Surviving Colorectal Cancer with Eleanor Ross
Written by Melissa Schenkman, MPH, MSJ
When Eleanor Ross took an over-the-counter medication that gave her an upset stomach and pain underneath her rib cage in March 2021, she did what most people do, she took a medication (Peto-Bismol) to alleviate her upset stomach and ate a bland diet. These were the treatments also recommended by her doctor, who informed her that the over-the-counter medication she took was also known for causing some intestinal discomfort.
Less than two weeks later the pain, discomfort, tiny bit of blood in her stool, and multiple trips to the bathroom came to a halt. Mystery solved, or so Ross had thought.
About two months later in June, her upset stomach was back. She went out to eat and afterwards the meal just did not sit right with her. This time though it was not just an upset stomach. She also saw bright red blood in her stool. From the first moment she saw the blood it never went away when she would use the bathroom.
Like so many of us, at first she consulted Dr. Google, but nothing in the search results–hemorrhoids, colitis, irritable bowel sydndrome—matched up with her symptoms. She had not had years of pain or mucous, or weekly or even daily changes in her bowel habits. After having an exam, her primary care doctor suspected Ross had a bleeding ulcer. She was prescribed medication for that for 10 days and told it should make a difference. It never did.
Finally, she was sent to a gastrointestinal specialist (GI) and for a colonoscopy. She had to advocate for herself to move up her GI appt , as it was scheduled for many weeks out. She also had to be clear with the doctor that she was there seeking a colonoscopy, knowing how common it is for people at her age for their symptoms to be overlooked and told “let’s watch and wait.”
“I remember telling the nurse anesthetist and the anesthesiologist right before the colonoscopy, that ‘I feel like when I wake up my life will be completely different. My symptoms were not lining up with anything, and it didn’t make sense,” Ross recalled.
She was right. When Ross woke up the GI specialist confirmed she had colon cancer in her tranverse colon, literally right in the spot underneath her rib cage where she had been experiencing pain. She was just 41 years old.
Colorectal cancer occurs when cells grow out of control either in the colon, also known as the large intestine, or in the rectum, the passageway between the colon and anus. These cancers develop from pre-cancerous growths called polyps, that can develop in your colon’s lining.
In 2023, the American Cancer Society estimates that doctors will diagnose 153,020 new cases of colorectal cancer and that 52,550 of those cases will result in death. Some of those new cases will forever change the lives of people in their 20s, 30s, and early 40s, as the numbers of those in our generation experiencing the condition continue to climb.
It’s one reason Ross shares her story, hoping like those of us at YMyHealth, that bringing awareness and detailed knowledge to you will help you make decisions about when to seek help and how to advocate for yourself with your healthcare provider, ultimately saving lives.
Colorectal Cancer Survival Rates
While survival rates are estimates, they provide a glimpse into how many people with a certain stage of cancer are alive after a certain number of years from the time they were officially diagnosed. The American Cancer Society breaks down relative survival rates–a comparison of people with the same type and stage of cancer–by how far the cancer has spread. Cancers are categorized as being:
Localized -cancer is only in the colon or rectum
Regional - cancer has spread outside the colon or rectum to nearby structures or lymph nodes.
Distant- cancer has spread beyond structures near the colon or rectum to distant parts of the body such as the liver, lungs, or distant lymph nodes.
The most up-to-date five-year survival rates for colorectal cancer are based on people who were diagnosed between 2012 and 2018. According to the National Cancer Institute's National Surveillance, Epidemiology, and End Results (SEER) database, the five-year survival rates of colon and rectal cancer are:
Noticeably, the survival rates are the highest for colon and rectal cancers that are localized to the colon and rectum–an earlier cancer stage which is more likely to be identified when patients get regular colonoscopy screenings regardless of whether or not you are old enough to meet the U.S. Preventive Services Task Force’s current recommended age for your first screening, which is 45 years old.
Factors that influence colorectal cancer survival
Age
The risk of colorectal cancer increases as you get older. The number of new cases increases by 80-100% with each five-year age group up until age 50. While the majority of colorectal cancer is diagnosed in people over the age of 50, as Ross shows us, this is not always the norm. She was only 41 years old. The number of cases in people under age 50 have been increasing for the past almost 18 years. Today, it is estimated that in seven years from now, by 2040, colorectal cancer will be the leading cause of cancer deaths in people ages 20–49.
Stage of cancer
The TNM System is used for staging colorectal cancers. “T” stands for tumor and describes the tumor’s size; “N” stands for nodes, as in lymph nodes and whether or not the tumor has spread to any lymph nodes near the colon or rectum; and lastly, “M” stands for metastasis denoting any spread of colorectal cancer to distant sites in the body–organs like the liver or distant lymph nodes.
Ross was diagnosed with a Stage IIA colon cancer, which was 2-5 centimeters and located directly underneath her diaphragm. Hers was a T3N0M0 in the TNM system. Stage IIA cancers are ones that have grown into the outermost layers of the colon and rectum, but have not grown through them, reached nearby organs, or have spread to nearby lymph nodes or distant sites.
To learn more about the TNM staging system, go here.
Despite her young age and being Stage IIA, her post-surgical pathology report revealed that she had microscopic lymphovascular invasion, meaning that the cancer was starting to make its way into her lymphatic system and bloodstream–a high risk feature of colorectal cancer.
Gender
Males have been shown to get colorectal cancer at higher rates than women. They are also more likely to die from the disease than women are.
