In his late 30s, pediatrician Thomas Holubeck, MD, developed constipation that lingered for six months. It slowly worsened and caused a small amount of bleeding. But, because he was young and felt fine otherwise, he didn’t get it checked out.
“I was 37. I was busy building a new practice, and I had a young family. So, I treated myself and delayed getting checked,” he says, remembering his choice 25 years later. “By all the signs, especially as a healthcare provider, I should have known better. But I fell into the classic trap of thinking it was just constipation—that I was healthy with no other medical problems.”
Then, he started to lose weight without trying. That’s when his primary care doctor referred him to Colorectal Surgeon Janice F. Rafferty, MD, who serves as Director of Surgical Oncology services at The Christ Hospital Network. After an exam and several tests, she made a diagnosis. Dr. Holubeck had Stage 3 colorectal cancer that had spread to his intestinal wall and nearby lymph nodes.
Aggressive treatment and a positive outcome
With a diagnosis in hand, Dr. Holubeck says Dr. Rafferty worked with him and his care team to create a comprehensive care plan that attacked his cancer vigorously.
“Within two weeks of my evaluation, I started radiation and chemotherapy,” he says.
From there, he said his treatment felt like a whirlwind. His initial radiation and chemotherapy treatments lasted three months, then, after his surgery in December 2000, he had another six months of chemotherapy. To combat anemia, he managed his nutrition and received bone marrow treatments to stimulate the growth of more red blood cells.
The aggressive care plan and follow-up care with Dr. Rafferty and the team at The Christ Hospital Health Network led to long-term success, he says.
“I was very fortunate. All the treatments before surgery made my tumor shrink, so Dr. Rafferty got clear margins with the procedure. She was able to remove all the cancerous tissue,” he says. “After the radiation, surgery and chemotherapy, I’ve been cancer-free.”
Dr. Holubeck, now 62, says his health rebounded after he completed his cancer treatment. His energy returned, and he gained back the weight he lost. He’s also stayed current with cancer screenings.
An unexpected genetic link
Dr. Holubeck’s young age at diagnosis triggered Dr. Rafferty to question whether genetics played a role in his disease.
“During my treatment, Dr. Rafferty considered the big picture and thought it would be a good idea for me to have genetic testing,” he says. “My results showed that I have Lynch syndrome.”
Lynch syndrome is an inherited disorder that creates genetic mutations in the body. These changes can increase your risk for various types of cancer, including colorectal, skin or stomach cancers. In women, it can boost the likelihood of endometrial and ovarian cancers.
Although he didn’t discover this genetic condition before his cancer diagnosis, Dr. Holubeck says he’s glad he knows now. It’s knowledge that will keep him and his children healthier in the future.
“It’s a blessing to know about the Lynch syndrome because I can monitor it annually,” he says. “We discovered that my youngest child has the mutation, as well. They’ve been monitored since they turned 19.”
Dr. Rafferty echoed the importance of genetic testing. But she stressed that it isn’t necessary for everyone.
“If you have a family history of colon cancer or if you know one of your family members has a genetic mutation that increases their risk, you should consider genetic testing,” she says. “Our genetic counselors dig into this with patients and their families. They spend a lot of time counseling people and explaining their genetic testing results.”
Colon cancer screening matters
According to the American Cancer Society, colon cancer is the third most common cancer in the United States. There’s growing concern, though, that colorectal cancer rates are increasing in people under age 55. That rise underscores the importance of screening tests. The good news is that catching the disease early can lead to good outcomes, Dr. Rafferty says.
“Colon cancer is a highly preventable disease, and it’s highly curable when found in the early stages,” she says. “Our great team here at The Christ Hospital can treat it aggressively and in a multidisciplinary fashion.”
To detect colon cancer as early as possible, Dr. Rafferty recommends you start screening at age 45. If you have a first-degree relative with colon cancer, you should start screening when you’re 10 years younger than they were at diagnosis. Your provider can help you find the test that’s right for you. Depending on your health needs, your doctor may suggest:
Colonoscopy: A colonoscopy is the gold standard for detecting colon cancer, due to its unmatched accuracy, and because it’s the only test that both detects and prevents colon cancer. This test uses a thin, flexible, lighted tube to detect polyps or cancers in your rectum or colon. It also involves the removal of precancerous polyps as they are detected.
CT colonography: Also called a virtual colonoscopy, this test uses X-rays to identify polyps or cancers in your colon.
Flexible sigmoidoscopy: This test is like a colonoscopy, but it only examines the lower third of your colon.
Stool tests: These tests analyze a sample of your stool for signs of blood or altered DNA that could indicate cancer.
Based on his experience, Dr. Holubeck says you shouldn’t shy away from screening—even if you think it might be uncomfortable.
“Knowledge is critical. You may be apprehensive, but it’s important to pay attention to what your provider says and stay on schedule with your screening tests,” he says. “It’s the best thing you can do for the loved ones in your life.”
Steps for lowering risk
It’s not always possible to prevent colon cancer. But you can stack the deck in your favor, Dr. Rafferty says. She suggests these steps to reduce your risk:
Know your family history
Avoid high-fat foods
Eat a high-fiber diet (at least 25 to 35 grams of insoluble fiber daily from foods like crunchy vegetables, fruits, whole grains or nuts)
Exercise
Maintain a healthy weight for you
Quit smoking if you are a smoker
Following these healthy lifestyle behaviors is vital to your long-term colorectal health. But for Dr. Holubeck, the most important lesson is to pay attention, get screened, and not delay treatment when something feels wrong.
“Listen to your body. When something’s out of balance or has changed, recognize that something’s up,” he says. “Keep your eyes open and address those issues. Don’t ignore symptoms like constipation, weight loss or a drop in energy. Go see your provider and get checked.”
Are you worried about constipation or other new symptoms that may affect your colon? Schedule an appointment with our colon and rectal surgery experts today.