The right team at the right time
Many consider colorectal cancer a disease that affects older people. But at 27, UK researcher Ronnie Wu received the diagnosis – and the complex, specialized care he needed to take on a fast-growing cancer.
For about a week in May 2020, UK chemistry doctoral student Yueming “Ronnie” Wu felt a little off – some stomach pains, constipation.
But the 27-year-old’s mild discomfort rapidly turned into full-blown illness. He took himself to UK Albert B. Chandler Hospital’s Emergency Department, where he was seen by Dr. Andrew Bernard, UK division chief of acute care surgery and trauma. Bernard immediately ordered tests to rule out common health issues, like gallstones or indigestion.
Wu’s pain worsened and his abdomen became distended. Further testing showed a narrowing in the colon, and he needed to go into surgery.
The Sanders-Brown Center on Aging researcher, who had no family history of cancer, was diagnosed with a worst-case scenario: advanced colorectal cancer that had eroded through the wall of his colon and had spread to the lining of his abdominal cavity.
“The fact that I had cancer totally flips my world upside down physically and emotionally,” Wu said. “I’m shocked and I’m scared, but I choose to face it with a positive attitude.”
With the UK Markey Cancer Center in the next building over, Wu could meet with his oncology team and start treatment immediately.
Eradicating the cancer
After recovering from his surgery, Wu began treatment with Markey medical oncologist Dr. Zhonglin Hao and hematology/oncology fellow Dr. Janeesh Veedu.
Though colorectal cancer is often considered a disease of the older population, the number of cases happening in people younger than 50 has risen sharply in the past 30 years. Hao and Veedu say that 12 percent of diagnosed colorectal cancers now occur in people under 50.
Hao and Veedu chose a variety of chemotherapies to target Wu’s disease. Halfway through his six-month chemotherapy schedule, Wu had a follow-up CAT scan and a colonoscopy. The result? The treatment was working and the tumor had shrunk.
That news led Wu to meet the team of doctors who would take him on to the next phase – a second major surgery to try to fully eliminate the cancer from his body.
The power of HIPEC
In October 2020, Wu met with Markey surgeons Dr. Sandra Beck and Dr. Prakash Pandalai to determine if he would be a candidate for cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, commonly known as HIPEC.
During this procedure, the surgery team first cuts out any sites of remaining visible cancer within the abdominal cavity. Once that step is complete, HIPEC begins: two catheters are placed in the abdomen to create a circuit with a machine designed to heat the chemotherapy in the abdomen to 103 degrees. One catheter pumps the heated chemotherapy into the abdominal cavity, while the second catheter brings it back into the machine. This circuit can run anywhere from 30 to 90 minutes depending on the type of chemotherapy used. In essence, it “washes” any remaining microscopic disease with the hot chemotherapy, with the goal of killing any lingering cancer cells.
“When we got the results back after the surgery, it was a home run.”
Dr. Prakash Pandali
“It’s highly effective at killing the cells we cannot see,” Pandalai said. “This is a treatment that’s not offered in many places, and we specialize in it.”
The goal of chemotherapy prior to CRS-HIPEC is to shrink as much of the tumor as possible, making it easier for the surgeons to then try to fully eliminate the disease.
In February, Wu underwent the lengthy CRS-HIPEC procedure with Beck leading the surgical resection and Pandalai in charge of the HIPEC portion.
“When we got the results back after the surgery, it was a home run,” Pandalai said.
A bright future
Right now, Wu’s prognosis is good. After the CRS-HIPEC procedure, he is now considered NED – no evidence of disease. He will continue to receive scans on a regular basis to look for any recurrence.
Hao has added an even more precise way to monitor Wu: a blood test called the Signatera QNS test. It looks for substances in the blood that colorectal cancer may produce – and would find this warning sign earlier than a scan.
Wu also has some optimistic advice for patients who find themselves in a similar situation.
“When you have symptoms, don’t ignore it,” Wu said. “Trust your doctors; they know what they are doing. Believe in the technology, medicine and the science.”