July 10, 2020

Pandemic doesn’t stop cancer care

When a busy elementary school teacher learned she had colorectal cancer, Kaiser Permanente gave her fast, personalized care.

Kamla Birusingh was shocked to receive a diagnosis of colorectal cancer at age 51.

When Kamla Birusingh’s annual home screening kit for colorectal cancer arrived in the mail from Kaiser Permanente last winter, she put it aside. At 51, with no family history of colorectal cancer or symptoms, the busy elementary school teacher felt screening could wait.

But Kaiser Permanente follows recommendations of the U.S. Preventive Services Task Force to screen average-risk adults between ages 50 and 75 with a colonoscopy every 10 years or with an annual at-home test. So, Kaiser Permanente mailed a second FIT kit, or fecal immunochemical test, and this time, Birusingh completed its directions for mailing a stool sample to screen for indicators of colorectal cancer.

“I got a call from Dr. Doug Epperson, my general practitioner at Kaiser Permanente Oakland,” Birusingh said. “He said the test came back positive. I needed a colonoscopy.”

“Winter break at the school would have been a great time to do the colonoscopy,” Birusingh said. “But I had family in from out of town. I scheduled and cancelled the appointment twice. Then COVID-19 happened. I’d just started the second-grade class I teach on remote learning and felt I couldn’t take the day off.”

Concerns eased

Birusingh pushed the colonoscopy from her mind until making an appointment for April 14. While she had concerns about leaving during shelter-in-place restrictions, they quickly evaporated when she arrived at the Kaiser Permanente Oakland Medical Center.

“COVID patients are separated from patients coming in for regular care. You’re screened when you come in, including having your temperature taken, and everyone there is masked.”

Birusingh’s colonoscopy was performed by gastroenterologist Rosa Maria Valadao, MD.

woman running next to lake

Birusingh was exercising at Oakland’s Lake Merritt less than a month after her successful colorectal cancer surgery.

“Dr. Valadao told me she’d found a polyp she’d send to the lab,” Birusingh said. “The next day at home, I got a call from her. The test results were back: It was invasive rectal cancer. I was floored.”

Moving quickly

The following day Birusingh had a CT scan and spoke with surgeon Amy Tolan, MD, to discuss her options.

And on April 29, Birusingh had robotic surgery to remove nearly two-thirds of her rectum; 33 lymph nodes; and her sigmoid colon, the part of the large intestine closest to the rectum.

“I cannot say enough nice things about Kaiser Permanente, from the minute I walked in, to the minute I walked out 2 days later,” said Birusingh. “I had the most caring nurses, who had me up and walking that first night. My physicians all called and came by, and my ob-gyn emailed me. It was the most incredible experience.”

The best was yet to come: The pathology report came back, and all the cancer had been removed.

Birusingh will undergo another colonoscopy in a year, then drop back to 3 and 5 years with each one she clears.

Spreading awareness

“Every day I feel better,” said Birusingh, who recovered at her home near Lake Merritt in Oakland, California. On May 27 she went on her first bike ride.

She never did tell the Castro Valley school where she teaches that she was hospitalized, instead emailing right up to her surgery and resuming the following day. “There was so much going on with COVID-19 that I didn’t want to add to their burden.”

“A delay of another 6 months could have resulted in a far more serious cancer for Kamla,” Dr. Valadao said. “COVID doesn’t have a stop date, so don’t wait to return your FIT kit or schedule a colonoscopy.”

“We are now doing pre-colonoscopy COVID testing on all patients,” added Theodore Levin, MD, clinical lead for colorectal cancer screening at Kaiser Permanente in Northern California. “We can do procedures and surgeries safely, and we are minimizing risk for all of our patients and staff.”

At the urging of her doctors, Birusingh called each of her 6 siblings to ask them to get colonoscopies, too.

“I took my health for granted,” she said. “But because of the diligence of Kaiser Permanente, I am one of the lucky ones.”

Learn more about cancer care at Kaiser Permanente.