Just before her 71st birthday, Augusta County resident Ruth Botkin was diagnosed with Stage 3 colorectal cancer after a complete bowel blockage diagnosis. Three of six lymph nodes resected were found to be cancerous – and Botkin had ostomy surgery, which allows waste to be rerouted.
While talking about this condition isn’t always easy, it is important. Colorectal cancer includes colon and rectal cancer and recently made headlines as the cause behind the celebrity deaths of Kirstie Alley, Quentin Lee and Chadwick Boseman, as well as Congressman Donald McEachin.
Botkin’s daughter, Melissa Howell, 42, of Staunton, said her mom had dealt with ulcerative colitis since her early 40s. At that time, her mother had insurance and had regular screenings. But when her mother’s situation changed in the early 2000s, and she didn’t have insurance, she wasn’t able to afford the medications or continue treatment for the condition. Her mom was later diagnosed with diabetes and received financial assistance for treatment – but did not do anything to address the colitis.
Howell said her mom had symptoms that were consistent with her ulcerative colitis diagnosis: diarrhea, constipation, stomach cramps, bloody stools and frequent bathroom trips.
In 2020 or 2021, Howell said her mom’s symptoms started changing: she needed to go to the bathroom but couldn’t, and her poop consistency changed.
“I remember expressing to her in early 2021 that she needed to ask her PCP (primary care physician) about these changes,” Howell said. “She just chalked it up as it’s part of the colitis, and it wasn’t a big deal. “
According to the Mayo Clinic, there may be no symptoms in the early stages of the disease.
Some of the signs and symptoms may include:
- A persistent change in your bowel habits, including diarrhea or constipation, or change of consistency of your stool
- Rectal bleeding or blood in your stool
- Persistent abdominal discomfort, such as cramps, gas or pain
- A feeling that your bowel doesn’t empty completely
- Weakness or fatigue
- Unexplained weight loss
The breaking point
In October 2021, Botkin’s cramps became so severe that she finally decided to go to the emergency room. She thought it was a simple fix that a laxative could help. But, after some testing, the hospital discovered the blockage, and she was diagnosed with obstruction of the colon. She had rectal resection surgery the next day and was given an ostomy.
“Given her lack of medical attention and treatment for the ulcerative colitis, I mean, what can you say? I was like, ‘Okay this is her diagnosis, this is why, what’s the treatment plan to move forward?’ There was no changing the outcome, and no reason to look at the past to everything that she should have done or she needed to do,” said Howell, a life and mindset coach.
“The present moment and moving forward was the only thing to look at. I told her to feel however she needed to feel, and release it, and then be ready to move forward. It was a solution mindset for me, and I think it helped to pull her into the same mindset, at least when she was with me.”
Botkin’s treatments have taken a toll on her body: radiation and multiple rounds of chemotherapy.
“The chemotherapy for her was a proactive treatment,” Howell said, “since all of the cancer was removed during surgery … after the third round, she decided that she did not want to continue with the chemo.”
Botkin still has periodic followups with her doctor and a CT scan every six months. If the next one scheduled for January is clear, the next scan will be in one year. All of her polyps have been removed, so her followup colonoscopy is in one year, Howell said. The hardest part for her mom has been getting used to ostomy.
In the family
Howell said a cousin, Sarah, died in her early 30s from colon cancer that had spread into her lymph nodes.
While Botkin didn’t get the preventative screenings, Howell said, she felt her mom would have been diagnosed with colon cancer at some point, based on her history. The screenings may have discovered the condition sooner, however, and perhaps prevented the ostomy, but that’s impossible to know for sure.
Following her mom’s diagnosis, Howell said that she did a lot of research.
Howell said that she had some symptoms herself over the years, which she ignored. She said in her early- to mid-30s, she had some blood in her stool. She thought it was odd, but it was not consistent and only showed up periodically in the years that followed.
Around the same time her mom was officially diagnosed with cancer, Howell also had changes in her bowel movement.
“But I was dealing with my mom, going to the hospital every day, working my full-time job, and managing my own responsibilities,” Howell said. “So my daily routines and eating habits were completely off.”
When Howell had her annual OBGYN exam later that year, she told the doctor about her mom’s diagnosis and mentioned the blood in her own stools that had become more regular – but not consistent.
Out of precaution, her doctor referred Howell to a gastroenterologist.
“Long story short, given my mom’s recent diagnosis, the change in my stools and the periodic blood in my stools, they scheduled me for a colonoscopy the next week,” Howell said.
The screening found one large polyp, which has now been removed. There were no signs of ulcerative colitis, which was a concern for Howell, since multiple family members, including her mom, had been diagnosed with that at an early age.
Because of her polyp, her doctor encouraged Howell to have genetics testing done. To her relief, the results were negative for changes to her DNA or an increased risk of colon cancer.
To be on the safe side, Howell said, she’ll have another colonoscopy in one year.
The U.S. Preventive Task Force made a recommendation in 2021 that adults ages 45 to 49 should be screened for colorectal cancer due to a recent trend for increasing risk of colorectal cancer in adults younger than 50 years. Previously, the recommendation had been for screenings to start at age 50.
“Maybe the story will inspire others to get checked and know that even the smallest signs in bowel changes should be handled,” Howell said.
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Crystal Graham