Race
In the United States, American Indian and Alaska Natives have the highest rates of colorectal cancer, followed by African American men and women. Ashkenazi Jews, who are people of Eastern European descent, have one of the highest colorectal cancer risks of any ethnic group in the entire world.
Genetics
If you have a close family member (parent or sibling) with a history of advanced polyps or colon cancer, or other types of cancer, it increases your risk of developing colorectal cancer. Your risk especially increases if that family member developed colorectal cancer before age 45.
Also, people with a family history of relatives having multiple polyps or inherited conditions like Lynch syndrome and familial adenomatous polyposis have an increased risk of colorectal cancer.
Ross did not have any family history of colon polyps, colorectal cancer, or the inherited conditions mentioned above. She also did not have any close relatives with other types of cancer. Since her diagnosis, all three of her siblings (in their 30s and 40s) have had a colonoscopy.
Lifestyle factors
Smoking, excessive alcohol use, and having a diet in which you frequently eat red meat and processed meat all increase your risk of colorectal cancer. So does being obese and not exercising. While Ross, like so many during their college days, ate fast food, drank alcoholic beverages, and had smoked some, for 15-plus years before her diagnosis she was eating a healthy diet, exercising, and not drinking or smoking.
Eleanor Ross found it hard to understand how after having no genetic predisposition to colorectal cancer and living a relatively healthy lifestyle that she could still be susceptible to the disease and be diagnosed with it. She completed her treatment in December 2021.
Importance of early detection and treatment
Early detection of colorectal cancer is a key factor in making its treatment successful. That’s because when cancers are found early on in their development, they are smaller and less likely to have spread to your lymph nodes or other organs.
Remember, it takes a minimum of 10 years for a polyp to become cancerous, which makes regular colorectal cancer screening one of the most powerful ways to fight this type of cancer, as it can often find and remove polyps before they become cancerous.
There are two types of screening tests: stool-based tests that look for blood in your stool and visual exams, such as a colonoscopy, that look inside your colon and rectum. Check out our animation here to see what a colonoscopy looks like and what it can do.
Coping with Colorectal Cancer
The emotional impact of a cancer diagnosis
Hearing the words, “You have colorectal cancer,” for anyone is difficult, but for someone who is younger than the recommended age for a first screening in the prime of their life, the emotional impact can be even greater. And once you become a colorectal cancer survivor like Ross is, it changes your perspective on life.
“After you go through something that is so scary, the things that you used to think of as scary now shift a little bit more on the spectrum to where they’re not as scary,” Ross said.
For example, she used to worry about aging and like many of us thought about, but was weary of trying Botox and any side effects that would be dangerous to her body from it. Now, after going through chemotherapy, she figures it can’t be worse. In many ways she has started to be a little bit more proactive and take those risks for herself as part of enjoying life.
Coping strategies
If you are going through colorectal cancer treatment, one of the best ways to cope is letting your community in to the fullest. It makes all the difference, Ross told me. All of her family and many of her friends rallied around her when she was sick. They motivated her to do everything in her power to fight the cancer.
She also had a cancer buddy, a friend going through treatment for a different type of cancer at the same time. They encouraged and motivated one another to get through their most challenging days. For Ross, this included infusions of chemotherapy that caused her tremendous fatigue.
The role of support groups
Support is vital, she told me, including online support from those currently undergoing colorectal cancer treatment and survivors. She found an incredible online support group, called Colontown. They have endless little neighborhoods with tons of useful and relatable information. It’s a very supportive place, and she highly recommends it.
Eleanor and her family after participating in the 2022 Boxer Brief 5K for Colorectal Cancer.
Improving Colorectal Cancer Survival
Early detection and treatment
If you are someone in your 20s, 30s, or early 40s right now, and you are on the fence about getting a colonoscopy or even going to a GI doctor, Ross wants you to remember colorectal cancer can happen at any age and it does not mean it will not happen to you.
“It’s becoming one of the top most prevalent forms of cancer in people under the age of 40 and that’s important,” Ross said. “Doctors don’t know why that is and they may never figure it out, but if you are having symptoms seek care with urgency and keep pushing until you have a clear picture with a screening that you are okay and not just someone’s opinion.”
She also believes that another line of defense is establishing a primary care doctor starting in your 20s, who you can have checkups with at least annually, something many young people do not do enough.
Lifestyle changes that can improve survival
There is no question that healthy eating, regular exercise, and getting regular exams, screenings, and blood tests are keys to improving survival long term.
For people who have chemotherapy as part of their treatment like Ross did, you lose a lot of muscle mass and your metabolism is highly impacted. Part of that is because you are kind of bedridden, she told me, as you do not have the energy to do anything else but fight the cancer. She took walks outside when she could.
Since her treatment ended, Ross has been putting in hard work with a personal trainer three times a week to rebuild her muscle mass base. Thankfully, she has gained back all her muscle mass, but did gain some additional weight in the process that she is working hard to regulate. It’s a matter of striking the right balance.
“I think there is a misconception by so many people that you can outrun cancer, that it is just bad luck with supplements, your diet or things like that. Some things are out of your control, but some are not,” Ross said. “Before I would have had immense guilt about paying for personal training, but now I know that my health is just as vital to the survival of my family.”
For more information visit the Colon Cancer Foundation’s Colorectal Cancer : Resources for Young Patients and Survivors*
*This article was first published by the Colon Cancer Foundation.
Subscribe to the YMyHealth newsletter to stay up to date on everything that’s health-related for millennials!
