Rob Hartley had just turned 40 last year and figured he simply was “getting old”. He was under stress at work and frenzied from just buying a house. He sometimes experienced shortness of breath and other times felt dizzy when he stood up.
“I knew something was wrong and something wasn’t right with me,” he says.
But like some folks, Rob blew off the possibility that his body was telling him something. It couldn’t be anything serious, he thought, not given his lifestyle. He was extremely active: working out, boxing, detailing cars, splitting wood, and more. He thought it must be something in his diet or the result of pressure from his job and the move.
“I thought it was just stress,” he says.
When he finally reached out to his primary care physician in May 2020, his blood work was alarming. “It showed my hemoglobin level at 4.6,” he says. “It’s supposed to be 15. They said I shouldn’t even be able to walk.”
He was instructed to pack a bag for a hospital visit, where he would receive a transfusion while they determined why his blood oxygen level was so low. Rob also underwent a colonoscopy that revealed a mass in his colon. Surgery was required right away.
“I was pretty nervous,” he says. “You don’t expect to hear that when you’re 40 years old. I’ve always been in good health and can count on one hand the number of times I’ve been to the doctor. They figured it was a cancerous tumor.”
It turned out to be Stage 4.
Bodies give signs for a reason
A few months prior to being hospitalized, Rob experienced some bloody stool. He chalked it up to the pressure he was under. “I didn’t think nothing of it,” he says. “It would come and go and then it stopped, and I didn’t notice it anymore.”
Laura Musselwhite, MD, a gastrointestinal oncologist at Atrium Health Levine Cancer Institute, says people like Rob often blame hemorrhoids and don’t visit a physician. Younger people in particular are prone to dismiss signals, but everyone needs to heed her message.
“Rectal bleeding is not normal,” Dr. Musselwhite says. “Even if you think you have hemorrhoids, you need to see a primary care doctor or a gastroenterologist so they can pick it up early and figure out why it’s happening.”
Some of Rob’s bowel movements were painful and his stomach hurt sometimes, too. It all made sense upon the discovery that a cancerous tumor was nearly obstructing his colon. He was surprised, but not exactly a rarity.
“At least a couple of patients a month come in with no other symptoms – maybe some bleeding, nausea and abdominal pain – and it turns out they have an almost obstructed cancer causing the problem,” says Matthew Abraham, MD, Rob’s surgeon at Atrium Health Cabarrus who removed Rob’s tumor. “Get your colonoscopies.”
Dr. Abraham removed the large mass toward the end of Rob’s colon and was able repair the organ without needing a colostomy bag. Rob had to return a few weeks later for a leak in his intestines, but that was repaired without additional surgery.
“Everything went really smoothly,” Dr. Abraham says. “He recovered quickly. He’s a fairly young, otherwise healthy young man who tolerated surgery well and was back to normal function within a week or two.”
Teamwork makes the care work
Dr. Musselwhite met Rob in May, shortly after his surgery and diagnosis of cancer – which wasn’t removed in its entirety. She says such discussions can be difficult for patients who have always been completely healthy.
“He had part of his colon removed and we placed him on chemotherapy, which is the standard of care when cancer has spread outside where it started from, plus a drug called Avastin, which is an antibody that targets blood vessels that feed the cancer,” Dr. Musselwhite says.
After five rounds of chemotherapy that went well - over a span of four and a half months - Rob underwent another CAT scan. It showed that those lymph nodes that had cancer had shrunk. At that point, Rob stated his preference to remain as mobile and active as possible, which meant not coming in for treatment as often.
“I totally understood,” Dr. Musselwhite says. “So, we switched over to a pill by itself. Now he comes about once a month. There were other options for treatment, and most are given through an IV, but we reached an agreement on the pill because that’s what he wanted.
Rob says he was scared at the beginning of this new chapter, wondering what the rest of his life would be like. But now he’s active as ever, working out, boxing, painting, detailing cars, etc.
“I want to give a shoutout to my doctors,” Rob says. “You can’t do it alone. As strong as you are, you have to have good people in your corner. The treatment I received was absolutely phenomenal.
“They don’t push anything on you. They take what you think and how you feel and say, ‘this is what we think. What do you want to do?’ As bad as it seemed, it was actually an amazing experience to go through.”
