Patient’s colorectal cancer discovered through colonoscopy

Craig Stewart says it was “a big surprise” when his colonoscopy showed he had cancer. Here’s how this patient of Dr. Patrick Loehrer has faced that diagnosis.

By IU Health Senior Journalist, T.J. Banes, tfender1@iuhealth.org

He’s a runner. He’s always taken care of his health. He has no history of cancer in his family.

“Given the standard rate at which colon cancer develops, I shouldn’t have had it. Not only did I have it, it had metastasized in my liver,” said Craig Stewart. Days earlier Stewart had gotten a CT scan and there was no trace of cancer. That was Feb. 13, 2017. On the fifth year anniversary of that diagnosis, Stewart talked about his treatment plan in the care of IU Health’s Dr. Patrick Loehrer.

March is National Colorectal Cancer Awareness Month, an opportunity to educate others about the disease of the colon and rectum. Stewart’s message: “I can say with absolute certainty that people should get a colonoscopy at the recommended age of 45.”

To help spread that message, Stewart facilitates a support group at St. Michael’s United Methodist Church, Bloomington, Ind. He met his wife, Marion Krefeldt, when they were both students at Indiana University. She is originally from Aachen, a westernmost city in Germany. They have been married for 38 years and have two children and four grandchildren.

The couple has enjoyed many travels back to Krefeldt’s homeland, visiting her parents, taking in musical productions, and eating traditional German fare.

Stewart spent most of his working career at IU working in technology. Coincidentally, he collaborated with IU School of Medicine faculty members to help accelerate research and upgrade a “super computer center.” It was one of those super computers that aided in the exam of Stewart’s tumor genome. That research helped develop a care plan for Stewart.

“What we know now is that my cancer tumor had eight known or suspected checkpoint mutations so it was able to grow with less interference from my immune system than cancer would normally get,” said Stewart, 62.

Through IU Health’s Precision Genomics program, physicians and researchers can sequence the DNA and RNA of cancer cells, compare those sequences to normal tissue and identify genetic differences that may cause the cancer. They can also determine specific treatments for the cancer.

Stewart’s treatment began with chemotherapy, radiation, and surgery.

“I rang the bell expecting to leave the infusion center in October 2017 but follow up scans in April 2018 showed I had a liaison in my liver,” said Stewart. “The initial belief was surgery hadn’t gotten all of it so we’d go in and take more of the liver.” IU Health’s Dr. Michael House, who specialize in surgical oncology, reviewed tissues that had been sequenced showing the checkpoint of the mutations.

“The rationale was that it would grow back and it did,” said Stewart. In August of 2019, with Dr. Loehrer serving as principal investigator, Stewart was enrolled in an immunotherapy trial.

“The immunotherapy kept the cancer at bay and then it came back in my liver and I’ve been on chemotherapy since. It’s not tremendously fun but every two weeks I feel under the weather for two days and the rest of the time I still feel fine,” said Stewart. His health and energy allowed him to run in six races last year. He finished first in his age group in three of the races and was one of the first 10 finishers in one of those races. One of those races was the “Hoosiers Outrun 5K.” He competed in the “Do Indiana Off Road” (DINO) race at Mounds State Park in Anderson earlier this month.

“I’m not slowing down,” said Stewart. When he and his wife make an extended trip to Germany later this month, he will continue his chemotherapy at a nearby hospital.

“I can’t say enough about Dr. Loehrer and IU Health Simon Cancer Center. When I first met Dr. Loehrer he told me he’d do his best to cure me and if he couldn’t cure me, he’d do his best to provide me with a good quality of life and that he’d always be honest with me. He’s done exactly that,” said Stewart. “He’s an excellent oncologist and a fantastic researcher. I’m alive today for two reasons – IU Health Simon Cancer Center and my wife.”