People, especially those under age 50, don’t often think they need a colonoscopy until something seems “off” or “not right.”

Michael Tomko is no different. However, in August 2018, Michael awoke from his first colonoscopy at age 47 to the unsettling news that he needed a biopsy. Michael had symptoms of rectal bleeding, or blood in the stool. He also had an ongoing change in bowel habits as well as stomach cramps, bloating, and fullness, which were the reasons he scheduled his colorectal screening before age 50.

Despite Michael’s symptoms, nothing could have prepared Michael and his husband for Michael’s diagnosis of stage III colon cancer. 

Michael received chemotherapy, then underwent surgery, and finally received radiation. Michael also received an ileostomy and he had many side effects from his treatments, including fatigue, bowel irregularities, LARS, and neuropathy.

Today, Michael is a survivor who thrives. Because he knows what it’s like to have been diagnosed with early-age onset colorectal cancer, he recommends anyone at any age with with symptoms to get a colonoscopy. 

Michael wanted to share his advice with others. He said, “Know your body! If your body is not functioning in a ‘normal’ manner, recognize that and get the symptoms checked out with a doctor, ASAP!” 

What Is Low Anterior Resection Syndrome (LARS)?

Low anterior resection surgery is one type of treatment that can be effective for curing colorectal cancer. This involves removing portions of the colon containing cancer cells and connecting the remaining parts of the colon, leaving only healthy cells. Rectal cancer patients may undergo resection of part, or the entire, rectum (the last six to eight inches of the large intestine), which can lead to a collection of symptoms known as Low Anterior Resection Syndrome (LARS).

Low anterior resection syndrome can occur after resection surgery to the lower part of the colon. After the resection (removal) of the part of the rectum containing cancer cells, your surgeon will perform an anastomosis (“hook up”) of the colon. Anastomosis means that the two remaining ends of the large intestine and the rectum are sewn or stapled back together, resulting in a shorter colon, which leads to the symptoms that make up LARS.

Michael's Top Tips for Living with LARS

As Michael has adjusted to life after colon cancer, he shared his thoughts on living with LARS:

• Be kind and patient to yourself; understand that your body is healing from treatments and/or surgeries, and LARS is about time and healing. Don’t get discouraged!
• The use of fiber, specifically Psyllium Husk powder, can really help to bulk up stools and slow down the digestive process, if you have frequency. I mix it into 3-4 oz. of water immediately after eating. (Psyllium Husk needs to be gradually introduced to the digestive system, so please consult with your doctor for specifics).
• Always carry “just in case” supplies with you or keep them in the car. These supplies include: flushable wet wipes, barrier cream, a change of underwear or disposable underwear; small plastic waste bags; and any medications you are taking.
• Find some form of mental and/or emotional support, such as a psychotherapist, social worker, LARS support group (Facebook has one called “Living With LARS"), and/or support from other patients who have been through the LARS journey. Most cancer centers have programs to connect LARS patients.
• Invest in a “water toilet,” if possible. This attaches to a regular toilet seat, and it supplies water. No special plumbing is necessary: You just need an outlet near the toilet. There are many models on the market. My favorite is the Toto Washlet.
• Finally, Michael wants to remind others, “You are NOT alone! We are all in this together.”