Lauren's algorithm to a cancer-free life
Though a genetic mutation may have stacked the odds against her, Lauren Speegle and her medical team are taking extra measures to help keep her cancer-free.
For Lauren, a 33-year-old mother of a toddler and a 9-month-old infant, high school math teacher, tutor and cheer-team advisor, fatigue was all part of the equation. Yet when she developed a low-grade fever and severe abdominal pain, she suspected there was more to it.
“I had a small hernia during my last pregnancy, so I thought maybe that was the problem,” says Lauren.
She called general surgeon Kelly Francis, M.D., who had consulted with Lauren for her hernia. Lauren trusted Dr. Francis and her medical expertise. Dr. Francis insisted on seeing Lauren in her office that same day. Upon examination, she felt a lump in Lauren’s abdominal wall and sent her to Orange Coast Memorial for a CT scan.
The results revealed an inflammatory mass in Lauren’s colon. She was admitted to the hospital and treated conservatively with intravenous antibiotics for a possible infection.
“The mass was unresponsive, leaving surgery as the only option,” explains Dr. Francis.
When Lauren awoke from the six-hour procedure, her husband, Justin, shared the difficult news. Dr. Francis had removed the mass as well as the 17 adjoining lymph nodes for testing. Initial results showed a large, malignant tumor. The second pathology report brought more troubling information: the cancer had invaded two of the lymph nodes. The extent of the tumor classified the cancer as stage IIIB – advanced, with a significant risk of recurrence.
Six weeks after her surgery, Lauren’s medical oncologist, N. Simon Tchekmedyian,M.D., initiated chemotherapy. If even a small number of cancer cells had escaped into Lauren’s bloodstream, they could establish new colonies, dividing quickly and generating new tumors.
And, Dr. Tchekmedyian had other concerns, as well.
“Lauren was young – far younger than the average colon cancer patient. Her family history didn’t show anything unusual,” says Dr. Tchekmedyian. “I recommended a comprehensive genetic evaluation – we needed answers.”
Dr. Tchekmedyian was right. Genetic testing revealed a rare variant in a gene known as MLH1. MLH1 is involved in repairing the mistakes that sometimes occur when the DNA of a cell is copied before it divides. If a mistake in the DNA is not corrected, the abnormal cells will continue to divide and the mistakes will continue to accumulate, sometimes resulting in cancer.
“When I was first diagnosed with cancer, Dr. Francis told me that she would do everything in her power to make sure that I got to see my kids grow up.”
Seven months after her colon tumor removal, Lauren had a second surgery to reconnect her colon. She was ready to put cancer behind her, but a follow-up colonoscopy revealed a new adenoma, or benign tumor.
During this surgery, Dr. Francis assisted gastrointestinal surgeon Tam Le, M.D., in removing Lauren’s entire colon and rectum. Dr. Le then used the lower portion of the small intestine to construct a new colon, which would allow for normal function.
Since the MLH1 variant could give Lauren a predisposition to other cancers, she had a difficult decision to make: should she have susceptible organs removed now to prevent cancer from potentially developing later?
“Here was a mother with two very young children. We weren’t about to take any chances with Lauren’s future, but the choice was Lauren’s to make, and hers alone,” says Dr. Francis. “Our advanced diagnostics and expertise provided her with all the necessary tools so she could make an informed decision.”
For Lauren, the answer was “yes.”
“When I was first diagnosed with cancer, Dr. Francis told me she would do everything in her power to make sure that I got to see my kids grow up,” says Lauren. “Prevention, surgery and being proactive were the best ways for me to take control of my future. So that’s exactly what I did.”
In August 2015, Dr. Francis assisted Lauren’s OB/GYN, Meagan Moore, M.D., in performing a total hysterectomy and ovary removal. Four months later, Lauren, Dr. Francis and plastic surgeon Eliza-Jasmine Tran, M.D., were back in the operating room for a bilateral mastectomy with reconstruction.
ADDING IT ALL UP
As Lauren looks back, she’s grounded by the love and support of her family and friends. She is also forever grateful to the specialists and her clinical team at Orange Coast Memorial who committed countless hours to helping her become cancer-free.
“When I first met Dr. Francis, I knew she was incredible, but what I didn’t know is just how incredible. She was by my side every step of the way, in every single surgery,” says Lauren. “Her care for me went well beyond the operating room.”
She adds, “I don’t have anything more to be afraid of. My scars remind me of my journey and that I can get through anything.”
For more information about the MemorialCare Cancer Institute at Orange Coast, please visit memorialcare.org/cancercare.