Conquering rectal cancer with personalized care
Sarah Murad had noticed some rectal bleeding for months, but she wasn’t overly concerned because, at age 42, she was too young to need regular colon screenings.
When the busy mom of two young kids mentioned it to her family doctor, she attributed it to lactose intolerance or a dairy allergy. She eliminated dairy but the bleeding returned in a few weeks.
Alarmed, she called a gastroenterologist friend in Massachusetts, who advised her to see a specialist right away.
The Newport Beach resident was shocked when a colonoscopy and biopsy at a community hospital revealed she had rectal cancer.
Colon and rectal cancers — once seen mainly in older adults — are now the leading cause of cancer-related deaths among U.S. men under age 50 and the No. 2 cause of death for women under 50, like Murad.
When she got that stunning diagnosis on Aug. 7, 2023, Murad began researching treatment options and hospitals. Then a friend of her father’s, who is a colorectal surgeon, recommended Dr. Skandan Shanmugan, a highly skilled UCI Health specialist in minimally invasive and robot-assisted surgery for colon and rectal cancer.
Murad was impressed by the integrated approach taken by Shanmugan and his team at the UCI Health Chao Digestive Health Institute, where he is co-director.
“They weren’t working in isolation,” she says. “I saw all my doctors in one visit, and they came up with a customized plan of treatment.”
Optimized therapy, personalized care
This patient-focused, multidisciplinary care is a hallmark of the institute, the surgeon says. Its rectal cancer program is one of only 65 U.S. programs and the first in Orange County to be accredited by the National Accreditation Program for Rectal Cancer.
“This means that we maintain the highest standards of quality and our patients have access to the latest clinical trials in colon and rectal cancer therapy,” he says.
A prime example of this high-quality, multidisciplinary care is the weekly tumor board, where all the specialists come together — surgeons, medical oncologists, radiation oncologists, radiologists, pathologists and gastroenterologists — to evaluate each case.
“We optimize and individualize treatments, not just for the type of tumor but also to honor the patient’s wishes, whenever possible” says Shanmugan, an associate professor and chief of the Division of Colon and Rectal Surgery in the UC Irvine School of Medicine’s Department of Surgery.
For Murad’s case, stage IIIb rectal cancer, the team recommended a multilayered plan of action, starting with chemotherapy to shrink her 1.5-inch tumor.
“The cancer had penetrated the outer layer of the rectal wall and spread to nearby lymph nodes, but it hadn’t traveled to any other organs,” says medical oncologist, Dr. Farshid Dayyani, who leads the clinical trials unit at the UCI Health Chao Family Comprehensive Cancer Center
Conquering chemotherapy
In September 2023, Murad began chemotherapy infusions every two weeks at the cancer center’s location in Costa Mesa, which she dubbed her ‘Chemo Spa’ because of its soothing atmosphere and welcoming nurses and staff.
They even made her treatments less daunting. “I am terrified of needles, but they created a plan,” she recalls. “I would put on numbing cream before I got there, then we’d ice the area and they would insert the needle in seconds, free of any pain!”
Murad realized her children needed help processing what was happening to her and to make the process less scary. She even created a fun game for her daughter and son, then ages 8 and 6, to normalize losing her hair to chemotherapy.
“I would cut my hair before each chemo session and each haircut had a different name,” she says. When Halloween rolled around, Murad's daughter wanted her mom to dress up as a mermaid.
