A Los Angeles mother found an unexpected cancer diagnosis after a routine ER visit, battled stage 4 disease with chemo and immunotherapy, and then became a candidate for a rare living-donor liver transplant that cleared her cancer; doctors say response to chemo is a major factor in choosing transplant, and experts warn early-onset colorectal cancer can be silent so people should stay on top of screenings and symptoms.
Amy Piccioli, a busy CPA and mother of three, went to the ER thinking she had a stomach bug and dehydration when scans revealed a mass in her colon and multiple lesions in her liver. She faced an automatic stage 4 diagnosis with no obvious warning signs, which left her reeling. She said, “I had no symptoms,” “I’m one of those people who’s very diligent about my health and very cognizant about changes in my body. So for this to have happened without any signs or symptoms was just shocking to me.”
“I just went numb — I couldn’t believe it,” she said, and the shock quickly shifted into a frantic rush to get treatment started. In June 2024 she began chemotherapy plus an immunotherapy agent, and scans three months later showed the tumors had shrunk, allowing surgeons to remove the primary colon tumor. That response created a window of opportunity to consider more aggressive options aimed at long-term control.
WOMAN’S ALARMING CANCER SYMPTOMS BLAMED ON PREGNANCY FOR YEARS BEFORE STAGE 3 DIAGNOSIS Chemo helped, but Piccioli understood it might never fully clear the liver disease because the tumors were widespread. “The cancer was all over my liver,” she shared. “In cases where the cancer is confined to one side of the liver, they can basically cut that portion out … but in my case, a resection was not a possibility because the cancer was everywhere.”
She also warned about the limits of systemic therapy: “it was always going to be a ‘whack-a-mole’ situation, where I would be on systemic chemo for an extended period of time, new stuff would pop up, and it would just be this cycle over and over and again.” Facing that reality, transplant became the long-term solution on the table. “The chances of eradicating the cancer entirely from my liver with chemo alone was very slim. In cases like mine, liver transplantation is really the only long-term solution.”
Liver transplantation for metastatic colorectal disease is more common in Europe than in the U.S., and Piccioli thought it might be out of reach. Her team found a specialized program at Northwestern Medicine in Chicago that evaluates these cases as a potential path to cure. Satish Nadig explained, “When liver metastasis is noted, our medical oncologists, along with our transplant surgeons begin to make care pathways tailored to the patient,” and he emphasized practical selection standards rather than hope alone.
“Response to chemotherapy is a critical gatekeeper for liver transplantation in colorectal liver metastases,” Nadig said, adding that demonstrated control helps identify patients whose tumor biology is favorable. “Demonstrated disease control or response is usually required, as it identifies patients whose tumor biology (less aggressive and not spreading quickly) is favorable enough to justify a transplant.” Those criteria aim to pick patients most likely to benefit long term rather than expose someone to major surgery with little chance of durable success.
Amy began searching for a living donor and shared the need with family and friends; a childhood friend, Lauren Prior, stepped up and proved to be a match. The living-donor transplant took place in December 2025, making Piccioli the first patient at that center to receive a living donor liver for metastatic colon cancer. Early recovery was rough but steady: “The first week or two were difficult, but by week four, I was up and around, getting back to doing normal life things,” she said. “About two months out, I started working out again. I’m now three months out and feel completely normal. It’s amazing what the body can do.”
Post-transplant testing brought the best possible news: her first blood screening for tumor molecules showed no evidence of disease. “So I have no evidence of disease currently,” she shared. She will remain in Chicago for monitoring through March before returning home to Los Angeles for ongoing follow-up and surveillance.
RED FLAGS FOR COLORECTAL CANCER THAT WARRANT SCREENINGS BEFORE 45 YEARS OF AGE Experts point out that early-onset colorectal cancer is often silent because routine screening usually begins at age 45 and symptoms can be subtle. “That’s because screening is absent before age 45 and symptoms (such as slow bleeding) are usually subtle,” Nadig cautioned, noting tumors can hide on the right side of the colon or behave in ways that delay clear warning signs.
JAMES VAN DER BEEK’S DEATH HIGHLIGHTS ALARMING COLON CANCER RISE IN YOUNGER ADULTS Piccioli urges people to watch their bodies and keep up with recommended checks, and she credited persistence for getting the care that saved her life. “Do the screenings at the recommended ages, follow up and just be diligent about your health,” she advised. “I think a lot of the reason that I got to Northwestern and was able to receive this transplant was because I was so diligent about calling the doctors, scheduling the appointments … I think that is really the most important thing: You have to be the captain of your own ship.”
