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In Memoriam

James's Story

by George Gay

My son, James Alan Gay, was born Oct. 19 1972. On August 14, 2002, at the age of 29 and after a year and a half battle, Jim, a healthy and vibrant young man, died of colorectal cancer. Unfortunately, Jim was not the first in his family to die of this disease. In 1981, my father was diagnosed with colon cancer. Ironically, at that time, Jim experienced bloody stools. He was ten years old then and initially the family doctor ignored the bleeding, attributing it to anal fissures. After eight days of persistent bleeding, we insisted that he have an exam and Jim was given a proctoscope exam that revealed a benign polyp. I remember telling my wife that "I hoped it was not the beginning of another nightmare" and she told me I was being paranoid, that my father's cancer was a result of his lifestyle and his age and had nothing to do with our son's symptoms. We were told that Jim's polyp was a "normal" juvenile polyp and that we were not to be alarmed. While I went in for a colonoscopy every two years following my father's diagnosis, Jim was not given any advice to do so after his polyp was removed because of his young age.

In November 2000, at age 27, Jim went to our family physician on his own, complaining about abdominal pain and embarrassing gas. He told the doctor that he was concerned because of our family history of colon cancer. Because of Jim's young age and apparent good health, the doctor did not order any imaging or blood tests. He attributed the pain and gas to the water that Jim was drinking and gave him antibiotics for a stomach disorder due to poor quality water. Jim continued to work until December of 2000, when he began to have symptoms like vomiting, loss of appetite, constipation and pencil stools. But it was not until a month later, in January 2001 that I learned of his symptoms. On January 12, 2001, Jim came to me and asked how he could treat his severe constipation. I did not know that he had already seen the doctor and advised him to try taking laxatives. When that did not work, I suggested that he try an enema, but that didn't work either. Then I told him to see a doctor, so he saw our family doctor again. At this point his abdomen was swollen like a pregnant woman's, and the doctor finally ordered a series of x-rays and CT scans. They revealed an obstruction in his rectum, and Jim was scheduled for surgery.

On January 26, 2001, Jim had surgery to remove the tumor and was diagnosed with Stage III rectal cancer, with 25 of 27 lymph nodes positive with cancer. The surgeon was optimistic and said he got all the visible cancer. Because he was so young, the surgeon expected that he would tolerate chemo and radiation well and that he would make a full recovery. Jim went through the standard treatment of chemo and radiation and after six months, he happily went back to work.. He was told that he was in total remission. For the next year, Jim followed up regularly, with monthly and then quarterly CT scans and blood tests. All of the tests came back negative for recurrence. On January 14, 2002, Jim began to show symptoms again. He thought he had the flu, so he went to the doctor again. More CT scans revealed another obstruction, this time in his lower intestine. The surgeon thought it was radiation damage and said it could be surgically repaired. On Jan. 26, 2002, one year to the day from his first operation, Jim was in surgery again. Only this time, he was told that the cancer had spread throughout the abdomen, and that it was inoperable. Following his second surgery, Jim became unable to eat and was put on TPN as his sole source of nutrition. Jim was given six months to live, without additional chemo and a up to a year with it. He chose to take the chemo, in hopes of gaining some valuable time, but the chemo didn't help. Jim fought a very brave and dignified battle, but lost that battle at 6:38 p.m., on August 14, 2002.

Jim died in my arms and I don't want any parent to go through what my wife and I did. I miss him so much!!!! I feel that if the doctors would have paid more attention to his family history and his history of polyps and ordered earlier colonoscopies for Jim, he may have lived to be 50. I firmly believe that in November 2000, if the doctor had ordered a colonoscopy then, and not worried about Jim being younger than "50", his cancer may have been caught sooner. Despite what the media tell us and what most doctors believe, many young people are dying from this terrible disease. Don't let your doctor put off a colonoscopy just because you are younger than 50 or because the insurance company is making a fuss, especially if there is family history of cancer or polyps. Be insistent with your doctors, if you are concerned. IT'S YOUR LIFE!!!!!!!!

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