Dad Who Experienced Rectal Bleeding Had Stage 4 Colon Cancer

In the spring of 2022, Thomas Packard found himself running to the bathroom a dozen times a day. He also noticed blood in his stool and just felt unwell. While he was bothered by this change, he thought he might have irritable bowel syndrome or something like ulcerative colitis. Still, he visited his doctor for a referral to see a gastroenterologist.

“The GI doctor basically said, ‘Yeah this could be concerning. It could be nothing. It could be just some inflammation. What we need to do is a colonoscopy,’” Packard, who was 36 at the time, tells TODAY.com.

Following the colonoscopy, the doctor came in and Packard knew something was amiss.

“(The doctor) had this really despondent look on his face and said, ‘I have no good way to say this. I have terrible news for you. You very likely have advanced colon cancer,’” he says.

Packard was stunned.

“In a moment, everything changes,” he says.

‘Now I am a person who has cancer’

When Packard’s symptoms first began, they were so mild that he thought little of them.

“They were so subtle,” he says. “It took me no more than a couple of months from when I was really cognizant that I was having something wrong to get into the (primary care physician).”

His doctor immediately referred him to a GI doctor, but they said something that struck Packard as odd.

“A funny thing they said to me was like, ‘Oh, just go to the emergency room if you bleed through your underwear. Otherwise go see the GI doc,’” he recalls.

About three months later, he saw a GI specialist and Packard explained his symptoms to the doctor who recommended a colonoscopy. In November 2022, six months after first visiting his primary care doctor, Packard underwent a colonoscopy. Packard remembers the doctor entered the room looking “completely devastated.”  

The doctor said based on the colonoscopy it appeared Packard had advanced stage colon cancer, but they needed to wait for the biopsy to be sure. Packard has no family history of colon cancer and he now knows he’s part of the overall trend of colon cancer increasing in young people. Still, the diagnosis was overwhelming.

“It’s like an upside-down feeling,” he says. “It’s the feeling of one minute ago I was a person who didn’t have cancer. Now I am a person who has cancer.”

The biopsy confirmed that Packard had “adenocarcinoma, which is the most common form of colon cancer,” and a CT scan discovered that the cancer had spread to his liver, making his diagnosis Stage 4 or what’s also known as metastatic cancer.

“Even though my primary cancer is in the colon, I actually had a lot of tumors — more than a dozen — in my liver,” he says. “Getting that result basically was the next blow.”

Packard, whose kids were 5 and 8 at the time, realized that his diagnosis suddenly “got really complicated.”

“Things go really really downhill,” he says. “It was a giant shock to see that CT result, to see extensive metastatic disease in the liver, and to be confronted with your imminent mortality.”

At the time, Packard lived in Seattle and the oncologist he visited did not give him good news.

“He said that they could not give any definite timelines but that many people in my position with the kind of extensive disease that I had could expect to survive six months to a year,” he says. “There was nothing that they could do. There was no surgery that could be done. Liver transplant was not an option. There were no curative option.”

The doctor informed Packard he could be on palliative chemotherapy to try to extend his life and let him enjoy the little bit of time he had left. Packard grappled with knowing his death would leave his children without a father.

“It was much more devastating and unacceptable to me to think about the fact that I wouldn’t be here for my kids,” he says.

While Packard lived and worked in Seattle, his children were with their mom, his ex-wife, in Denver. Facing what he thought was a death sentence, Packard knew he needed to be closer to his children.

“I was traveling every other week to go to Denver and spend time with the kids,” he says. “I realized if I don’t have long to live, I need to be near my kids.”

In Colorado, he met a new oncologist who started him on systemic chemotherapy.

“He confirmed … the extensive nature of the tumors in the liver meant we could not operate,” he says. “The only choice to do medically was to start chemo with the hopes that chemo would shrink the tumors and we would get to a point where we could cut them out.”

