Cancer down under

Colorectal screening saves the life of Kalispell woman

Mary Fleming-McMillan of Kalispell received a one-of-a-kind Christmas gift from her brother, artist Jeff Fleming, last year.

It wasn't one of his famous carved bears. But it expressed his brotherly love beyond any material possession.

It was a promise to pay for a colonoscopy, the gold standard of colorectal disease screenings.

"It was really cute," she said with a laugh.

For Fleming-McMillan, the gift represented peace of mind that her rectal cancer had not returned. She shared her story to promote March as colorectal cancer screening month.

Her ordeal began about five years ago when she went to her annual exam with nurse practitioner Janna Sullivan at the Northwest Women's Health Care in Kalispell. She was a little concerned about blood that she had noticed in her stools.

"She (Sullivan) said you're 40 now so it's time to do a rectal exam," Fleming-McMillan recalled.

While performing the digital exam, Sullivan immediately felt the tumor. But as a veteran of several Pap test cancer scares, Fleming-McMillan wasn't worried.

She was referred to Dr. Craig Harrison, a Kalispell gastroenterologist. Fleming-McMillan couldn't believe that her biopsy showed cancer.

"I was in shock," Fleming-McMillan said.

It was the last thing she expected as an extremely fit woman devoted to a healthy lifestyle. At the time, she worked at The Summit, signing up like-minded people for memberships.

Then she got angry.

"It really ticked me off," Fleming-McMillan said. "My whole life was turned upside down."

The news got even worse.

Because her tumor was low and appeared to share a blood vessel with her lymph nodes, conventional surgery would leave her without an operable sphincter muscle to control bowel movements.

As a single woman, she couldn't imagine a dating life with a colostomy bag. Yet, as a divorced mother with three children, Fleming-McMillan had a strong will to survive this potentially deadly cancer.

"It was like I'm not going to let this kick my butt," she said. "I just didn't believe I was going to die."

Fleming-McMillan began looking for options. Fortunately, local oncologist Dr. Karen Hunt found one for her with a treatment offered at the University of Washington Medical Center in Seattle.

With financial help from Wings, Fleming-McMillan flew to Seattle to meet with a surgeon.

"He took one look and said 'I can fix that,'" she recalled.

But first she went through a protocol of chemotherapy and radiation in Kalispell to shrink the tumor and kill cancer cells.

During the chemo treatment, Fleming-McMillan wore a bag and pump 24-7. She recalls people asking about the device when she shopped.

"I'd say that's my tequila drip bag," she said with a laugh.

Her treatment provided little else to laugh about.

While the chemo left her fatigued, her body reacted so adversely to radiation that she had to quit the treatment a week early.

After six weeks of healing, Fleming-McMillan went to Seattle in September 2001. She was worried about more than surviving the surgery.

Even with the new surgery, she knew she might wake up with a colostomy bag if cancer was apparent in her lymph nodes. A right-side bag meant temporary, and a left-side one was forever.

During the procedure, the surgeon removed the diseased section of the rectum to spare the sphincter muscle. He then formed a loop in her colon, create a "J pouch" to reduce urgent and frequent bowel movements.

In the anesthetic fog after surgery, Fleming-McMillan recalls grasping for the bag. Relief flooded through her as she touched a temporary ileostomy bag installed on her right side.

Three days later, pathology confirmed that her lymph nodes were cancer-free.

But her trials far from over. She spent a week in the medical center recovering as her abdomen swelled as if she were pregnant.

"I was stapled from here to here," she said, marking a 6-inch-long incision down her abdomen.

Recovery at home was no picnic, either, as she coped with the ileostomy bag while she healed.

Because her bladder was desensitized, Fleming-McMillan also had to catheterize herself at home for two months until her bladder began working again.

"Nobody tells you that stuff," she said. "I wish I could have talked to someone else beforehand. I'd never had any kind of surgery."

With the help of ostomy nurse Marilyn Eberly, Fleming-McMillan obtained a bag that fit her properly after some embarrassing accidents.

"She was so awesome," she said.

When she was healed up, local surgeon Dr. James Bonnet reversed the operation and Fleming-McMillan became bag-free. By spring, she was back to her exercise routine and put the experience behind her.

She said she never feared the return of her cancer or ruminated about why she came down with a cancer most common in men 70 years of age and older.

"I'm not the type of person that dwells on those kinds things," she said. "I consider myself a success story."

Because of her experience, Fleming-McMillan's family got screened for colorectal cancer. They all received a clean bill of colon health.

According to national statistics, only 40 percent of eligible men and women undergo these life-saving screenings. Each year, 135,000 people are diagnosed with colorectal cancer. Of those, 56,000 die because they failed to take advantage of screenings that make colorectal cancer one of the most preventable and survivable with early detection.

The National Colorectal Cancer Action Campaign recommends testing for everyone 50 and older. Types of screening include:

-Fecal occult blood test (stool test): Recommended every year, this screening places a small stool sample on a test card to check for blood. Home kits are available.

-Flexible sigmoidoscopy: The doctor uses a short, thin, flexible, lighted tube to check for polyps and cancer. Recommended every five years.

-Colonoscopy: A physician uses a long, thin, flexible lighted tube to find and remove most polyps and some cancers. Recommended every 10 years.

Recommendations vary for people with family histories of colon cancer, unusual findings during screening tests or symptoms that include:

-Blood in or on your stool.

-Pain, aches or cramps in your stomach that occur frequently with no explanation.

-A change in bowel habits, such as having stools that are narrower than usual.

-Unexplained weight loss.

Anyone experiencing any of these symptoms should consult their health-care providers.

Fleming-McMillan urges people to not fear such screening tests as the colonoscopy she completed recently with Dr. Harrison.

"The worst thing about it is the laxative stuff you drink that cleans you out," she said with a laugh. "It's not painful."

She also urges women not to forego their yearly Pap tests or resist digital exams. Fleming-McMillan believes she wouldn't be here today without that digital exam.

"Janna Sullivan saved my life."

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com.