Was opting out of surgery the right decision?

March 5, 2020

North York General Hospital is one of only two hospital sites in Toronto to be a part of a Canada-wide clinical trial using a novel approach to treating rectal cancer. In this Phase II trial, led out of Mount Sinai Hospital, patients with rectal cancer are provided with a non-surgical option for treatment and receive only chemotherapy and radiation, followed by a period of intensive follow-up. Clinical trials from around the world have already shown promising results using this approach.

A cancer diagnosis at 45 took Aneta Fishman, a mother of three, by total surprise and turned her life upside down, but as part of her healing she’s sharing her story about how just over a year ago she learned that she had stage III rectal cancer.

Before her diagnosis Aneta was in a great place with her career, she felt fulfilled and challenged in her role with the York Region School Board working on the equity and inclusion education strategy. In the years prior she was principal at an elementary school and always found the strength and resilience of children to be inspiring. Though it wasn’t until after her diagnosis with colorectal cancer that she would truly come to appreciate how much.

 “This diagnosis made me a better person, educator and leader,” says Aneta. “It’s changed the way I see life and how grateful I am – it’s definitely given me more perspective on why we are here.”

Aneta enrolled in the clinical trial after being referred to Dr. Peter Stotland, a cancer surgeon at NYGH, who determined that she met all the criteria.

“Approximately 30 percent of patients with rectal cancer could benefit from a treatment regime consisting of only chemotherapy and radiation,” says Dr. Stotland. “Although surgery is often an important part of colorectal cancer treatment it does comes with some risk, which is why being able to provide patients with an alternative, that can achieve the same results, is an important advance in care that we must pursue.”

North York General’s Colorectal Cancer Program is one of a few in Canada where every rectal cancer diagnosis is individually assessed by a team of cancer specialists including, surgeons, radiologists and medical oncologists. Determining which patients would benefit from participating in a clinical trial is a decision that is informed by this group of cancer experts.

“The care at North York General was great and the team was extremely supportive,” says Aneta. “Having Michelle as my Patient Navigator is amazing, she’s always available to answer all my questions and no matter what’s happening I feel as though she is holding my hand from a distance.”

By the summer of 2019, the chemotherapy and radiation combination treatment were complete and further testing did not detect any cancer. Monitoring Aneta’s health is one of the most crucial steps in the clinical trial and to ensure there are no changes she requires medical checks and an MRI every 3 to 6 months for the next 5 years.

Throughout her diagnosis and on-going treatment, Aneta experienced what most people living with cancer feel at one point or another: a tremendous sense of loss of control. Aneta came to the realization that sometimes people have no choice but to roll with change and that “the only decision we have is how we respond to what happens to us.”

She has since taken to raising funds and awareness about colorectal cancer, especially the importance of screening and for younger adults to follow-up with their doctor if they experience any changes with the body.

Last September she went back to work as a principal, returning to Anne Frank Public School, the first in Canada named after, the German-born Dutch-Jewish diarist and victim of the Holocaust. As the granddaughter of Holocaust survivors, returning to the school she helped open has been especially meaningful in this new chapter in her life.