In December 2022, a month after he was diagnosed, Packard started chemotherapy. He could tell it was working because some of his symptoms improved.

“I was feeling better on chemo, which I know seems ridiculous,” he says. “When the cancer is making you very sick, it is possible.”

A CT scan confirmed what Packard suspected — the chemotherapy was working.

“We saw that many of the tumors on my liver had shrunk —including one of them which at the beginning was about the size of a grapefruit,” he says. “It was about half of the size after about three months.”

While this was welcomed news for Packard, the doctors realized he needed more intensive treatment to get him to a point where he could undergo surgery to remove the remaining masses on his liver. His doctors presented his case to a multidisciplinary care clinic for a chart review and a surgical oncologist had an idea for how to treat his liver metastases.

“(She) knew that (hepatic artery infusion) technology actually is very useful for people who are in exactly my position,” Packard says. “Basically, people who have colorectal cancer that have liver metastases (the) … entire disease burden is in their liver and their colon.”

For hepatic artery infusion (HAI), doctors insert a pump under the skin that delivers high doses of chemotherapy directly to the liver via the hepatic artery, according to an article in the Journal of Surgical Oncology. Even though the doses are higher, they cause fewer side effects than systemic chemotherapy and more effectively reduces tumors, says UChicago Medicine.

When Packard heard about this treatment, he didn’t realize how transformative would be. At the time, he was estate and funeral planning and thought this was just another experimental treatment.

“‘This cancer will kill you’ and that is the only message I heard,” he says. “It’s something that I worked really hard on accepting during that time because I had no choice.”

But the surgeon who suggested it shared all the benefits with him. Still, he felt dubious.

“(I said) ‘But if I’m going to be dying here in a year or two, and this thing maybe adds a month or two to my life, what’s the point,’” Packard recalls. “She looked and me and was like, ‘I’m not sitting here having a meeting with you to talk about extending your life a couple of months … I’m here because I believe that we can use this therapy to get you to a place where we can completely remove your cancer.’”

Packard says he experienced “cognitive dissonance” at that moment. He had spent all this time believing he’d never be cancer-free and suddenly he learned that he could be.

“It was the first time I even experienced (hope) in my cancer journey,” Packard says.

Treatment

Much like regular chemotherapy, Packard needed to go to an infusion center to receive his HAI chemotherapy. But that’s where the differences end. Staff use a needle to insert the treatment into a reservoir directly into the Intera HAI pump and it only takes about 10 minutes.

“You don’t feel anything,” he says. “I was getting chemo through that pump for two weeks, 24 hours a day, a very slow, low amount of it coming out.”

He started HAI therapy in July 2023 along with systemic chemotherapy for two weeks. Then three months later, Packard received “another life changing call.”

“The doctor said, ‘The surgical oncologist and I have just reviewed your latest CT scan and we want you to know that we think you’re now eligible for resection,” he says.

“It paid off. That was the right choice,” he says. “I would have never believed that this would have happened to me that I would be able to go from being told that there was really no hope to a glimmer of hope … then to be told now you’re eligible for resection.”

In October, Packard underwent liver surgery to remove all of the tumors and in December he had colon surgery to remove the primary tumor. It was followed by several rounds of radiation.

“By the end of 2023, roughly one year after starting treatment, I was declared no evidence of disease,” Packard says.

‘A lot of gratitude’

 “Colon cancer right now in the U.S. is the leading cause of cancer deaths among men under 50,” Packard says.

A report from the American Cancer Society agrees that colon cancer is the number one cancer death of young men, past TODAY.com reporting says.

That’s why Packard feels it’s so important to share his story with others. He hopes it encourages people to see their doctor if they notice any bowel changes and to undergo regular colonoscopies when they’re 45.

“What I feel now is a lot of gratitude for all of the people who helped me get to this point,” he says. “I want to use this time that I have not to just obviously hang out with my kids and enjoy everything that life has to offer, but I also want to give back and help other people who are in this position.”