July-September, 2003

Women's Health

Marjory Stiles: running away from colon cancer

Marjory Stiles, a 57-year-old avid runner, former 33-year staff fixture at the Springfield Family YMCA and colon cancer survivor, is her husband’s hero.

“She’s always lived life to the fullest, but even more so since her diagnosis.                        

Marjory has a unique way of putting things behind her and moving on with life. She never felt sorry for herself, never dwelled on her illness. Her attitude is that life’s too short for that,” Jim Stiles says. His first wife, whom Marjory was acquainted with, died of cancer in the early 1980s. 

After eating blackberries she’d picked from a relative’s home in West Plains one afternoon in July 2000, Stiles vomited all night. Her husband convinced her to go St. John’s Regional Health Center’s ER early the next day, where she saw St. John’s ER physician Patrick Conner, M.D. She was diagnosed with advanced colon cancer that afternoon.

“I was in shock that I had cancer. I didn’t even cry because I was in denial, and it all happened so fast. When she heard the news, my twin sister Marilyn said she just couldn’t believe that I could have cancer, since I was so healthy, and a runner. My doctor said that I had probably had the cancer for awhile, maybe even a few years. My stomach had been hurting on and off for a long time and I just ignored it. Runners tend to ignore pain anyway, and I must have a high tolerance for it,” Stiles says.

St. John’s surgeon Nicholas Shoults, M.D., performed surgery the next day –  July 15, 2000 – to remove the diseased portion of her colon and perform a colostomy. A colostomy is a surgical opening through the abdomen to provide a new path for waste elimination to let the colon heal after surgery. An incision is made in the abdomen and the affected part of the colon is located. The surgeon clamps the colon on both sides of the diseased portion and then removes it. One end of the colon is then brought out through a separate incision in the abdomen and sutured in place. The other end remains clamped off.

When the surgery is completed, the patient has an ostomy and a stoma. The ostomy is the opening created in the abdomen, and the stoma is the end of the colon that protrudes through the skin. A bag, commonly called a colostomy bag, is used to catch the waste from the stoma and must be emptied several times a day.

After her surgery, Stiles spent a week at St. Johns Regional Health Center, then about six weeks recovering at her home in east Springfield.

“I sat in my recliner and my husband and Marilyn, who lives right across the street from me, waited on me like a queen,” she laughs. “I would have never have gotten through this if it weren’t for them. My husband stayed with me all day and my sister stayed with me all night. I started walking around my neighborhood about three weeks after surgery, but I didn’t run again for almost a year, when I ran a one-mile leg of the 2001 Springfield Marathon.”

Stiles’ oncologist, Patrick Gomez, M.D., who practices at St. John’s Clinic – Cancer & Hematology, prescribed a six-week course of radiation therapy, which she received at St. John’s Radiation Oncology department, then a year of chemotherapy. Stiles wore a chemotherapy-administering pump for a few months, then began going to the cancer and hematology clinic for chemotherapy. About half her hair fell out as a result of the chemotherapy, she says. 

“Dr. Gomez told me I probably wouldn’t lose my hair, but it started falling out. So I went to his office and asked him about it and he said, ‘well, you still have more than your husband,’” she says, chuckling. “I bought a couple of wigs in case I lost more, but it stopped falling out.”

A year after her surgery, the colostomy came out and she was declared cancer-free.

“I was so glad to get the colostomy out and overjoyed to hear I was cancer-free. Life returned to normal,” she says.     

Stiles ran a 5K run sponsored by Drury University in the fall of 2001. It was her first complete race since her diagnosis the year before.

Shortly thereafter, she took a part-time job as a “lunch lady” at Pepperdine Elementary School. She transferred to Robberson Elementary after Pepperdine closed.

“It’s a no-stress job and I love it. I love being around the kids and the teachers. It’s a great atmosphere and I could probably stay there forever,” she says.

Stiles returns to Gomez’s office every three months for bloodwork and CT scans to check for signs of cancer and has screening colonoscopies (a visual examination of the colon with a lighted, flexible endoscope) every two years. She eats a low-fat diet that’s high in whole grains, fruits and vegetables and takes calcium and vitamins. She encourages those 50 and older to get screening colonscopies every five years.

Colorectal cancer screening guidelines
Beginning at age 50, both men and women should follow one of the five screening options below:

1. A fecal occult blood test (FOBT) every year, or

2. Flexible sigmoidoscopy every five years, or

3. A fecal occult blood test every year plus flexible sigmoidoscopy every five years, or (Of these first three options, the combination of FOBT every year and flexible sigmoidoscopy every five years is preferable.)

4. Double-contrast barium enema every five years, or

5. Colonoscopy every five years

 
Prevention
Most colon cancers develop from adenomatous polyps. Polyps are precancerous growths in the colon and rectum. Removing them can lower a person's cancer risk.

Diet and exercise: People can lower their risk of developing colorectal cancer by managing the risk factors that they can control, such as diet and physical activity. It is important to eat plenty of fruits, vegetables, and whole grain foods and to limit intake of high-fat foods and to get at least 30 minutes of physical activity five or more days a week.

Vitamins and calcium: Some studies suggest that taking a daily multivitamin containing folic acid or folate can lower colorectal cancer risk. Other studies suggest that increasing calcium intake via supplements or low-fat dairy products will lower risk. Some have suggested that vitamin D can lower colorectal cancer risk.

Nonsteroidal antiinflammatory drugs: Many studies have found that people who regularly use aspirin and other non-steroidal antiinflammatory drugs (NSAIDs such as ibuprofen or naproxen sodium) have a 40-50 percent lower risk of colorectal cancer and adenomatous polyps. However, no randomized trials have yet proven that aspirin-like drugs cause this reduction.

Female hormones: Hormone replacement therapy (HRT) in post-menopausal women may slightly reduce their risk of colorectal cancer. The overall health effect of HRT is a positive one for most women but the decision to take estrogen should be based on discussion of benefits and risks with a physician.