Changing the colorectal cancer story

“I was very optimistic when I went in for the CT scan after the surgery. The operation had gone well and I was fully expecting positive news. Instead my doctor told me that the cancer had come back.” Faced with this latest blow, Eve drove home, trying to figure out how she was going to say goodbye to her 8-year-old twin daughters.

Eve’s journey is familiar to anyone who has experienced cancer. The illness that kicked off her long fight all those years ago at first seemed innocuous.

“I was travelling to a political event in Des Moines, Iowa with a friend. I’d had stomach aches for a while, but as a woman I thought it was a feminine issue and didn’t think too much about it. Unfortunately, on the plane ride there, the pain in my belly became so excruciating that, as soon as we landed, I went straight to hospital.”

After being told that she was experiencing constipation and prescribed laxatives, Eve was discharged from hospital and carried on with her trip. “I walked the precincts in the snow in Iowa, went to the hospital in the day and went to political events at night.” Meanwhile, she was getting sicker and sicker.

The air pressure of the plane ride had caused the tumour to block the entirety of Eve’s colon. “I was only 40 years old, I had no history of cancer in my family and I was far from home. It was a big shock–not a good way to find out that I had this very scary disease.”

Although rarer at Eve’s age, (the median age of diagnosis for colon cancer is 68 in men and 72 in women, and for rectal cancer is 63 for both),1 colorectal cancer is one of the most common forms of the disease. Indeed, it is estimated that 1.8 million people around the world are diagnosed with colorectal cancer every year.2

For Eve, life changed forever in that Des Moines hospital, and what followed was a long journey that she still finds herself on today. Initial surgery to remove part of her colon went well, but a year later she found out that her cancer had spread to her ovaries.

Eve’s cancer had moved on from Stage 3, where it was initially in her colon and local organs, to Stage 4, where it had spread to distant parts of her body.3 Like Eve, 1 in 5 people with colorectal cancer do not discover their disease until it has become metastatic4 – the point at which the cancer has spread throughout the intestine or even to other organs, thereby making it more difficult to treat.3

Since then, Eve has been on many different treatments and has also been on clinical trials, at the forefront of medicine. “Since the day that I woke up in Des Moines, my journey has been extensive and exhaustive. I’ve had 47 surgeries and had every dispensable organ removed. I’ve been given every form of chemotherapy. I’ve had targeted treatments and I’ve been on clinical trials.”

For most people with advanced colorectal cancer who do not respond to earlier lines of therapy, treatment options are limited. In fact, for people whose disease has progressed after receiving two rounds of treatment, nearly half of those in Europe and the US will receive no further treatment at all.5,6 Eve’s example, however, demonstrates that further treatments may make a meaningful difference to patients’ lives, even if others, such as chemotherapy, have failed along the way.

Eve is now doing what she can to address this, and other issues, in a professional capacity, working for a life sciences trade association in California helping provide access to new treatments for patients. “As I battled with cancer I realised in my heart that I wanted to do something that would help people with the disease, to help them get treatments that could keep them with their families and keep them fighting. I’m not a scientist, but I can use the experience that I have gained through my career to help others get access to innovative drugs, such as cancer immunotherapy.”

Through all of the treatments and emotional ups and downs, Eve remains incredibly positive. “My twin daughters are aged 14 and they continue to be my inspiration to live. I’ve got to stay around to make their lives miserable – being a teenager wouldn’t be any good without a mom to embarrass them!”, she jokes.

“The fact is, I may never go into remission, but if my cancer can turn into a chronic illness, that’s pretty good. In fact, it’s great.”

At Roche we have a long heritage of working in colorectal cancer and our mission is focused on finding the ‘next thing,’ such as cancer immunotherapy , that could give people like Eve a chance to spend more time with their loved ones. Our research continues.

References

1. ASCO Cancer.Net [Internet; cited 26 April 2019.] Available from:

2. WHO [Internet; cited 26 April 2019.] Available from:

3. ASCO Cancer.Net [Internet; cited 26 April 2019.] Available from:

4. Riihimaki M, et al. Patterns of metastasis in colon and rectal cancer. Scientific reports. 2016;6:29765.

5. Abrams TA, et al, Chemotherapy usage patterns in a US-wide cohort of patients with metastatic colorectal cancer. J Natl Cancer Inst. 2014; 106(2):djt371.

6. Tampellini M, et al. Treatment of Patients with Metastatic Colorectal Cancer in a Real-World Scenario: Probability of Receiving Second and Further Lines of Therapy and Description of Clinical Benefit. Clin Colorectal Cancer. 2017; 16(4) 372–376.