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The Cutting Edge - Rectal cancer and the power of endurance

Cutting Edge Spring 2012

Rectal cancer and the power of endurance

Date: March 1, 2012

Despite her grueling ordeal, Suzanne Merrill is on the mend and has no regrets about her decision to soldier through treatment.
Despite her grueling ordeal, Suzanne Merrill is on the mend and has no regrets about her decision to soldier through treatment.

When she heard the diagnosis–cancer–the first thing Suzanne Merrill thought was, I’m going to die.

It scared me to death,” says Merrill, 65, who was diagnosed with Crohn’s disease as a young adult and underwent one operation 25 years ago to correct intestinal problems associated with the condition. For years afterward she lived in good health. But in February 2011, she found herself back in her gastroenterologist’s office, complaining of pain and discomfort. After some testing revealed a possibility of rectal cancer, her physician sent her for further testing at The Johns Hopkins Hospital, under the care of gastrointestinal surgeon Jonathan Efron.

She would need extensive surgery to remove the tumor. Unfortunately, Merrill’s condition was such that the cancer had compromised other areas as well, so her operation would also require participation by a urologist and a plastic surgeon. But first she’d need 30 days of intensive radiation. The location of her tumor, she says, made the radiation even more difficult. “When I finished, I didn’t even want to have the surgery,” Merrill says. “I didn’t realize that I’d hardly be able to walk. It was horrible and one of the hardest things I’ve ever gone through.”

When she says she considered not having the operation, Merrill isn’t being dramatic. Aside from the challenges associated with radiation, she was also hesitant because the surgery would require that she receive a colostomy—something she did not want. But when she began expressing her reservations to Efron, the surgeon was adamant that the procedure wasn’t just important—it was vital. “They thought if I didn’t have it, I wouldn’t survive,” Merrill says.

It’s not unusual, Efron explains, for patients to feel hesitant, especially about the prospect of getting a colostomy. But, he continues, for Merrill, the alternative would have been fatal. “It was just a matter of time so that she could come to terms with it,” he says.

After much indecisiveness and back and forth, Efron told her that a decision needed to be made. From booking an operating room to coordinating schedules, planning the surgery would be a time-intensive undertaking, and the sooner they got started, the better. Ultimately, Merrill decided to go ahead and do it.

The surgery took place in September and required 12 hours to complete, with Efron joined by surgeons from urology and plastics. Not only did the surgeons need to remove the tumor, but Merrill had also developed fistulas that needed to be repaired, and the surrounding area needed to be reconstructed. She spent the next week in the hospital recovering, only to return again after developing an infection.

Every day, she says, Efron came to visit her, even on the weekends, and he always had time to answer her questions. “When I’d get upset, he’d say, ‘Don’t cry, you’ll make me cry,’” she recalls. “I’m so glad I found Dr. Efron.”

Finally, after another week in the hospital, she was able to return home for good. Today, Merrill is still recovering from the difficult procedure. But, she says, she’s getting stronger every day, and her physicians have said she’s cancer-free.

“I’m so happy I made the decision to go through with it,” she says. “It’s all turning out OK now.”

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