Symptoms and a screening save Bryan's life
Bryan Bromley has a loving wife, three dogs, a collection of vintage motorcycles and even a Tiki bar in his home – a tribute to his late grandfather who was a skilled Polynesian entertainer. A healthy, strong 47-year-old, Bryan was a less than likely candidate for what would turn out to be colorectal cancer.
Bryan’s odyssey began with a streak of blood on toilet tissue, a symptom of many conditions, ranging from harmless hemorrhoids and anal fissures to serious illnesses, including colorectal cancer. In early November 2017, Bryan’s primary care physician referred him to Harvinder Sahni, M.D., gastroenterologist affiliated with MemorialCare Orange Coast Medical Center, who performed a colonoscopy, a visual examination of the colon and rectum using a tiny camera at the end of a flexible tube. A mass measuring eight-and-a-half by eight centimeters was found in Bryan’s lower rectum and biopsied on the spot. By the time Bryan awoke from the procedure, a cancer diagnosis was confirmed.
Then, Jack Jacoub, M.D., oncologist and medical director of the MemorialCare Cancer Institute at Orange Coast Medical Center, joined Bryan’s medical team, and an aggressive treatment plan began to take shape. Chemotherapy and radiation would be used to shrink the tumor, followed by surgery to remove the remaining mass and surrounding tissue.
After four months, the treatments reduced Bryan’s tumor to half its original size. He consulted with Tam Le, M.D., general and colorectal surgeon, who specializes in robotic-assisted surgery, an advanced minimally invasive surgical method.
“The surgery to remove all or part of the rectum can be difficult,” says Dr. Le. “The robotic-assisted surgery is a highly effective, safe and less invasive procedure, yet in this country, only 15 percent of proctectomies are done this way. I’ve been performing robotic surgery since 2011, and I wouldn’t do it any other way.”
Robotic-assisted surgery has numerous advantages for both patient and surgeon. For patients, smaller incisions mean less pain, a shorter hospital stay, optimal outcomes and faster recovery. For surgeons, the advantages of using robotic arms include greater precision and increased visualization, especially when working deep inside a narrow pelvis. One robotic arm carries a tiny, three-dimensional camera that illuminates and magnifies the target area. The other arms bear multi-articulated surgical instruments that give the surgeon enhanced dexterity and control. The result is precise removal of targeted tissue with less damage to the healthy tissue and blood vessels around it.
On March 9, 2018, Dr. Le successfully removed Bryan’s rectum, including the malignancy, nearby lymph nodes and enough surrounding tissue to minimize the risk of recurrence. He attached the remaining colon directly to the anus to preserve normal function.
“There’s a high incidence of leakage while the surgical connection is healing, so we protect it with a temporary procedure called an ileostomy,” says Dr. Le. “We disconnect the ileum, the bottom of the small intestine, from the top of the colon, and we pull it through a small incision in the abdomen to form what’s called a stoma, an opening through which waste can be collected. When the colon is healed – usually about three months later – we reverse the ileostomy and allow the waste to pass through normally.”
After aggressive treatment for colorectal cancer, Bryan found peace during his recovery by redecorating various corners of his home in a Tiki theme and maintaining his motorcycle collection. Though he is still in recovery, Bryan continues to maintain a positive outlook. “I am so fortunate that I was surrounded by people who had the skill and patience to put me back together,” says Bryan.
Colorectal cancer is not a disease typically associated with youth. The risk of colorectal cancer increases with age, but it can occur in younger adults and even teens. In fact, 10 percent of new patients are under the age of 50 and, because of their youth, they’re often misdiagnosed. However, in the past two decades, the incidence of this form of cancer has been increasing – especially in people aged 45 to 49. As a result, the American Cancer Society now recommends that people of average risk begin screening at age 45 instead of 50. In addition to the routine colonoscopy, there are now reliable stool-based tests. When caught early, colorectal cancer is 90 percent treatable.
For more information on our cancer services, visit memorialcare.org/cancercare.
Look for our upcoming Colorectal Cancer screening this March in our next issue. Scan this QR code to listen to Dr. Ashkan Farhadi’s podcast on Keeping Your Colon Healthy or visit memorialcare.org/podcasts.