Our representatives are available to schedule your appointment Monday through Friday from 9am to 5pm.
For a Northwell ambulance, call
(833) 259-2367.
Insights
One year, two cancers
Blindsided by a diagnosis of colon cancer and then a finding of breast cancer, Teresa Bermudez has become a believer in the power of screenings
It started with a simple stomachache. But over several days in August 2020, Teresa Bermudez’s discomfort grew to what she calls “howling pain,” until, finally, she went to the emergency department at Mather Hospital.
There, a computed tomography (CT) scan revealed a bowel obstruction — something was blocking food and liquid from passing through her intestines. A medical emergency, a bowel obstruction can cut off the blood supply to the colon and lead to life-threatening complications, such as tissue death and infection.
Bowel obstruction surgery
Bermudez was quickly admitted, and her doctors immediately summoned surgeon Mohamad Abouzeid, MD — who took a look at the results of her workup and knew the situation was even more dire than first understood. “A tumor was blocking her intestine,” he says. “It was obvious she had colon cancer.” Bermudez, then 62, needed surgery, and she needed it fast.
The secretary and mom of two grown sons was shocked at the news and shattered at the thought of what she might leave behind if the worst happened. “I had just become a grandmother for the first time,” says Bermudez, who lives in Yaphank with her husband, Claudio. “I was terrified.”
But Dr. Abouzeid helped ease her fears. “He was incredible,” says Bermudez. “You hear this booming voice coming down the hall and you’re like, ‘Oh, thank God.’ Dr. Abouzeid explained everything so plainly, and never made us feel rushed — he’d just sit in the chair and say, ‘OK, what’s going on?’ I was never afraid to ask dumb questions.”
What is a colostomy?
Less than a week after Bermudez’s trip to the ED, Dr. Abouzeid performed surgery to remove the portion of Bermudez’s colon that contained the cancer. Then, in a procedure called a colostomy, he routed the top end of her colon outside her body through an opening (called a stoma) made in the abdominal wall, with a bag attached to collect the body’s waste.
The colostomy was temporary but necessary to allow her body to heal. Eventually, it would be reversed to allow for normal bowel function.
The operation revealed that Bermudez had stage IIA colon cancer — her cancer had grown through the muscle layer of the colon but had not spread to her lymph nodes. She was lucky. When colon cancer is caught at this stage, the prognosis is excellent, with a five-year survival rate of 91%.
Most patients with stage II colon cancer don’t require further treatment after surgery. But when the cancer obstructs the colon, as in Bermudez’s case, there is a higher risk for recurrence, so after surgery, she underwent six months of chemo treatments. A few months later, in the spring of 2021, Dr. Abouzeid performed her colostomy reversal.
Colon cancer screening
Bermudez felt blindsided by her diagnosis. Sure, her primary care physician had been suggesting for years that she get a colonoscopy to screen for colon cancer. But no one in her family had ever had the disease, so she assumed her risk was low and put off making an appointment.
As she now knows, that assumption was wrong. Colorectal cancer is the second most common cause of cancer deaths for men and women combined, and most cases occur in people without a family history. Regular screenings not only help catch colon cancer when it’s small and easier to treat, says Dr. Abouzeid; colonoscopy can even prevent the cancer from developing in the first place. That’s because in this screening test, a doctor views the entire length of the rectum and colon with a special scope, and can remove any suspicious polyps, or growths. Since polyps can develop into cancer, the exam is detection and treatment, all in one.
“Now I tell people, go when your doctor tells you to go,” says Bermudez. She heeded her own advice when it came time for her mammogram last year, even though she was undergoing treatment for her colon cancer at the time. And she was lucky she did: The test revealed ductal carcinoma in situ, or DCIS. Considered the earliest form of breast cancer, DCIS is a collection of abnormal cells inside a milk duct. DCIS is preinvasive, meaning it hasn’t spread out of the ducts and into nearby breast tissue.
Roughly one in five new cases of breast cancer are DCIS, and nearly all can be cured. In April 2021, Bermudez underwent a successful lumpectomy — a focused surgery in which just the affected duct was removed.
Colon cancer risk factors
Two separate cancers occurring one right after the other can suggest that a person has an inherited genetic vulnerability to developing the disease. But Bermudez’s tests did not reveal any known cancer-causing genes. Instead, doctors believe her cancers were just an unfortunate coincidence — after all, getting older is the most important risk factor for cancer overall and for many individual cancer types. Each year, almost 80% of new colon cancer cases and 70% of new breast cancer cases are in people over 55 years old.
The following factors can also increase your risk of developing colorectal cancer:
- Gender — Men have a slightly higher risk of developing colorectal cancer than women.
- Family history — Colorectal cancer may run in a family among first-degree relatives or other family members.
- Inherited conditions — About 5% of people who develop colorectal cancer have inherited gene mutations that cause family cancer syndromes, including Lynch syndrome and familial adenomatous polyposis (FAP).
- Inflammatory bowel disease (IBD) — People with IBD have a higher risk of colorectal cancer.
- Adenomatous polyps — Many polyps are not cancerous, but certain types, called adenomas, can develop into colorectal cancer over time.
- Race — African-Americans have the highest rates of non-hereditary colorectal cancer in the United States, while those of Ashkenazi-Jewish descent are at higher risk for hereditary colorectal cancer syndromes.
- Obesity and physical inactivity — People who are overweight or lead a sedentary lifestyle may have an increased risk of colorectal cancer.
- Nutrition — A diet that's high in red meats and processed meat could raise your colorectal cancer risk.
- Smoking — Those who have been smokers for a long time are more likely than nonsmokers to develop colorectal cancer.
What to do when you are diagnosed with colon cancer
Watch expert physicians from Northwell Health Cancer Institute discuss what patients should know about colon cancer, including care options and common misconceptions about the disease.
A bright future
Today Bermudez is cancer-free. Her doctors will continue to monitor her with follow-up screenings for the next five years, but she remains optimistic. Retired now, she has plenty of time to enjoy her life. The granddaughter who was born shortly before it all started is now 2 years old and has a baby sister.
“I’m going to see my grandchildren and do some gardening,” said Bermudez on a recent fall afternoon. “It’s beautiful out today. It’s beautiful every day I open my eyes.”
Related news
Cancer prehabilitation and rehabilitation is key to survivorship and can include pain management, activity and mental wellness programs.
Knowing the risk factors associated with breast cancer at an early age empowers women to take control of their health and reduce their risk of dying from the disease
The face of colon cancer is changing. This woman found cancer in her sigmoid colon at just 34.