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Managing Crohn’s and Colon Cancer: Stacy’s Story
Getting cancer when you have Crohn’s may seem like an insurmountable challenge. Take lessons from a mother of three who battled back from both.
By Vanessa Caceres
Medically Reviewed by Farrokh Sohrabi, MD
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Stacy Gicale barely remembers life before Crohn’s disease. The Evansville, Ind., resident was diagnosed in 1987 when she was only 11 years old. Because of the condition, she weighed 48 pounds at the time — so little that doctors, who knew less about Crohn’s disease than they do now, thought she might have an eating disorder.
Throughout Gicale's teen years and early adulthood, there were times when living with Crohn’s was fairly low key. But there were also times when she needed serious treatment. She had the first of her resection surgeries, done to remove a diseased part of her intestines, when she was just 21.
Finding Cancer and Crohn’s
After Gicale's latest resection, in January 2014, doctors performed a biopsy and found cancer, specifically adenocarcinoma cells, in an obstructed area of her small bowel.
In fact, a lifelong fight with Crohn’s increases the risk for health complications, including cancer, says Lea Ann Chen, MD, a gastroenterologist at the NYU Langone Medical Center and an instructor in medicine at the NYU School of Medicine in New York City. In the general population, small bowel cancer is not that common. "The hypothesis is that it’s related to inflammation,” she explains.
Unlike colon cancer, which is often found via a colonoscopy, small bowel cancer can be hard to pinpoint. There is no specific method to screen for it, yet its risk is approximately 30 percent of colorectal cancer risk in patients with Crohn’s disease of the colon, according to a report published in 2013 in the journal "Inflammatory Bowel Diseases."
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Gicale’s doctors told her they are almost positive that her cancer can be traced back to her Crohn’s disease, suggesting a link between the many ulcers and surgeries she's had. Gicale received chemotherapy every other week for several months, from March to early September, 2014.
Her Crohn’s disease, she says, has taken a back seat to managing chemo and its side effects. Sometimes she felt an aching in her bones, similar to achiness from the flu. The chemotherapy also caused some neuropathy, which has led to sensitivity to things like cold drinks.
The good news for Gicale, though, is that tests in August 2014 found no evidence of cancer in her body.
Balancing Life With After Cancer
For Gicale, who has a daughter, 11, and two sons, 8 and 5, it was especially important that the chemotherapy not upset family life too much. Although she says it’s not easy to balance a condition like Crohn’s with cancer treatment and a busy family life, she offers these suggestions:
1. Push yourself to keep a normal routine.Gicale is proud to say that, even while receiving chemotherapy, she didn’t miss any of her children’s after-school activities, and her children noted that mom didn’t “quit” taking part in their lives. “It may not have been perfect, but I wanted to be there,” Gicale says.
2. Find ways to enjoy the down time.Though the family stayed active, they couldn’t do as much as they normally would during the weeks when Gicale had chemotherapy. Instead, they would hang out at home, watch movies, and just be together. She looks at the bonding time as a positive. “Maybe it’s good that we didn’t have the hustle and bustle,” she says.
3. Encourage your kids to open up about their feelings.At one point during Gicale’s chemotherapy, her daughter had on-and-off stomach issues. They took her to the doctor, but nothing specific was found. Everyone later realized that she was stressed over her mom’s cancer. She even revealed she felt she couldn’t cry in front of her brothers. That’s a lot of stress for a child to hold in. “You have to make sure kids are talking about how they feel,” Gicale says.
Dr. Chen also advises people to stay on all medications recommended by their doctors and to always keep scheduled follow-up appointments — for both cancer and Crohn's.
“One problem we see frequently is a patient will feel well and stop taking medication, even though there’s ongoing inflammation,” she says.
Video: CASE DISCUSSION: Upper GI Crohn’s disease with obstruction
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