Kirsten Warren was used to caring for things – her two teenagers, her plot at the Long Beach Community Garden and others in the community through her psychotherapy business. But at age 52, when she starting experiencing rectal bleeding – a common sign of colorectal cancers – Kirsten turned her attention to her health.
Concerned, she went to her primary care physician and then her gynecologist, who referred her to Imad Shbeeb, M.D., medical director, Colorectal Surgery Program, MemorialCare Todd Cancer Institute, Long Beach Medical Center.
An expert in diagnosing and treating colorectal cancers, Dr. Shbeeb recommended a colonoscopy. A colonoscopy is the most common type of screening for colorectal cancer. During this test, doctors use a long, thin, flexible, lighted tube to check for polyps or cancer inside the rectum and the colon.
“My colonoscopy revealed a 7-8 cm tumor in my rectum,” says Kirsten. “Dr. Shbeeb referred me to an oncologist, Dr. Sassan Farjami. That same day, I was diagnosed with stage 3 Adenocarcinoma.”
At the MemorialCare Todd Cancer Institute, a multi-disciplinary care team, including Dr. Shbeeb and Dr. Farjami, as well as pathologists, radiologists, gastroenterologists, genetic counselors and others, worked with Kirsten to develop a comprehensive treatment plan to tackle her cancer. In Kirsten’s case, the team determined that a combination of therapies and minimally invasive surgery was the best course of action.
Kirsten received chemotherapy, radiation and hyperthermia treatments. Hyperthermia is a specialized therapy that involves heating selected tumors to 106 to 108 degrees for up to one hour.
Certain cancer cells can become resistant to cancer treatment when they become oxygen-starved due to poor blood supply. Heat application causes increased blood flow and oxygen to the tumor making the cancer cells more susceptible to cell death. Hyperthermia is always preceded or followed by radiation or chemotherapy because it enhances the effectiveness of these treatments.
At Long Beach Medical Center, all cancer care and support is provided in the MemorialCare Todd Cancer Institute (TCI), which houses the most advanced technology for cancer treatment, wellness programs, support groups and patient navigators that together treat the whole patient under one roof. Five days a week, for six weeks, Kirsten received various treatments at TCI.
As a result, her tumor shrunk down to ½ cm – the size of a fingernail. She then was ready for surgery to remove the cancerous tissue.
“Surgery to remove cancerous tissue is a primary treatment at all stages of colorectal cancer,” says Dr. Shbeeb. “Minimally invasive surgery has many advantages for the patient including less blood loss, less need for pain medication and less scarring. It also means a shorter hospital stay and a better outcome.”
During surgery, Dr. Shbeeb used minimally invasive techniques to remove about 10 inches of rectal tissue, then reattached the colon to the tissue that was leftover. After her surgery, Kirsten’s labs came back clear – the cancer was gone.
However, the surgery left Kirsten’s colon weak and she needed a temporary ileostomy bag. An ileostomy is used for people with an injury or disease in the digestive system. The operation changes the way the body gets rid of waste. After the surgery, there is an opening called a stoma in the belly. Waste will pass through the stoma into a pouch that collects it.
Kirsten had the bag for eight weeks. Then, Dr. Shbeeb performed reversal surgery to close up the ileostomy. Part of her final treatment plan was maintenance chemotherapy to prevent the cancer from returning. The week of Thanksgiving 2015, Kirsten officially finished all her treatments.
Now cancer free, when Kirsten isn’t back to caring for her community garden plot or enjoying time with her family, she’s encouraging others to listen to their body.