‘TIME IS A GIFT’

Young parents battle Stage IV colon cancer

By Rachel Sauer

April 2023

Kacie Peters and Erik Stanley got together after an early-morning walk that felt like it would never end.

They met at a New Year’s Eve party in Chicago in 2012. Kacie, who had flown in from Philadelphia to visit a friend, didn’t know anyone else at the party. Then, her friend decided the apartment was too full and that Kacie needed to find somewhere else to spend the night.

Erik offered to let Kacie stay at his studio apartment. He’d sleep on the couch so she could have the bed. Accepting his offer, they walked, took a bus, took a train, and walked again – almost four miles. Every so often, Erik sheepishly promised, “Just a little bit farther.” 

When she woke up the next morning, Kacie noticed a book about serial killers on Erik’s nightstand.

What could have been a big “uh-oh…” moment instead developed into a long-distance relationship and then a wedding a year and a half later. 

Since then, in their 10 years together, Kacie and Erik have ventured to far-flung places, moved halfway across the country, and for the past six years found daily delight in their son, Nate.

They’ve been through some challenges, but always together, generally laughing, grateful to have each other’s hand to hold. 
And now, together, they’re each battling stage IV colon cancer. Kacie is just 36 – she was 34 when she was diagnosed on New Year’s Eve in 2019 – and Erik is 41.

Even though a growing number of young people being diagnosed with late-stage colorectal cancer, the odds of this happening with both members of a couple are “one in a hundred million,” says Christopher Lieu, MD, University of Colorado Cancer Center associate director for clinical research and Kacie’s oncologist. “It’s almost incalculable.”

Yet the improbable odds don’t change the facts. “This is what’s happening, so we’re dealing with it and living our life with our son,” Erik says.

“I try to find the silver linings with things and try not to focus on the bad stuff,” Kacie adds. “Of course there’s stuff we talk about to each other in private, plans we have to make, but we’d rather be an example that you can get through things together and still have a really good life, the life you want to live.”

PAYING ATTENTION TO SYMPTOMS

For Kacie, it started with pain in her upper abdomen. She had a busy job she loved and frequently traveled for work. She figured the pain was just stress. For months she was in and out of doctor’s offices, in and out of urgent care, always leaving with incorrect diagnoses and medications that offered only temporary relief.

The pain grew bad and persistent enough that she was hospitalized for an urgent colonoscopy on the last day of 2019. She had barely regained consciousness after the procedure when she received the news that she had cancer, and the medical team wanted her to consent to surgery that night.

“I was alone when I got this news – Erik was at the Children’s Museum with Nate – but I don’t think it was a total surprise because I’d had a month and a half of throwing up blood,” Kacie says. “But I still had to call Erik and say, ‘Guess what, I have cancer, I’m going into emergency surgery right now.’”

“Definitely the worst call I’ve ever received,” Erik says.

Kacie was initially diagnosed with stage III colon cancer and spent much of 2020 having surgery and chemotherapy treatment, working with a multidisciplinary team from the CU Cancer Center.

“She’s definitely benefited from multidisciplinary management,” says Lieu, an associate professor of medical oncology. “She’s had surgery with Dr. Steven Ahrendt, chemotherapy with me. The whole team has worked in conjunction to make sure we’re doing everything possible for her.”

She had a brief period of remission, but the cancer returned in August 2021 and this time it was stage IV.

A SECOND COLON CANCER DIAGNOSIS

Through 2020 and 2021, Erik supported Kacie through chemotherapy treatments and surgery while making sure life was as normal as possible for Nate.

“This is hard to talk about because I don’t want to imply it was a burden,” Erik says. “She’s the person I love, and I wanted to do everything I could for her, and she made it easy. But I don’t think we talk enough about the pressures that come with a cancer diagnosis.”

At the beginning of 2022, Erik began experiencing symptoms that by now were painfully familiar: exhaustion, constipation, abdominal pain. He knew he couldn’t write it off as just stress, and on February 22 he received results from a CT scan that were an awful near-repeat of Kacie’s three years before.

“It was a shock,” Erik recalls, and Kacie adds, “We’re thinking, ‘How could this be happening with both of us?’”

Sunnie Kim, MD, a CU Cancer Center member and Erik’s oncologist, says: “When I first met Erik, he’d had a CT scan that showed sigmoid colon cancer that unfortunately was involving his kidney, the abdominal wall lining, and his liver. The sigmoid lesion was so big that we as his care team debated whether to start chemo right then and there.”

His multidisciplinary care team suggested he first have a nephrostomy, or a procedure in which an opening is made between the kidney and the skin of the back to let urine drain from the kidney, and a diverting colostomy.

“After that, I felt very nervous about sending him home, so we ended up just starting chemo in the hospital on March 2,” says Kim, an assistant professor of medical oncology. “We were concerned that the mass was causing issues with his kidneys, and we didn’t know the pace of its spread, so it was important to be very aggressive and get the ball rolling.”

Since then, Erik has had eight cycles of chemotherapy and a CT scan in April showed that his liver metastasis has shrunk, as has the primary sigmoid mass. 

Lieu and Kim have worked in close collaboration, and after consulting with Kacie and Erik following Erik’s diagnosis decided that it would be beneficial to have them be treated by different oncologists.

“We did leave it open to Kacie and Erik,” Kim says, “but that’s one of the benefits of a multidisciplinary approach. We’re in constant communication as a team and with Kacie and Erik.”

BENEFITS OF MULTIDISCIPLINARY CARE

Because of that communication between Kim, Lieu, and other members of the care team, Kacie and Erik receive their chemotherapy treatments in the same week, easing the logistical challenges of childcare and recovery. Both Kacie and Erik have gone on disability while they receive treatment, “and we’re so lucky that was an option for us,” Kacie says.

However, having cancer can be costly, and unexpected expenses are almost guaranteed. In the spring 2022, a friend established a GoFundMe for the family that so far has raised more than $122,000, which they’ll use to help with any unexpected medical expenses as their treatment continues.

The financial cushion has been a significant stress relief, Kacie says, though their ultimate goal is to see their cancers shrink enough that they can go back to work and pass the rest of the GoFundMe donations along to others dealing with cancer.

The most common question the couple receives, Kacie says, is “How did this happen? Were there environmental factors that caused this? Some rare twist of genetics?”

“Unfortunately, the answer is we just don’t know,” Lieu says. “There’s research happening here at CU and all over the world trying to figure out the confluence of factors that can lead to this, because it’s not just one thing. With Kacie and Erik, my hypothesis is that it’s probably a combination of things – genetic factors, environmental exposures that just slightly increase the chance of developing colorectal cancer in people as young as they are.”

Both Kacie and Erik, as well as Lieu and Kim, emphasize the importance of not ignoring out-of-the-ordinary symptoms “and I would even say getting a second opinion if you’re still concerned,” Kim says. “Patients know their bodies and it’s important that we don’t automatically think it can’t be colorectal cancer because they’re too young. We’re seeing more and more that there isn’t a ‘too young.’”

TIME IS A GIFT

For now, and for each day, Kacie and Erik are focusing on their time together as a family. “It’s really important to us not to look at it as ‘buying time’ but as appreciating time,” Kacie says. “Nate’s 6 and he needs to have as much of a normal life as we can give him.”

So, they walk to Stanley Marketplace for tater tots, and they stroll through downtown Denver festivals. When the community pool is open, swimming is frequently on the agenda, as are peaceful moments on the porch swing in the gloaming light of late afternoon.

“I know it sounds so cliché, but you realize that time is a gift,” Erik says.

“And we don’t want to waste it,” Kacie adds. “Not a minute of it.”