The milestones were stacking up for Becky Grubb in mid-May 2021. She gave birth to her second child, a daughter, a few months earlier, and now, in the afterglow of Mother’s Day, Grubb was on the eve of her 40th birthday.
But this day – the 13th of May – came tinged with shadow. Grubb had repeatedly tested negative for various gastro-intestinal problems during and after her pregnancy. During that time, she experienced bowel-movement changes, including diarrhea and blood in her stool. Grubb now faced something she didn’t expect at the dawn of 40 – a colonoscopy.
She assumed she’d wake up to learn she had colitis – unpleasant, yes, but treatable. Instead, when she awoke, “the doctor was patting my arm, and a nurse was crying in the corner.”
Soon after, the mass seen on her colonoscopy was confirmed: stage IV colorectal cancer. Grubb’s busy life – raising her family and building a career – turned upside down. Her personal shock arrived in tandem with the global community spiraling deeper into the COVID-19 pandemic.
Her best friend, an anesthesiologist in St. Louis, offered stern advice that would prove pivotal. “Get yourself to UCHealth right now – right now,” Grubb recalled.
Key points:
- The colorectal cancer incidence rate in adults under age 55 is rising about 1% to 3% annually in the United States, according to the Cancer Research Institute. Colorectal cancer is the nation’s second-leading cause of cancer death.
- Becky Grubb was diagnosed with stage IV colorectal cancer at age 40 in May 2021. Under the care of a multidisciplinary team at the CU Anschutz Cancer Center, Grubb continues to raise her family and build her career.
- Grubb and her doctor emphasize the importance of paying attention to your body and not ignoring symptoms. “You know when something is not right … keep advocating for yourself,” Grubb says.
Grubb, who also learned she had lesions in her lungs, had doubts that a second opinion would change much. “I took my husband and had the mindset, ‘Why am I doing this? I’m trying to navigate all these things in my life: parenting, work and social obligations.’ And within about five minutes with Dr. Messersmith, I was like, ‘Where do I sign?’”
Wells Messersmith, MD, a professor in the Division of Medical Oncology at the CU Anschutz School of Medicine, devised a care plan for his new patient who asserted: “I need a plan. That’s what puts me at ease,” Grubb said. “I joke that Dr. Messersmith speaks Becky.”
She was put on a chemotherapy regimen and, a couple months later, underwent lung surgery by John Mitchell, MD, a cardiothoracic surgeon, to remove tumors in one of her lobes.
“Dr. Mitchell looked at her scan and met Becky on the same day as my appointment, which is unheard of, normally,” Messersmith said. The multi-disciplinary approach is a hallmark of treatment at the CU Anschutz Cancer Center, of which both Messersmith and Mitchell are members. “We were hoping at some point we could cure her with surgery,” Messersmith said, “but unfortunately the lesions in the lungs turned out to be too widespread.”
Then came another round of chemotherapy, followed by colon surgery to remove the original tumor. Because of Grubb’s young age, doctors performed an ovarian transposition, moving her ovaries outside the field of radiation, so that she wouldn’t experience early menopause and its attendant symptoms, including bone loss.
Grubb’s treatment regimen has included surgery, radiation, chemotherapy and immunotherapy – the latter being a clinical trial. “All of these small, incremental advances can lead to long periods of prolonged survival,” Messersmith said. “I often tell my patients, ‘Even in cases where we can’t cure you, we can turn this into more of a chronic disease, like diabetes or hypertension.’
“Ideally, we’d like to cure people,” he added. “But if we can just keep things at bay, we’ll go that route and hopefully preserve their quality of life.”
Grubb, as she nears the fifth anniversary of her diagnosis, is leading as active a lifestyle as anybody in their 40s. She continues to work full time as a communications manager and busily keeps up with, along with her husband, Erik, all the activities of her 7-year-old son, Micah, and 5-year-old daughter, Reese. She has a knack for keeping things light – wearing a tutu (along with her doctor) – at a 5K run/walk benefit for colorectal cancer research and finding the humor in her family hereditary history.
