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Minnesota mom grateful her colon cancer diagnosis came early

It would have been easy to ignore that one instance of blood in her stool. Anna Dahlgren felt fine -- a little tired, like any mom with a young child and a full-time job might feel. She didn't think her family history was troublesome. And she was...

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Anna Dahlgren, right, and son, Isaac Bogatzki, 7, sit for a portrait in Duluth’s Enger Park. Dahlgren was diagnosed with colon cancer at age 33. (Steve Kuchera / skuchera@duluthnews.com)

It would have been easy to ignore that one instance of blood in her stool.

Anna Dahlgren felt fine - a little tired, like any mom with a young child and a full-time job might feel. She didn’t think her family history was troublesome. And she was only 33.

She figured it was a hemorrhoid, the West Duluth woman said. “Cancer was the last thing on my list.”

But Dahlgren, a medical laboratory technician at Duluth Family Medicine Clinic, said she decided to bring it up to one of the doctors who practices in the clinic’s residency program.

That was a Sunday, June 19, 2014. The following Monday she saw Dr. Katelyn Mohrbacher, a third-year resident at the clinic who now practices in family medicine and obstetrics/gynecology at an Allina Health clinic in Hastings, Minn.

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Mohrbacher wasn’t thinking cancer either, she said during a recent phone interview. But something troubled her. The pattern of the blood in Dahlgren’s stool was atypical.

“It was different than hemorrhoids,” Mohrbacher recalled. “I couldn’t put my finger on it.”

It could be colitis, Mohrbacher thought, or perhaps an inflammatory bowel.

The two women differ slightly in recalling their discussion about whether Dahlgren should have a colonoscopy, a procedure not normally recommended until age 50.

“Together we made that decision,” Mohrbacher said.

But Dahlgren remembers resisting the idea.

Mohrbacher said, “No, it’s not normal and you’re getting it done,” Dahlgren recalled.

Dahlgren now credits Mohrbacher’s advocacy for saving her life.

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A ‘FAIRLY LARGE POLYP’

Once the decision was made, things moved quickly. On July 1, 2014, the colonoscopy was performed by Dr. Theresa Smith, a gastroenterologist at Essentia Health-Duluth Clinic. 

Considering Dahlgren’s age, Smith, too, thought she would find only hemorrhoids, she said.

She found an unpleasant surprise.

“She had this fairly large polyp that was nasty-looking,” Smith recalled. “I took it out. It turned out that it was cancer.”

Dahlgren, the mother of a then-5-year-old, was home alone when she got the call two days later, she said. “That’s not what I wanted to hear.”

Dahlgren waited until after the July 4 holiday weekend to tell family members, she said, because she didn’t want it to dampen festivities at the family’s cabin.

Yet the news wasn’t all bad because the cancer had been caught so early. Within a couple of weeks, Dahlgren underwent a colon resection in which about 18 inches of her large intestine and about 20 lymph nodes were removed, she said, to make sure none of the cancer remained.

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Because the tumor hadn’t reached the wall of the colon, it was diagnosed as stage 1. It meant, she learned, that she wouldn’t need chemotherapy or radiation, just some recovery time at home and checkups.

“Her chance of a normal life span is almost 100 percent because her cancer was caught early,” Smith said.

“But if I would have waited, it would have been a totally different story,” Dahlgren said.

GENETIC ROOTS?

Nonetheless, the brush with cancer has changed her life. Since then, Dahlgren has had her gallbladder removed after a polyp was discovered there and had another polyp removed from her colon, although neither was cancerous. But it means she will have an annual colonoscopy for the rest of her life. 

Moreover, her son Isaac, now 7, will have to start having colonoscopies beginning when he is 23 - 10 years before his mother was diagnosed. That’s standard practice for immediate family members of someone diagnosed with colon cancer, Smith said.

Action for Isaac would be more aggressive if it were known Dahlgren’s cancer had a genetic component, Smith said. But Dahlgren’s colon cancer didn’t fit the “rigorous criteria” required for her insurance to cover genetic testing, the doctor added.

Both Smith and Dahlgren thought genetic testing was worthwhile and fought her insurance company over the matter, the women said. Finally, Dahlgren said, the insurer agreed to partially cover the cost of testing, which was scheduled for this month. 

Patients often aren’t interested in that, Smith said.

“The majority of my patients refuse to go through genetic testing, which kind of boggles my mind,” Smith said. “Personally, I’d want to know, because it has implications on how often testing should be done.”

If there’s no genetic component, the biggest risk factor for getting colon cancer is simply getting older, Smith said. 

Diet and environment also can be causes of colon cancer, Dahlgren learned. Although she believes she was a healthy eater already, she is eating more whole grain now, taking better care of herself and making sure she gets enough sleep, Dahlgren said. At her doctor’s recommendation, she also takes a 325-milligram aspirin each day. 

‘CHECK IT OUT’

The experience has turned Dahlgren into a crusader regarding colon cancer and cancer screening. She joined the Colon Cancer Alliance and attended a conference in Arizona. Asked by the Minnesota-based Colon Cancer Coalition to spearhead a Duluth observance during Colon Cancer Awareness month in March, she learned it would cost $5,000 to get the Aerial Lift Bridge lit in blue, the color identified with colon cancer. That wasn’t feasible, but the Enger Tower could be lit in blue at no cost. Unfortunately, it was foggy on the night the tower was lit to honor colon cancer.

Knowing others in the region have dealt with colon cancer, Dahlgren hopes to form a group here. 

She also wants to encourage people not to ignore the warning signs of a potential colon cancer, which is the second-leading cause of death among cancers in the United States, according to the American Cancer Society.

“Pay attention to everything,” Dahlgren said. “I don’t want people obsessing about everything, but if you feel something doesn’t look right or feel right, check it out.”

Smith affirmed that.

“I would say the vast majority of people who come in with bleeding in their 20s and 30s are not going to have cancer,” she said. “But it’s not impossible, and that’s why it shouldn’t be ignored.”

The Colon Cancer Alliance reports that one in 10 cases of colon cancer is diagnosed before age 50, and the number of younger colon cancer patients is increasing.

It’s still uncommon in younger adults, Mohrbacher said, “But we are starting to see it a little more.”

‘SAFE RATHER THAN SORRY’

Although deadly, colon cancer tends to develop slowly. Dahlgren said she was told that by the time her polyp was removed, it probably had been growing for six to eight years.

Dahlgren credits Mohrbacher specifically and the kind of care offered at Duluth Family Medical Clinic for the early discovery of her cancer. In the learning environment of the residency program, the doctors aren’t “pressured by insurance companies to have these quick 15-minute appointments,” Dahlgren said. 

There’s also the advantage of consultation among residents and faculty members, she said.

“There was a lot more discussion about my case and what to do than one person saying come back and check with me in a month,” Dahlgren said.

During her residency in Duluth, Mohrbacher was able to spend up to 45 minutes with a patient, she said. By then in her third year, she didn’t engage in a lot of consultation about Dahlgren’s case, she said. But the experience helped shape the kind of doctor she is now.

“I weigh in on being safe rather than sorry,” Mohrbacher said. “That’s how I doctor.”

Dahlgren said it scares her to think of what might have happened if she hadn’t been in the medical field, if her doctor hadn’t encouraged her to get a colonoscopy. She said she believes she was spared so she could bring awareness to others about heeding the warning signs.

“It doesn’t matter how old you are; it’s not normal to have blood in your stool,” Dahlgren said. “And if your doctor tells you: It’s fine, you’re young - find another doctor. Or keep pushing it.”

Related Topics: HEALTH
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