder to pinpoint, such as abdominal pain and unintentional weight loss. Finally, some tumors bleed a small amount over a long period of time, resulting in anemia (low red blood cell count) that is picked up on blood work.

Colon Cancer Appearing More in Younger People

Although the average age people are diagnosed with colon cancer is 68 for men and 72 for women, according to the American Cancer Society, the National Cancer Institute reports that since the 1990s, colorectal cancer cases have been rising among adults younger than 50.

Research published in CA: A Cancer Journal for Clinicians found the proportion of cases in people younger than 55 years old increased from 11% in 1995 to 20% in 2019.

“We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population,” cancer epidemiologist and lead study author Rebecca Siegel said.

MORE: All Americans Should Begin Colorectal Cancer Screening at Age 45, According to New Guidelines; Previous Age Was 50

Researchers are still trying to determine why younger people are being diagnosed in greater numbers. Some experts point to risk factors, which include obesity, physical inactivity, and smoking, as a possible explanation for the increase.

“We don’t know for sure why we are seeing earlier onset and (cancer mortality) from colon cancer,” Dr. Yeo told SurvivorNet. It is likely a combination of factors, including diet and genetics as well as access to care and some environmental factors.”

Dr. Paul Oberstein Explains Common Colon Cancer Symptoms

What Increases Your Risk for Developing Colon Cancer?

For some people, certain risk factors can influence their risk of getting colon cancer. They include the following:

• Are older. About 90% of cases are in people aged 50 or older, according to the U.S. Centers for Disease Control & Prevention (CDC). Yet it is possible to get this cancer earlier in life.
• Have inflammatory bowel disease.  Crohn’s disease or ulcerative colitis can, over time, cause cells in your intestines to turn cancerous.
• Have a family history of this cancer. Just under one-third of people who get colon cancer have family members with the disease.
• Have a gene mutation. About 5% of colorectal cancers are caused by an inherited genetic mutation that causes syndromes such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (Lynch syndrome).
• Don’t exercise very often. Staying active can lower your risk.
• Eat a diet that’s high in meat. Regularly eating red meats like burgers and steaks, and processed meats such as hot dogs and bacon might put you at higher risk.  Eating more fruits, vegetables, and whole grains instead might lower your risk.
• You are overweight or obese. Having too much weight increases your risk of both getting colon cancer and dying from it.
• Drink a lot of alcohol.  Limiting alcohol to one drink daily for women and two drinks daily for men could help lower your risk.
• Use tobacco. Long-term smokers are more likely to get this cancer than nonsmokers.

Which Treatments are Best for You?

It’s important to understand that your doctor has many ways to treat colon cancer, depending on what stage the cancer is, including:

• Surgery
• Radiation therapy
• Chemotherapy
• Targeted therapy
• Immunotherapy

Surgery

Surgery is the main treatment for most early-stage colon cancers, according to the doctors SurvivorNet spoke with. The surgeon will remove the part of the colon or rectum where there is cancer, along with a small area of healthy tissue around it. Taking out as much of the cancer as possible is important for improving your outcome.

The surgery may be performed through small incisions (laparoscopy), or through a larger incision. Some people may need to wear a special bag (ostomy) to collect wastes after surgery.

Radiation Therapy

This treatment aims high-energy x-rays at the cancer to destroy the abnormal cells. The radiation can come from a machine outside your body, or be placed directly inside your body. Sometimes people get radiation before surgery, to shrink the tumor and make it easier for the surgeon to remove. This is called neoadjuvant radiation.

Chemotherapy

This treatment uses strong medicine to stop cancer cells from dividing, no matter where they are in your body. You may get a combination of chemotherapy drugs as your first treatment. Chemotherapy has been very well studied for colorectal cancer, and it is known to improve survival.

The most common therapy is a combination of chemo drugs called FOLFOX:

• FOL = leucovorin calcium (folinic acid)
• F = fluorouracil
• OX = oxaliplatin

Your doctor may add medications like irinotecan (FOLFIRI) or cetuximab, depending on how well your tumor shrinks with treatment and other specifics about your particular cancer. For FOLFOX, the medications are given through the vein and require regular doctor visits.

To determine exactly which chemotherapy regimen you get, your doctor will consider your age and how well you might tolerate the side effects of chemotherapy. Gene mutations (for example, BRAF and KRAS) and the location of the primary colon tumor also factor into the decision.

You can also get chemotherapy before colon cancer surgery, which is called neoadjuvant chemotherapy. Getting chemo first helps to shrink the tumor, which can make both the surgery and recovery easier, according to SurvivorNet’s experts. Chemo is also a treatment for cancer that returns after therapy.

Targeted Therapy

This treatment targets substances like proteins or genes that the cancer needs to grow. This makes targeted therapy more precise than chemotherapy, and less likely to damage healthy cells. One example of targeted therapy is bevacizumab (Avastin), which stops the growth of new blood vessels that feed tumors. Another group of targeted therapies are called epidermal growth factor receptor (EGFR) inhibitors, which block the cancer from growing.

Immunotherapy

This treatment makes your own immune system a more efficient cancer fighter. A group of drugs called checkpoint inhibitors, which includes pembrolizumab (Keytruda) and nivolumab (Opdivo), work by preventing cancer cells from hiding from your immune system. Checkpoint inhibitors may extend the amount of time before the cancer spreads.

Dr. Paul Oberstein, on which treatments doctors use to turn stage 4 colon cancer into a chronic but manageable disease

Contributing: SurvivorNet Staff

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