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Setting her sights on a future without rectal cancer

March 03, 2020 | UCI Health
uci health colorectal cancer patient claudia sanchez
After months of pain that was dismissed as hemorrhoids, Claudia Sanchez went to the hospital. “By the time I made it to the ER, I couldn’t even sit,” she explains. The doctor ordered a CT scan. The results brought devastating news: Sanchez had a large rectal tumor.

Claudia Sanchez has always been a force. Confident. Positive. Successful. In the early 1990s, the Los Angeles native earned an academic scholarship to the University of Rochester in New York, where she received her bachelor’s degree in chemistry.

She picked up a master’s degree in forensic science back home in Los Angeles and spent two decades in various leadership positions in the aerospace industry. Then she launched her own business as a software architect, helping companies make technical decisions and refine business practices.

She blazed through Southern California on her motorcycle, traveled often with her partner, Colleen Miller, practiced martial arts and basked in the devotion of her boisterous extended family. Her work meant she sat on airplanes a lot and logged too many deskbound hours. When she started to experience discomfort in March 2018 and doctors told her it was hemorrhoids, it sounded plausible.

Pain dismissed as hemorrhoids

“They just gave me some medication and sent me home,” says Sanchez. Over the next few months, however, her conditioned worsened. By May 2018, she landed in an emergency department near her Long Beach home. That’s when her life turned upside down.

“By the time I made it to the ER, I couldn’t even sit,” she explains. The doctor ordered a CT scan. The results brought devastating news: Sanchez had a large rectal tumor. Supported by her family, she was hopeful that her community hospital physicians could remove the tumor.

Unfortunately, once the doctors began surgery, they discovered that it was a much bigger problem that was beyond their capabilities.

She already knew cancer ran in the family.

Her father had died of gallbladder cancer; both of her sisters had fought triple-negative breast cancer. Now Sanchez would battle Stage IV rectal cancer that had spread to her liver and uterus.

Rallying a support network

As she waited in her hospital bed, it never dawned on Sanchez to give up. What she needed was a superhero — maybe a few of them. Emboldened by their sibling’s determination to fight — Sanchez told everyone she wanted action, not tears — older sister Veronica Behning and younger sister Sofia Rejon telephoned UCI Health.

Dr. Mehraneh D. Jafari, who specializes in colorectal disease and laparoscopic colorectal surgery, was on call that evening. By then, Sanchez was also bleeding internally. Jafari helped the family arrange for her transfer to UCI Medical Center in Orange.

“I knew it would be a tough case because we were seeing her after someone else had tried to operate,” Jafari says. “But I agreed to treat her because I could see she clearly needed comprehensive care, and we could deliver that.”

Coming to UCI Health via ambulance

Sanchez was so sick, though, she couldn’t even be discharged from the local hospital.

“I had to go by ambulance to UCI,” she explains. “I was bleeding because the doctors had nicked my tumor. I had staples from an incision from my belly button down, and I still had the tumor inside of me.”

Her pain was off the charts, and she was terrified — a feeling unfamiliar to her. Thankfully, it was a feeling that would vanish at UCI Medical Center.

“There are really no words to describe what happened once I was wheeled in the door at UCI,” says Sanchez. “The team that came to see me that morning left me with nothing but confidence. It was like, ‘Okay, I’m home now.’”

Oncologist Dr. Jason A. Zell was the attending physician on call when Sanchez arrived.

“Claudia had really advanced disease, but there was never a question in my mind,” he says. “We would assemble a team and we’d be aggressive about controlling it.”

Specialists handle complex cases

Zell says that the UCI Chao Family Comprehensive Cancer Center has a team of top specialists who tackle these types of complex cases. Think of it as a brain and skill trust that doesn’t give up — on anyone.

 “We have 12 multidisciplinary tumor boards, which work as forums for doctors to get together each week to discuss complex cases like Claudia’s and prioritize treatment.”

After addressing her excruciating pain, Zell had Sanchez start radiation to stop the internal bleeding. Then as an outpatient, Sanchez endured weeks of intensive chemotherapy to shrink her tumors before surgery.

Meanwhile, an all-female surgical dream team assembled.

This time it would be the perfect trifecta: colorectal surgeon Jafari, liver surgeon Zeljka Jutric and gynecologic oncologist Jill Tseng. One by one, each doctor painstakingly removed Sanchez’s colorectal tumor, ablated her liver metastases and performed a total hysterectomy.

Tiny incisions, major surgery

Because they used laparoscopic and robot-assisted surgical techniques, Sanchez needed only a few tiny incisions measuring about a quarter of an inch each.

“Claudia had multiple metastases just in her liver, some of which were located in difficult spots and considered unresectable — or inoperable — even,” says Jutric, who joined UCI Health to develop its state-of-the-art laparoscopic liver surgery program.

With Jutric’s expertise at radiofrequency ablation, Sanchez’s liver was essentially scrubbed clean. Jafari and Tseng removed the primary tumor.

The cancer center is Orange County’s only National Cancer Institute-designated comprehensive cancer center, where teams of doctors use advanced techniques and emerging treatments in the most complicated cases.

Treating cancer as a team

Sanchez’s surgery was grueling — lasting more than 12 hours — but the results were what the doctors hoped for. They were able to remove all evidence of disease, and three days later Sanchez headed home.

“The patient really benefits from our multidisciplinary approach, because as surgeons, we learn from each other and are able to push the boundaries further when we are working as a team,” explains Tseng. “For the right patient, these minimally invasive procedures represent a major advancement in cancer.”

Compared to traditional open surgery, minimally invasive surgery means less pain, fewer days in the hospital and a quicker return to normal functioning and much needed chemotherapy.

This is not to suggest Sanchez was done — far from it. Because parts of her digestive tract had to be removed, she left the hospital with an ostomy bag. After four additional months of intense chemotherapy, in March 2019, Jafari performed a long and complex surgery to reconnect Sanchez’ digestive system, eliminating the need for the ostomy bag.

Remaining committed to fighting

Sanchez had many days where she was in pain, sick and debilitated. But she remained wholly committed.

“I never once thought, ‘Poor me’ or asked, ‘Why did this happen to me?’” she says.

“Sometimes in life there’s a mountain that gets put in your path. My job became to move the mountain because everybody who watches me, everybody who loves me, everybody who is around me, everybody who wants to know me, they gotta learn that mountains can be moved somehow — whether you’re making a tunnel to go through them, you’re walking around them or you’re blowing them up.”

Today Sanchez, now 46, is adjusting to a full, if somewhat altered life. She’s back to work, traveling and spending lots of time with the friends, coworkers and family who supported her through every step of treatment. Because of residual neuropathy in her hands and feet after chemotherapy, she was slow to hit the road on her Honda Shadow motorcycle.

Dogs provide motivation to move

She and Miller also have adopted Staffordshire bull terriers Blu and Bella. The dogs came at a point during treatment when Sanchez was struggling to motivate herself to move. “Once I got the two girls, I just had to walk them. No choice.”

As it turns out, dog walking was fine training for what came next. In April 2019, Jafari requested a favor. She asked Sanchez to be captain of the digestive disease team’s Guts & Glory group in the third annual UCI Anti-Cancer Challenge.

Sanchez, her medical team and 32 of her supporters participated in a 5K Challenge walk that June. Sanchez handed out superhero shirts. Overall, UCI’s Anti-Cancer Challenge raised more than $635,000 for cancer research.

Sanchez — ever the competitor— was looking forward to the 2020 UCI Anti-Cancer Challenge on June 6.

“Our team came in fourth for donations,” she says. “So I’m already planning for 2020, and I think we can do a lot better.”

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