August 13, 2019
When it comes to her health, 23-year-old Rebecca Buseman is experienced beyond her years. Diagnosed with ulcerative colitis at age 5, she has spent countless hours visiting doctors and gastrointestinal specialists, looking for ways to alleviate the symptoms of this painful condition. So when physicians diagnosed the college senior with colon cancer in October 2015, she was ready for the fight.
“In the back of my mind, I knew this was something that I may have to deal with someday,” Becky says. “It was a big blow but one I was, oddly enough, ready for.”
Growing with care
She was ready because she understood the risk.
Ulcerative colitis, a chronic disease that causes inflammation and ulcers in the lining of the large intestine, takes its toll on the body. And Becky’s case was difficult to manage. She received biologic injections and a variety of medications through the years, but the allergic reactions Becky had to many of the standard medications added a host of challenges to her treatment.
Her sister, who is a physician, cautioned Becky that patients with poorly controlled inflammatory bowel disease face an increased risk for colon cancer. Becky was vigilant about checkups and colonoscopies.
The condition has played a pivotal role in Becky's life. Yet her recollections of childhood and young adulthood are mostly positive – spending time with her Overland Park family and friends, playing games, watching movies and just being a kid. She hesitates to say she was a “sick kid” but admits the ups and downs were challenging.
“It’s been a roller coaster,” she says. “I was pretty sick most of elementary school and then I was better for a time and then things flared up again.”
During one of the “up” periods last year, Becky studied in Japan. It was a lifelong dream that would be followed by a big “down.” A couple months after returning home, Becky experienced severe stomach flu-like symptoms and weakness. Her parents drove to her Manhattan, Kansas, apartment and brought her home. Initially diagnosed with a bacterial infection, a follow-up colonoscopy revealed a large tumor at the junction of Becky’s sigmoid colon and rectum.
A life-changing diagnosis
The diagnosis was stage 3C colon cancer. The tumor measured 9 cm and had spread to 10 surrounding lymph nodes.
“It was a fast-growing, locally advanced cancer with a high risk of recurrence,” says Raed Al-Rajabi, MD, medical oncologist with The University of Kansas Cancer Center. “This was a complicated case that required collaboration across several areas.”
A multidisciplinary tumor board met to discuss Becky’s case. Physicians agreed she should undergo a subtotal colectomy (a procedure to remove the majority of her colon), followed by chemotherapy every 2 weeks for 6 months.
Becky met with John Ashcraft, DO, a colorectal surgeon with the cancer center, who recognized time was of the essence.
“It was a big, aggressive tumor in the context of colon cancer, especially for someone who has regular screenings,” he says. “The colectomy was the best way to remove the tumor and also greatly diminish the chance of recurrence.”
The road to healing
Dr. Ashcraft laparoscopically removed most of Becky’s colon and created an ileostomy – an opening in her abdomen that allows the small intestine to remove waste from her body into a bag.
The surgery was a success, and Becky began the next phase of her journey. Living with an ileostomy has been a big adjustment. But Becky’s years of health flare-ups have given her strength when she hits a hurdle. She vigilantly watched and learned from her ostomy care nurses. And within weeks of recovery, she was testing the waters, literally, swimming with visiting family and friends.
In December 2015, Becky began chemotherapy. She finished treatment in May 2016 – the same month she completed her marketing degree and graduated from Kansas State University.
Becky measures her milestones in great company. Her family has taken every step of her journey by her side.
They accompanied her to her appointments, stayed by her side in the hospital, helped her navigate treatment and adapt to the ileostomy, and supported her decisions along the way.
“I don’t think I can quite describe how important a role they have played in my life,” she says. “They are there for me always.”
Now, she is excited to be regaining a measure of health for the future – a future in which family will remain a strong focus. Because chemotherapy and radiation can cause infertility, Becky met with Courtney Marsh, MD, MPH, a reproductive endocrinologist, to harvest and freeze some of her eggs prior to surgery.
“It was important to me that I still have the opportunity to try to start my own family someday,” she shares.
As she moves forward, ulcerative colitis, for the first time, is not a factor since her colon has been removed. In the future, she may even be eligible for surgery to reverse her ileostomy. Right now, she focuses on healing and learning a new “normal.”
“I’m starting the next chapter of my life. At this point, I’ll continue pushing forward and working toward the same goals I have always had. It’s just taking a little extra work to get there.”