It's not uncommon to get a surprise on your birthday. But this was one surprise Stacy Hurt did not want.
"I was diagnosed with stage 4 colon cancer on my 44th birthday," she says. "Growing up, I was always an athlete. I played tons of sports. I was always healthy."
She had no common risk factors for the condition, which include being overweight or obese, older than 50, physically inactive, a heavy smoker and/or drinker, and having a personal or family history of colorectal cancer. Hurt was a normal weight. She wasn't the typical age. And she was extremely busy working full-time as Vice President of Training and Development at a pharmaceutical company in Pittsburgh, and raising her sons, Griffin and Emmett.
Now 10 years old, Emmett was also a surprise. Hurt says there were no warning signs during her pregnancy that he would have a rare chromosomal abnormality. He was born severely disabled, without the ability to walk, talk, or feed himself.
"He has several special needs and a nurse that takes him to school," Hurt says. "I always say that we need an Alice from The Brady Bunch. We do it all. My mindset was that I really needed to stay healthy for my kids."
So despite her hectic life, Hurt ate healthfully and continued to work out. But in September 2014, her health took a sudden turn.
"I started to feel like crap," she says. "I was experiencing rectal bleeding, abdominal pain, fatigue. I thought it was the wear and tear of caring for Emmett and working."
"Rectal bleeding in the young is often dismissed as having come from hemorrhoids," Dr. Greenwald says. "Sometimes prolonged but unexplained abdominal pain or discomfort may be a sign of colon cancer, although there are many causes of this."
Hurt's husband insisted she see a doctor, and her doctor said he wasn't going to mess around with her symptoms.
"He said he was sending me for a colonoscopy," Hurt recalls. "The tumor in my rectum was so large, the doctor could not get the scope around it."
She remembers having a brief moment of confusion.
"I thought, I don't know how this could happen," she says. "I do everything right. I'm healthy. I'm fit. I eat right."
That thought only lasted a few minutes. Then Hurt entered "fighter mode."
To find out the stage of her cancer and check if it had spread elsewhere in the body, Hurt had a CT scan, which came back clear. But a physician friend strongly urged her to get a PET scan, as well. A PET scan generally detects abnormalities at the cellular level, whereas a CT scan might only detect a change if the disease has become more advanced.
Hurt's PET scan showed cancer in her liver, lungs, and lymph nodes, in addition to her rectum. She was diagnosed with stage 4 colon cancer.
"If I hadn't had that PET scan, I'd be dead," she says.
When an 'Old Person' Cancer Skews Younger
Hurt is part of a growing group of younger Americans being diagnosed with colon cancer, according to Greenwald.
"Most colon cancer occurs in people over the age of 50, but 10 percent of cases are diagnosed in the young," he says. "While colon cancer rates have dropped for those over age 50, the past decade has seen an increase in the number of colon cancer cases diagnosed in those under 50, some estimate an increase by 2 percent each year. Much of that increase seems to be in diagnoses of rectal cancer in younger people."
In fact, a January 2015 study in JAMA Surgery found that by 2030, the incidence rates for colon and rectal cancers in people ages 20 to 34 will increase by 90 and 124 percent, respectively, and by 27 and 46 percent, respectively, in people ages 35 to 49.
I thought, 'I don't know how this could happen. I do everything right. I'm healthy. I'm fit. I eat right.'
Colorectal cancer is already common: It's the fourth most diagnosed cancer in U.S. men and women and is expected to kill nearly 50,000 people in 2016, according to the National Cancer Institute. About 135,000 new cases are diagnosed each year in the United States, and approximately 1 in 20 people will be diagnosed with colorectal cancer in their lifetime, according to the American Cancer Society. And while most people get a colorectal diagnosis when they're older, this increase in younger diagnoses means you shouldn't write off changes in the bathroom, no matter your age.
"It is wise to see a physician when you have rectal bleeding, noticeable change in bowel habits, unexplained abdominal pain or unexpected or unexplained weight loss," Greenwald says.
Seeking Integrative Treatment
The week after her PET scan and diagnosis, Hurt met with an oncologist to begin chemotherapy. At the same time, she says she "fine-tuned" her approach to treatment from a nutritional standpoint.
She had her first scan in December 2014 to see how treatment was going.
"I was very lucky," she says. "I responded very well. My tumor had shrunk from 11 centimeters to 3 centimeters."
Hurt says doctors added another drug to her treatment right after Christmas that year, and she continued to be a busy working mom. She held a webinar at work during her chemo week, even though she needed multiple glasses of liquid to keep her hydrated and talking. She also continued to care for Emmett with her husband, something Hurt calls "the hardest thing" — despite what happened next.
The Crash and the Comeback
Her tumor had shrunk enough for surgical removal, so doctors resected Hurt's rectum and liver and also took out a few lymph nodes that came back "negative for cancer," she says. "It was kind of a miracle. The doctors kept saying it was weird. Great, but weird!" Then, just after surgery, she was recovering in her hospital room when her vitals crashed.
"I coded," Hurt says. "People filled the room. The best way I can say it is that I started to fade. They suspected internal bleeding. I remember the surgeon saying, 'I will get you through this,' and I said, 'I know you will.' I remember thinking that I did not go through all this with the cancer to bleed out on a cart."
Hurt woke up to a clock. "I must not be in heaven!" she thought. Doctors discovered what had caused the problem: A robotic arm had nicked a blood vessel during her first surgery. She required several blood transfusions, but she made it through. "Being so strong and healthy saved my life," she says. "I got out of the hospital on my husband's birthday."
The family has faced more challenges since the surgery, the biggest being when Hurt's mother-in-law passed away from cancer last year. "I fight in her honor every day," Hurt says.
Hurt went back on chemo in June 2015 after she had recovered from the bleed. She had radiation on the remaining spot in her lung a few months later in October, and was finally declared NED (no evidence of disease) on March 1, 2016.
She will remain on the chemo indefinitely. But through it all, Hurt has had a deep awareness of all the ways she could turn her struggle into a positive message.
"I see so many people in the world who feel defeated by their circumstances," she says. "I saw a need for hope. Dealing with Emmett, I never understood why. But being diagnosed with cancer, I did. I realized some things just happen. In life, it's how you deal with it. It's not the tragedy that defines you, but the triumph."