ST. LOUIS - At age 43, Joelle Myszka was a healthy and active person who enjoyed regular hikes and yoga with her husband. When she noticed intermittent bleeding while going to the bathroom, she made an appointment with her primary care physician.
“I’m adopted, so I don't know a lot about the medical background of my biological family,” Myszka said. “However, I do know that both my maternal and paternal grandmothers passed away of colon cancer – my paternal grandmother was in her 50s, and my maternal grandmother was 91.”
Armed with this history, her doctor quickly referred her to a gastroenterologist for a colonoscopy, which was scheduled for April 13, 2023. When she awoke from the procedure, she learned a tumor had been discovered that was likely cancerous.
“The doctor couldn’t say for sure what it was. He needed to wait for the pathology report, but he did say he was ‘shocked’ to see what was inside of me,” Myszka said. “Seven days later, I got the call confirming my diagnosis and was told I needed to get into an oncologist and surgeon as soon as possible.”
Myszka was referred to Mercy oncologist Dr. Kavitha Kosuri, who pointed her to Mercy GI surgeon Dr. Kathryn Galie. To make sure she was in the right place, she also met with surgeons at another health system.
“Dr. Galie was incredible and was my clear choice,” Myszka said. “She spent an hour with me and my husband talking through treatment options and learning what my wishes were. It was clear Mercy was the place for me.”
Doctors presented Myszka’s case to the Mercy tumor review board because it was in an area where there was no perfect course of treatment. She continued to weigh her options and, after much research, decided on the transanal excision, or TAE, surgery. While this type of surgery is less invasive and often used in early-stage rectal cancers, there is a potential that radiation and chemotherapy will still be needed
“My tumor was addressed, but the pathology report said there were still a small number of cells left behind, so I would need radiation and chemo,” Myszka said. “Once my body healed from surgery, I started 31 days of radiation in combination with chemotherapy pills, which ended in August 2023.”
Myszka will continue to visit Dr. Galie every three months for the next few years, and regular MRIs will help monitor for any recurrence.
She recommends anyone experiencing even a slight change or minor bleeding to get checked out. And upon deciding where to go for care, she said, “Someone told me, whoever your care team is, make sure you’re comfortable with the decisions they would make for you if you’re unable. Be an advocate for what you want in your care.”
More Younger Patients Are Diagnosed with Colorectal Cancers
According to the American Cancer Society, while the rate of colorectal cancer overall is declining due to increases in screening and changes in lifestyle-related risk factors, rates in those younger than 55 have been increasing by nearly 2% per year since the mid-1990s.
“Consistent with the international trend, I have been seeing an upsurge of young people with colorectal cancer in my own practice,” Dr. Galie said. “Not all of these are caught at an early stage like Joelle; in fact, younger patients’ cancers are more often found at a more advanced stage.”
Dr. Galie said patients with a family history of a first-degree relative with colon cancer (parents, siblings) or – like Myszka – two second-degree relatives (grandparents, aunts, uncles) with colon cancer under 60, are at increased risk and should get screened earlier than average-risk patients. She recommends age 40, or 10 years younger than the age at which the relative was diagnosed, whichever is sooner.
"To go a step further, patients with a first-degree family member with precancerous colon polyps found before the age of 60 should also have their first screening colonoscopy at age 40.” Dr. Galie said. "I also highly encourage everyone, even if younger than the standard colonoscopy screening age of 45, to be mindful of a change in bowel habits and rectal bleeding and pursue medical evaluation if changes are noticed. It could save a life."
