Jessica Dilts had the world in her hand. She’s in phenomenal shape, works out, is a runner, has a good job and is engaged to be married. She is a non-smoker who has always taken care of herself. She was training to run the Detroit Free Press Half-Marathon in 2014 when she discovered blood in her stool. She felt fine but mentioned what she saw to her OB/GYN during her yearly exam and was referred to a gastrointestinal doctor.
Since Jessica was young with no family history of colorectal cancer, the physician she was referred to did not feel she needed a colonoscopy and attributed the blood in the stool to running. Jessica was relieved. She continued her training and ran the half-marathon.
One year later, in late summer 2015, Jessica started to have trouble with bowel movements. There seemed to be a blockage in her colon. Once again, she made an appointment with the gastrointestinal physician she saw a year earlier. This time, a colonoscopy was scheduled. The colonoscopy showed there was a tumor in Jessica’s rectum. Further scans indicated even more devastating news. The cancer had spread to the liver and lungs.
On Oct. 15, 2015, Jessica, who was then age 32, was told that she had stage 4 colorectal cancer. She met with a surgeon who told her that if she had a simple digital rectal exam in 2014, most likely the cancer could have been caught at an earlier stage, possibly before it spread to other organs.
“It’s frustrating. I questioned how this could be happening to me when I did everything right,” said Jessica.
Jessica lives in New Hudson, Michigan, and works as a sales representative for a biopharmaceutical company in a nearby community. She did her research on colorectal cancer and wanted the best expert she could find. Someone she works with gave her the name of a medical oncologist at M.D. Anderson, in Texas, where Jessica went for a second opinion. That physician recommended another medical oncologist in Michigan, Philip Philip, M.D., Ph.D., F.R.C.P., an expert in gastrointestinal and neuroendocrine oncology at the Barbara Ann Karmanos Cancer Institute.
When Jessica returned from M.D. Anderson in late Oct. 2015, she went to see Dr. Philip at Karmanos Cancer Institute’s Weisberg Treatment Center in Farmington Hills, where she has been treated ever since.
Both experts at each cancer center felt that Jessica was not a candidate for surgery, due to the extent of the cancer in her liver. In early November 2015, Jessica began an aggressive chemotherapy regimen and has remained on maintenance treatments ever since. According to Dr. Philip, Jessica has tolerated the treatments remarkably well. Jessica has follow-up scans every three months to track the results of her treatment. Jessica’s recent scans showed that the tumor in her rectum is not visible, the spots on her lungs are extremely small and her liver tumors continue to shrink.
Jessica underwent genetic testing and did not have a genetic marker for colorectal cancer. Her brother Tim, who is two years younger, had a colonoscopy which came out clear.
That was great news for Jessica and her family. However, Jessica realizes with stage 4 cancer she would need to continue treatment for the rest of her life, or until a cure is found.
According to the American Cancer Society, it’s estimated that there will be 95,520 new cases of colon cancer and 39,910 new cases of rectal cancer this year in the United States. Currently, colorectal cancer is the third most common cancer in both men and women. Although colorectal cancer incidence rates have been declining for several years, there has been a spike of about 2% per year among those younger than age 50, primarily due to an increase in rectal cancer. In Michigan, the 2017 estimated rates for new cases of colorectal cancer is 4,660; and estimated deaths is 1,680.
“We have certainly seen over the last 10-15 years an appreciable increase in young patients with newly diagnosed colon or rectal cancer,” said Dr. Philip. “Many of those patients present with stage 4 advanced disease since symptoms don’t often appear until the cancer has spread. Most of those patients are in their 30’s and 40’s but some are in their 20’s. That being said, the incidence of younger adults getting colorectal cancer is still low for screening purposes.
“We seldom see a genetic predisposition in the younger patients, such as the Lynch syndrome, or even a strong family history of colorectal cancers.”
Dr. Philip also stated that when it comes to routine screening, physicians follow the standard of care that calls for commencing screening at age 50 for those at average risk, or earlier if there is a high risk of colorectal cancer. There could be some reluctance to screening a patient who has symptoms, such as rectal bleeding.
“In general, rectal bleeding is more frequently due to benign causes, such as hemorrhoids, than cancer itself. Rectal hemorrhoids are the most common cause of rectal bleeding.”
In Jessica’s case, there were no indicators as to why this disease was diagnosed at such a young age.
“Science hasn’t matured enough to tell us why someone of Jessica’s age develops colorectal cancer. Additional research is desperately needed to help determine why there is an increasing number of young adults being diagnosed with colorectal cancer. At the genetic level, using present day technology, there doesn’t seem to be major differences in the way this cancer appears in young patients compared to older patients.”
Karmanos continues to educate practitioners in the community through symposiums and raises awareness and education for the public through a number of educational activities.
Dr. Philip added, “Physicians who care for young patients who are confronted with symptoms that may suggest colorectal cancer must carefully decide whether or not to do certain tests, such as a colonoscopy, to rule out the disease. Such patients would also benefit from a multidisciplinary team approach by colorectal cancer experts, and special care should also be considered for the patient’s psychosocial needs, which could be very different than the average colorectal cancer patient in their late 50’s and 60’s.”
Now age 34, Jessica looks back at her experience and feels fortunate. Other than losing her hair, she has been able to tolerate the treatments. Jessica would take a couple of days off work following her aggressive treatments and return to work the rest of the week. Her boss has been extremely supportive and so are the people she works with. Jessica’s fiancée Aaron Cash has been with her every step of the journey and the support of family and friends, as well as so many others Jessica has met since being diagnosed, has been heartwarming.
“This journey has really been incredible,” said Jessica. “The outpouring of love and support has been amazing. The medical team at Karmanos is like family and I’m so grateful for their compassion and expertise.
"I never imagined this but being diagnosed with cancer has, in a way, made me like a new person. It’s opened my eyes to the world and changed how I look at things. My appreciation for the simplest everyday activities we so often take for granted now bring joy and fill my heart with gratitude. I feel so blessed.”
Jessica’s experience has led to her new passion – raising awareness of colorectal cancer. She is willing to do whatever she can to help promote the importance of prevention and early detection. She is an ambassador for Fight Colorectal Cancer and helped secure Michigan as a Blue Star State, recently receiving a State of Michigan proclamation from Governor Rick Snyder proclaiming March 2017 as Colorectal Cancer Awareness Month in Michigan.
Jessica also plans to participate in this year’s Scope It Out 5K run/walk events in Texas and Detroit to raise funds for colorectal cancer research.
“The more we can share about this disease the more we can help others survive it and remain healthy,” said Jessica.
“No one is guaranteed tomorrow, even those not diagnosed with metastatic cancer. If sharing my story can save one life, it’s worth it.”