Paying it forward
Becky Grubb grew up in St. Louis and after college moved to Denver, where she has cultivated a formidable crew of support.
She credits her care team at the CU Anschutz Cancer Center for being the heartbeat behind her five-year cancer journey. Meanwhile, her crew has been the steady pulse that’s kept her and her family going through the ups and downs of a challenging half-decade.
“I am incredibly lucky that my parents, sister and in-laws in the Midwest have dropped everything to be by my side when I needed them most,” Grubb said. “While I don’t have family here locally, I have a huge village. I could not do this without them. That’s what makes me cry.
“I can talk about the illness, the fighting, and the toll it’s taken on my family all day, but I will never be able to repay the people who have come back into my life to support me, who’ve taken care of my kids, who’ve jumped on an airplane last-minute to help me. That’s why I want to pay it forward – to help other people, to tell my story.”
“My mom had breast cancer when she was in her early 40s. So, there’s history of cancer at a young age, but not colorectal cancer,” Grubb said. “We try and one-up each other when we compare situations. I am currently winning.”
Grubb has the KRAS G12D mutation, which is one of the more common mutations in colorectal cancer. “We’re hoping that by using different drugs that have different affinities for the various mutations – where we combine these KRAS inhibitors with other targeted drugs or immune therapies – that we can get a nice, prolonged stabilization of the tumor,” Messersmith said.
Earlier in her care plan, Grubb was on an immunotherapy clinical trial. While the drug appeared to slow tumor growth, it caused heart problems and, after conversations between physician and patient, the treatment was discontinued.
“I always connected with Dr. Messersmith on the fact that I am relatively young,” Grubb said. “I was relatively healthy outside of this, so my thought was: ‘Let’s go get it; let’s knock it out.’ And I feel that way with the clinical trial – that if I can stand it, let’s do it.”
For about two months, Grubb has been on a pill-form KRAS inhibitor, with fewer side effects. “If this clinical trial doesn’t work, it doesn’t work, but we are providing data that could help the people diagnosed after me,” she said. “I’ve been fortunate that most everything has worked, but managing the side effects has been a huge challenge.”
“My advice would be to have a reality check with your body. You know when something is not right, or is outside the normal, and then just keep advocating for yourself. It's also important to have a doctor who will advocate for you, because there are really good people who will take it seriously.”
– Becky Grubb
Grubb takes comfort in knowing that one of the nation’s leading experts in colorectal cancer is her doctor. That doesn’t stop her from deluging her physician with information. “I send stuff his way all the time. I send articles. I send trials,” she said. “The last time, of course, I sent him an article, he was the one who had written it.”
Grubb says she loves how her providers are flexible in accommodating her busy schedule. It’s not unusual for them to offer the choice of late- or early-morning appointments. “I’m like, ‘I have school drop off, and then I have a meeting.’ I’m still trying to function,” Grubb said. “I’ve had a few conversations about ‘what does it look like living?’ The cancer may never go away, but if we can stop it for the next 20 years, OK, so what does that look like?”
Messersmith said the climbing rates of colorectal cancer among younger people remains a mystery; the rate has been dropping in people ages 65 and older. Diet, exercise, the microbiome, obesity, microplastics and overexposure to antibiotics – as well as multifactorial triggers – are all being studied as potential causes for the unusual rise.
“In reaction to that, the screening recommendations have been adjusted so that they recommend screening for patients 45 and older, not 50,” Messersmith said. “And the other thing that we’re always reminding people is don’t ignore symptoms.”
In retrospect, Grubb would’ve listened more closely to her gut when her GI tract started acting up over five years ago.
“My advice would be to have a reality check with your body,” she said. “You know when something is not right, or is outside the normal, and then just keep advocating for yourself. It’s also important to have a doctor who will advocate for you, because there are really good people who will take it seriously. So, don’t let it slide, because if you catch it early, it’s more manageable and you don’t have to go through all this, potentially.”