When no one in your family has a history of colorectal cancer and you do not meet age-related screening recommendations, investigating symptoms becomes a crucial avenue to diagnosis — and saving someone’s life.
In 2020, Dan Chamberlin, 46 years old at the time, took what he describes as stomach issues, with blood in his stool, as a sign to contact his primary care doctor, Manu Chander, MD, an internal medicine physician with Endeavor Health Medical Group, who recommended he meet with a gastroenterologist for further tests.
He then met with gastroenterologist Lesley Rhee, MD, who performed an upper endoscopy and a colonoscopy to investigate Chamberlin’s gastrointestinal tract. She found a large tumor in his rectum, and referred him to colorectal surgeon Monika Krezalek, MD.
“Although at the time Dan did not qualify for a routine colonoscopy screen because he was too young, he sought medical assistance because of blood in his stool, pain and other symptoms,” Dr. Krezalek said. “This was a lifesaving step that connected Dan with a team of experts who could guide him through decisions related to his rectal cancer.”
Since then, colonoscopy screening guidelines changed in 2022, with recommendations shifting to start screenings at the age of 45 instead of 50. Those older than 75 should have continued colonoscopies based on overall health, past screening results and life expectancy.
A multidisciplinary team’s guidance
After the colonoscopy, Chamberlin received additional imaging and laboratory tests, including a CT scan, PET scan, MRI and CEA (a carcinoembryonic antigen screen looks for a protein that can be produced by cancer cells). This confirmed a locally advanced rectal cancer without obvious metastatic disease (cancer spread) but with a couple small nodules in the lungs that would be observed over time.
Next, a multidisciplinary tumor board at Endeavor Health, consisting of a team of colorectal surgeons, medical and radiation oncologists, pathologists, radiologists and gastroenterologists, met to discuss Chamberlin’s case. The team, led by Dr. Krezalek and accredited by the National Accreditation Program for Rectal Cancer (NAPRC), develops personalized treatment plans for patients based on the latest evidence-based guidelines.
The board recommended chemotherapy and radiation (total neoadjuvant therapy), followed by surgery.
In July 2020, Dr. Krezalek performed a robotic low anterior resection with a diverting loop ileostomy. The 6-hour surgery removed about 1 foot of Chamberlin’s large intestine and rectum and surrounding lymph nodes. Three months later, the ostomy was reversed.
“Dr. Krezalek is very cautious and methodical,” Chamberlin said. “In all of our conversations, I felt listened to and that she reviewed all the data points. I had multiple doctors giving opinions about the spread and removal of the cancer.”
An isolated blessing
Treatment and surgery happened during the height of the COVID-19 pandemic. For Chamberlin, this was an odd blessing because he didn’t feel like he was missing out on anything, with so many regular events being cancelled. Also, being isolated reduced the possibility of infections. He also was grateful to be able to easily rest and have easy bathroom access for his ostomy needs.
On the other hand, the isolation was a mental weight for Chamberlin. He was worried about the unknown and the impact the cancer and a pandemic would have on his teenage daughter, Noa.
“People would stop by to bring me food or wave through the window. I felt cared for and protected, but I also was completely isolated and alone. This is a good and bad thing when you are dealing with the emotional side of cancer. The hardest part was not knowing what was going to happen.”
Five-year perspective
The surgery took place in 2020. Five years later, Chamberlin is thriving and cancer free.
“Dan had routine surveillance with me and his medical oncologist, Dr. Matt Adess,” Dr. Krezalek said. “His journey is a testament to the power of early detection, expert multidisciplinary care and the resilience of the human spirit.”
It took Chamberlin about 3-4 years to feel like himself, with full strength and stamina. He had physical therapy to restore strength to muscles and functions that were impacted by surgery.
He took care of his spirit in a different way, finding joy in music and attending concerts, sometimes up to five per week. His range went from jam bands, like Phish to My Morning Jacket and Jeff Parker, WSP and Lettuce — to smaller bands and jazz musicians like Bill Frisell and Neal Francis. Chamberlin kept an Instagram account called “@shoesnshows” to memorialize the events; the pictures only showed his shoes at different events.
“I became more of a risk taker since the surgery, and I define myself in other ways than my cancer,” Chamberlin says. “I say yes more, and I don’t hold back. I question why we as a society do certain things. I no longer question if I’m living my life; I know that I am.”
If you or a loved one are due for a colonoscopy or you have pain or discomfort, abnormal bowel movements or other concerns, do not wait — early detection can save lives.
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