picture by: Andria Devlin
Andria Devlin didn’t have any risk factors or a family history of colon cancer, so when she began experiencing gastrointestinal issues in her early 40s, she didn’t think much of it. She was having sporadic bleeding with bowel movements and chronic constipation, but didn’t recognize them as much of an issue at the time.
“As a busy wife and mom of two kids, I was putting everyone else first. My symptoms would come and go without rhyme or reason and were easily explained away, which is kind of the problem,” said Devlin, who works as the director of early childhood education at the Lawrence Arts Center.
When her symptoms didn’t subsidize, Devlin turned to her primary care provider for help. Dr. Malati Harris, a physician at Free State Family Medicine, prescribed different treatments that provided some relief, but didn’t fully alleviate her symptoms. At that point, it was time to turn to a gastroenterologist for answers about what else might be going on.
Devlin received a referral to Dr. Teresa King, a gastroenterologist with Lawrence GI Consultants. King was able to schedule a colonoscopy in February 2017. From that point on, Devlin’s life changed dramatically.
A colonoscopy is an exam used to detect changes in the colon and rectum. During the procedure, a patient is sedated and a long, flexible tube is inserted into the rectum. A tiny video camera at the tip of the tube allows a doctor to view the inside of the colon. What King saw in Devlin’s colon was immediately concerning.
“In a normal, healthy colon, we see smooth, pink tissue lining the colon. In Andria’s case, I saw an area where very rough-looking, lumpy, bumpy tissue had grown from the colon lining,” she said. “Without biopsy results, we don’t know for sure that it’s cancer. We can tell that it’s an area that doesn’t look normal, and that gives us pause that it might be cancerous.”
King sent the biopsies to the LMH Health laboratory for processing. When the results came back the following day, the news wasn’t good: Devlin had colon cancer.
“During the colonoscopy, Dr. King used the words ‘ugly tissue’ and knew there was something there,” Devlin said. “She called me the following day, February 7, to break the news to me. I’ll never forget that day. It was my child’s 15th birthday.”
Detecting colon cancer
There are a number of factors that can increase a person’s risk of colon cancer—a family history of the disease; medical conditions like Crohn’s disease or ulcerative colitis; a sedentary lifestyle; alcohol or tobacco use; obesity; or a diet low in fruits, vegetables and fiber and high in processed meats.
But Devlin didn’t have any of those typical risk factors. And at 42, she was also relatively young to be diagnosed with colon cancer.
“We know that the incidence of colon cancer increases with age, but we’re starting to see it more in younger people than we previously had,” King said.
She said that’s why the American Cancer society now recommends that people start getting screened for colon cancer at an earlier age — 45 instead of 50.
“Those who have risk factors may need to begin screening at an earlier age,” King said. “We also see a higher incidence of colon cancer in African Americans, so it’s important to talk with your doctor to determine the appropriate age for you.”
But what about cases like Devlin’s, where cancer develops even earlier than the recommended age for screening? King said that what helped Devlin the most is that she alerted her doctor to her symptoms.
“Be on the lookout for rectal bleeding, a change in bowel pattern, unexplained weight loss and new abdominal pain,” King said. “Any symptoms of concern should be reported.”
Next step? Oncology
Getting the diagnosis of colon cancer wasn’t easy for Devlin. Not only did she get the news on the night of her child’s birthday, it was also the night of the all-city choir concert.
“Dr. King told me she’d get the referral to oncology in the morning, but I asked her to do it that night instead. I got off the phone with her, ate dinner with my family, went to the concert and lived our life. I knew I had cancer but no one else except for my husband knew at that point,” she said. “My first thoughts were that I was going to die and wondered what that would look like for my family, for my husband as a caregiver, for my kids who were 14 and 12.”
The next morning, Devlin got a call from the LMH Health Cancer Center with the news that there was an opening in the schedule with oncologist Dr. Luke Huerter. She was familiar with Huerter from when her father was being treated for esophageal cancer.
“My first experience with oncology was with my dad, so I’d already witnessed the wonderful care that the team at the Cancer Center provided. But when you fast forward to your own treatment, it’s a very scary place to be,” she said softly.
The center aims to schedule patients for their first appointment within 48 hours or two business days after a referral. Devlin’s first appointment with Huerter lasted nearly an hour, providing time for her to learn more about the treatment she would face.
“When I first meet a patient, we go step by step through their pathology report and talk about the appropriate disease staging, which sometimes then involves having scans,” Huerter explained. “We talk about the appropriate treatment and the right order of treatment, which varies depending on the type of cancer. We talk about what to expect with treatment and their prognosis, both with and without treatment.”
