Colon cancer ribbon

Young colon cancer patient faces ‘devastating’ diagnosis

Healthy and with no medical insurance, Melisa Valenzuela was in her 20s when she learned the shocking news that she had extensive cancer.

Melisa Valenzuela has always been a competitor.

Growing up in East Los Angeles, she sought out the toughest challenges. “Especially basketball,” she said, recalling her school days. Playing with other girls didn’t interest her. “I was a tomboy. During PE in middle school, I would sneak into the boys’ line to play basketball with them because they were more competitive.”

That spirit also turned up in the classroom. A straight-A student, Valenzuela, now 31, is working toward a degree — and a career — in broadcast journalism.

Melisa Valenzuela
Melisa Valenzuela

She has also stepped up when challenges presented themselves at home. The oldest of three children, Valenzuela lives with her dementia-afflicted grandmother, serving as primary caregiver. “That’s my role,” she said. “She was always taking us to the mall, to the movies. Now it’s my turn.”

Even the COVID-19 pandemic was no match for the health-conscious Valenzuela. When public facilities began shutting down in early 2020, Valenzuela organized a “fitness boot camp” for her friends. “We did intense workouts five days a week,” she said.

It was during those high-intensity sessions that Valenzuela, only 28 at the time, began to suspect something was wrong.

“My lower abdomen felt very tender,” she remembered. At first, she dismissed the discomfort. She didn’t consider seeing a doctor — she had no health insurance or primary-care physician.

But more symptoms followed.

Symptoms Intensify

She began experiencing constipation. Then came what felt like a urinary tract infection. “Going to the bathroom was a nightmare,” she said, tears in her eyes.

Stubborn and independent, Valenzuela still did not seek help or tell her parents. Instead, she tried self-care, buying a bunch of over-the-counter remedies, none of which worked. She was getting worse. She visited the clinic that had fitted her with an IUD and had it removed, thinking it might be the cause. It wasn’t. The pain persisted, and now it was accompanied by deeply discolored urine. That sent her to the emergency room.

Doctors there, startled by her “brown like coffee” discharge, prescribed antibiotics. They didn’t help, either. She tried another hospital, where she was told her intestines were inflamed and that she may have diverticulitis, an infection of small, bulging pouches that can form in the digestive tract. They fitted Valenzuela with a colostomy bag — something she hated — to bypass and, it was hoped, relieve the inflammation.

But Valenzuela did not have diverticulitis at all. Months later, when doctors finally performed a colonoscopy to closely examine her colon, they found a tumor. A biopsy confirmed it was cancerous. 

The news hit hard.

'I Wanted to Quit'

“We were devastated at first,” said Valenzuela. “My mom and sister were with me. They cried on the spot. Dad had a breakdown, but away from me. And my brother tried to be strong in front of me, but Mom says he started crying, too.”

Colon cancer is the fourth most common cancer in the U.S. Most cases occur in people over 50, but it can strike young adults and even teenagers. Still, screening for colon cancer isn’t recommended until age 45, unless there is a family history of the disease. Valenzuela had none.

Her cancer diagnosis helped explain everything Valenzuela had been going through. The tumor in her colon was also impacting her bladder and threatening her uterus. Valenzuela began chemotherapy to try to shrink the tumor in preparation for eventual surgery. Her family knew what her next step should be.

“My parents wanted me at City of Hope,” she said. A close family member had been treated there. 

Andreas Kaiser
Andreas Kaiser, M.D.

Andreas M. Kaiser, M.D., remembers his first meeting with Valenzuela, as he sought to reassure a frightened young woman in deep distress, already enduring chemotherapy, embarrassed by her colostomy bag, suspicious of doctors, and desperate to end her mounting symptoms but terrified of what surgery might do to her.

“Melisa was emotionally vulnerable. Every cancer patient is,” explained Kaiser, City of Hope’s chief of colorectal surgery. “You build trust by saying the truth.” 

But the truth was very hard to take. Her tumor was so extensive, Valenzuela could lose parts of multiple organs, including her colon, bladder and uterus. Surgery might leave her unable to have children. Kaiser laid out all the possibilities. Was he just being thorough, protectively describing the worst-case scenario?

