Holistic approach to treatment helps woman with rectal cancer

Naturopathic physician Mary Attwood, ND, underwent several life changes in 2022. She and her family moved from Portland to Olympia, and she started a new job.

“I felt like I had just made it,” she explains. “After years in school, then owning my own practice, I found my dream job at Heart of Wellness in Tumwater and had reached this summit.”

But Attwood, 43, says it was a false peak. She was still dealing with painful hemorrhoids — a common side effect of pregnancy — more than a year after having her second baby.

By the time the holidays arrived, sugar and alcoholic beverages, even in moderation, aggravated her symptoms. And they worsened in early 2023. She had a hard time passing a bowel movement, and there was a lot of bleeding.

“I’m a doctor, and even I ignored some warning signs,” she says. “I moved; I got a new job; I changed insurance. I was explaining away the symptoms until I couldn’t anymore.”

That’s when Attwood saw gastroenterologist Marshall McCabe, MD, at the Olympia Multi-Specialty Clinic.

“We both initially thought I had ulcerative colitis,” she recalls. “But when the bleeding persisted, Dr. McCabe got me in for a colonoscopy as soon as possible.”

Her colonoscopy revealed a cancerous kiwi-sized mass in her rectum.

Although it was shocking to hear she had cancer, Attwood was relieved to finally know what was going on.

“I was so worried,” she says. “There were times I was passing a lot of blood, and it really scared me, so I was grateful to know what was wrong.”

Know the symptoms of colorectal cancer

No matter your age, it’s important not to ignore symptoms. When detected early, colorectal cancers are very treatable.

Early symptoms of colorectal cancer can include:

• Changes in bowel habits, such as diarrhea or constipation, that last more than a few days
• Rectal bleeding with bright red blood
• Blood in the stool, which might make stool look dark brown or black
• Cramping or abdominal (belly) pain
• Decreased appetite
• Unintended weight loss

If you’re experiencing symptoms, have a family history of colorectal cancer, or are 45 or older, schedule an appointment with a primary care provider to talk about screening options.

A multidisciplinary team approach to cancer treatment

Although Attwood lives near Olympia, she decided to have treatment at the MultiCare Regional Cancer Center in Tacoma. It’s one of only two cancer centers in Washington to hold an accreditation from the National Accreditation Program for Rectal Cancer.

“My doctor said, ‘We’re getting you the best surgeon, and that’s Laila Rashidi,’” she recalls. “I was told I would be in some of the best hands in the country.”

Attwood assumed she would have surgery first, so she made an appointment with MultiCare colorectal surgeon Laila Rashidi, MD. But after a scan revealed swollen lymph nodes, the goal was to stop the cancer from spreading and shrink the tumor as much as possible before surgery. That meant chemotherapy and radiation first.

“I had psyched myself up for surgery,” she explains. “I was thinking, ‘Oh, I’ll just need a month off for surgery, then I’ll be back to work.’ It was hard news to take.”

But when Attwood met with medical oncologist Sunil Rangarajan, MD, she felt so cared for that she was ready to start treatment.

“Dr. Rangarajan is so kind and generous — a fabulous human,” she adds.

Attwood also felt reassured by MultiCare’s multidisciplinary approach to her treatment. Her case was presented at the tumor board, where collaboration occurs between all disciplines — medical, surgical and radiation oncology, pathology, among others — to discuss treatment protocols and patient progress.

“Mary had a wonderful outlook throughout treatment, which makes a big difference.” adds Dr. Rangarajan. “Having a positive attitude is healing.”

She had chemotherapy every other Thursday from late April to early July 2023.

“Every time I was there, I had an opportunity to shine a little light around the room,” says Attwood. “People are just so scared. So, I would come with my big heart in a bright dress.”

“Mary had a wonderful outlook throughout treatment, which makes a big difference.” adds Dr. Rangarajan. “Having a positive attitude is healing.”

Extra support for mental health during chemo

The second round of chemo was the hardest for her — physically and emotionally.

“It occurred right around the one-year anniversary of my brother’s death,” Attwood says. “Your emotional health plays out in the body; I had a lot of vomiting.”

She needed extra support during this time and was grateful to find it through oncology social worker Betsy Allen, MSW, LICSW, OSW-C.

“It was really important that I took care of myself, especially that month,” she adds. “I valued Betsy’s care and kindness. I felt seen and heard.”

“One of the benefits of counseling is having an unbiased, neutral place to talk through feelings and fears, and not put stress on a spouse or kids,” explains Allen. “I think that’s how Mary saw it. We called it her safe space.”

Success with radiation and surgery

Radiation treatment was overseen by radiation oncologist Christopher Premo, MD, and lasted the month of August.

“Dr. Premo was so supportive and kind. I always felt I was in good hands,” Attwood says.

She could tell her tumor was shrinking as treatment continued because her symptoms started disappearing.

“But new ones showed up,” she explains. “When you get radiation to the pelvis, it affects your bladder, and I had to start wearing diapers on the drive to Tacoma.”

When Attwood completed radiation, she took a trip to Sedona, Arizona.

Attwood in Sedona after completing radiation treatment.

“I participated in healing activities that filled my cup and my heart,” she says. “I left Sedona with 25 percent fewer symptoms — I came with diapers and left without them.”

“I appreciated that Mary took a holistic approach to treatment, combining traditional therapies with naturopathic therapies, while also prioritizing her mental health,” says Dr. Premo. “The trip to Sedona was very important for her healing, and we were able to safely adjust her treatment plan to accommodate her trip.”

Because Attwood had emotionally prepared for surgery in March, she says she felt ready for it in November.

“Dr. Rashidi held my hand and showed up for me,” she says. “She’s someone who treats everyone with generosity and kindness. Her reputation at work is glowing.”

Attwood says she recovered well from surgery and didn’t even need any major pain medicine.

“She had a big operation — robotic low anterior resection — in a minimally invasive fashion using the da Vinci robot and was able to leave the hospital the very next day,” says Dr. Rashidi.

If you have rectal bleeding, go to the doctor

Attwood is feeling great, working at a job she loves and enjoying her kids.

“My husband Adam and I have two girls,” she says. “They keep you in the present. When I was going through treatment, my 6-year-old asked, ‘I heard people with cancer might die — are you going to die?’ I said, ‘Not today.’ I don’t have a choice here; I need to be around for my kids.”

“Cancer can be scary,” says Dr. Rashidi. “But colorectal cancer is one of the most treatable cancers there is, and the technology is getting better and better every day.”

Attwood advises that if you have rectal bleeding, go to the doctor.

“It is a warning sign you should not ignore, even if you have a story like I did of why it’s there,” she adds.

Her latest scan in December showed no signs of cancer.

“My mantra last year was, ‘We can do hard things!’ And that’s so true,” Attwood says. “To anyone in active treatment or in the initial testing phase: You can do hard things!”