Devlin underwent CT and PET scans shortly thereafter and learned that the cancer wasn’t confined to the tumor in her colon. It had spread to both of her lungs, and there was concern that some of her lymph nodes were also involved. On Feb. 17, Dr. Jared Konie, a surgeon with Lawrence General Surgery, placed a port in her upper chest, allowing treatment to begin a couple of days later. Devlin went from having a colonoscopy to her first chemotherapy treatment in two weeks.
Ups and downs of treatment
Devlin was placed on the same chemotherapy regimen that her father underwent during his battle with esophageal cancer, which was hard for her. She underwent eight rounds of chemo over a period of six months.
“Chemo is hard. It just kind of hangs out in your body and gets worse as it goes,” she said. “Toward the end of the eighth round, I had a significant allergic reaction to one of the drugs. We put a pause on it and were in talks about when to have surgery to remove my primary tumor.”
Because the tumor was so low in her rectum, Devlin turned to a colorectal specialist at The University of Kansas Health System to perform her surgery. She’d already received the go-ahead to remove the tumor but would have to be off of chemo for six weeks prior to surgery.
“We made the choice to stop chemo at that point since we knew we would already have to switch my regimen due to the allergic reaction and I had the tumor removed,” she said.
The procedure required a temporary ileostomy, where the small bowel is diverted through an opening in the belly. Digestive contents are routed through the opening or stoma, collecting in a pouch that sticks to the skin. The ileostomy allows the colon to rest and heal following surgery. While some patients live with an ileostomy for the rest of their lives, Devlin’s was reversed within six weeks. And even better news arrived – she no longer needed to be on chemotherapy. Her last treatment was in July 2017.
Devlin’s scans were clear, showing no active signs of cancer in her colon or lungs — at least until January 2018. It was at that point that a spot on her right lung that had been there since the beginning of treatment began to grow.
“The growth on her lung was a metastatic spot that resulted from Andria’s colon cancer. This means that cancer cells had broken away from the primary cancer where they first formed and formed a spot in another part of the body – in this case, her lung,” Huerter said.
A course of stereotactic body radiotherapy (SBRT) was prescribed to treat the spot on Devlin’s lung. This treatment uses machines to perform image-guided radiation therapy, allowing oncologists to deliver focused radiation to tumors in different parts of the body. The SBRT cleared that spot as well as a subsequent one that popped up in January 2020. Devlin’s had clear scans ever since.
Though her scans don’t show signs of cancer, Devlin is clear that she lives with stage four cancer. She says that its part of who she is — going in for regular scans and lab work while living with a chronic illness.
“I don’t let it rule my world in any way,” she said. “A lot of the time you might think of a chronic, debilitating illness that keeps you at home. I’m the face of someone living with stage four cancer, but it doesn’t define who I am at all. I never want it to.”
Both King and Huerter know that having a colonoscopy following her primary care physician’s recommendation saved Devlin’s life. The fact that she didn’t put it off allowed the screening to catch her colon cancer, making treatment possible. Huerter is optimistic about her prognosis.
“Andria is not only alive, she’s doing amazingly well with no evidence of cancer. Only 15% of people who are diagnosed with stage four colon cancer are alive at the five year mark,” he said. “My hope is that she’ll live many, many years before she needs treatment again. If and when she does, she certainly has lots of treatment options available.”
Cancer care close to home
Because of the LMH Health Cancer Center, patients in Lawrence don’t have to travel far from home to receive cancer treatment.
“I’m alive today because of how my body responded to the chemo and because of the care my team provided,” Devlin said. “Dr. Huerter saw me as a human, a mom and a teacher in our community. He wanted to know about my family, spent the time to get to know us and then we talked about my cancer. He didn’t see me just as my disease.”
The Cancer Center holds accreditation from the Commission on Cancer, which is a recognition of the quality care that it offers patients.
“This accreditation provides assurance that the institution you’re at provides multidisciplinary cancer care that’s held to the highest standard,” Huerter said. “It ensures accurate and appropriate diagnosis and treatment of your cancer.”
Today, Devlin works as the director of early childhood education at the Lawrence Arts Center. She and her husband, Brandon, are parents to a college student and a senior at Free State High School and are looking forward to the future.
“Cancer isn’t a death sentence, but it puts time into perspective. You see how important your hours are when you’re told you have cancer, sometimes even your minutes,” she said. “I’m really thankful for everyone in the LMH Cancer Center. When you’re told you have cancer, you think you’ll do anything or go anywhere for treatment. I could have gone anywhere, but my best care was right here in our own backyard.”
— Autumn Bishop is the marketing manager and content strategist at LMH Health, which is a major sponsor of the Journal-World’s Health section.