“No — it was the most likely scenario,” Kaiser affirmed, sadly.

And it almost ended right there.

“I was always so healthy, and suddenly all these things are piling on top of me,” recalled Valenzuela, crying profusely now. “I almost wanted to die because what would be the point of being alive?

“I felt overwhelmed. I told Dr. Kaiser I wanted to quit. 

“But he calmed me. He reassured me. He was straightforward, and he didn’t lie. He told me it would be hard. He also said that without surgery I would have a slow and painful death, so I had nothing to lose by going ahead with the operation.”

Those tough but caring words from Kaiser, who “felt like a dad to me,” plus support from her family, convinced Valenzuela to go for it.

Surgery Delayed

But surgery couldn’t happen right away. In January 2022, Valenzuela developed a “massive” bleeding problem that required five rounds of emergency radiation to “allow her to finish her chemo treatments, and then, after an appropriate break, to have the surgery,” Kaiser said.

On May 22, she was ready.

Melisa Valenzuela
Valenzuela's family took her to her favorite restaurant near City of Hope, Janet's Mediterranean Cuisine, a month before her big surgery. 

Kaiser’s goal for the procedure: To take out as little as possible, but as much as was necessary to excise the tumor with “good, safe margins.” Despite all the advanced imaging available today, Kaiser knew he’d be assessing and reassessing that goal every step of the way during the long procedure, in close consultation with a urologist and others. He enlisted the help of gynecologic oncology surgeon Ernest Han, M.D., Ph.D., associate professor and chief of the Division of Gynecologic Oncology, and urologic surgeon Kevin Chan, M.D., clinical professor in the Division of Urology and Urologic Oncology, for the complicated procedure. 

In the end, it all went better than anyone expected.

“During surgery we saw that we could preserve her uterus,” he said. “We did remove a cyst on her ovary, but we saved the organ. She should still be able to have children.” The team also rebuilt her bladder. It’s smaller now, and Valenzuela makes many more bathroom trips than before — a small price to pay. The team also removed one fallopian tube, a portion of her rectosigmoid colon and a 10 cm-long segment of her abdominal wall to make sure every part of the tumor was excised in what stretched to a seven-hour surgery. 

Best of all, when Valenzuela awoke from surgery, she looked down and her colostomy bag was gone. Kaiser had repaired the remaining length of her colon. She was whole again.

“He made a joke about it,” said Valenzuela, smiling now. “He came into the room and said, ‘Hey, what happened to your bag?’" 

Kaiser, also smiling, explained, “Sometimes, when there’s good news, I joke.”

'Back to Normal'

Valenzuela recovered rapidly, with only a minor complication — an abscess that needed to be removed. “It was smooth sailing after that,” she recalled, thanks in large part to round-the-clock family support. Both Mom and Dad took leaves of absence from their jobs and alternated at Valenzuela’s bedside, making sure she was never alone, day or night (except for one week because of a COVID-19 scare when the rules prohibited it. “Loneliest week ever!” she said).

Now, one year after her ordeal, Valenzuela says she is “totally back to normal” and occasionally has to glance at her scar to remind herself that she had cancer. Kaiser believes (“fingers crossed,” he said) that she’s cured   because, although the tumor had grown beyond the colon, it had not spread to the lymph nodes. Time will tell, and Valenzuela will continue to be monitored regularly.

Meantime, Valenzuela is filled with praise and gratitude for Kaiser (“I owe him so much”) and everyone at City of Hope who cared for her. “If not for City of Hope, I don’t think I’d be alive and whole. They are the big reason I’m healthy and capable and normal.”

She’s determined to make the most of her second chance.

“I was so depressed a year earlier,” she said. “But this just makes me realize how strong I am, and that I can do whatever I want, and I’m going to do it all at 100%!”

She’s keeping her word. Barely one month after surgery Valenzuela, the super competitor, was back at school, completing the one remaining course she needed to graduate.

Naturally, she got an A.