Opening up about Cancer

I don’t know what tomorrow holds, but I am ready for a new chapter as I start my bonus round in life.

On March 16th, 2021, I received a call from my doctor, “You have stage 3 Colorectal Cancer.”

My world was rocked. I had just made it through the first year of the pandemic and was a month into a new job. All the emotions flooded in, anger, anxiety, and a deep sense of hopelessness.

My diagnosis wasn’t related to family genetics. Inherited colorectal cancers are less common (about 5 to 10%). Mine was considered “environmental”. There are several possible lifestyle and dietary risk factors for developing colorectal cancer. They include diets rich in red, processed, or grilled meats, pre-existing diseases, smoking, alcohol use, and disruption to the circadian rhythms (poor sleep & stress). Chronic stress is a risk factor for a wide range of diseases and disorders. These include several types of cancer.

In many cases, cancers grow slowly over many years. They start as polyps and turn into cancer over the course of 10–15 years. Prompted by a recent alarming rise in colorectal cases, the recommended age to start having regular colonoscopies was lowered. 45 is the new 50. I was 39 when I was diagnosed. WTF.

Fast-forward to October 2022, and it’s time to start my bonus round in life. Life is different now. I’m still coping, but I am also ready to speak up about my experience and share everything I have learned. I’m now 5 months removed from my last surgery with no evidence of disease (NED). Furthermore, I’ve decided that I have to let go of the “old me” and embrace the “new me” — both metaphorically and literally. I am a work in progress, letting go of unrealistic expectations and appreciating the person I am now becoming, working to find joy in every day that I am alive.

I’m not going to lie. The first month I was diagnosed was an emotional blur. Trying to find a care team is the worst. I was a ball of emotions, and I would not have survived the journey without the selfless support of those around me. (Jenn, I love you to the moon and back!)

The thing you should keep in perspective is that cancer is a marathon, with a constantly moving finish line. You don’t rush into a marathon. You take time to understand, plan, and find the treatment plan. I can now say that in retrospect, but at the time my mindset was “Let’s Go!” All I wanted was to rush into a solution. This is why you need to surround yourself with a personal care team that can advocate on your behalf. With the help of my wife and mother, I meet with teams at multiple healthcare groups, ultimately going with UCLA Health.

My treatment plan consisted of total neoadjuvant therapy (TNT) combined with short-course radiotherapy. So what does that mean? Five sessions/one week of radiation, followed by 18 weeks of Chemotherapy (6 IV drips of oxaliplatin every 3 weeks combined with two weeks of capecitabine pills). And lastly, two surgeries. One to remove the tumor (a low anterior resection), followed by ileostomy takedown, 3–5 months after healing.

On April 5th, 2021 my journey began. I’ve only known one way to approach problems for most of my life. With perseverance, persistence, and perspiration. But just because you are comfortable doing the hard things, or you can “take a punch” doesn’t mean we should double down on old patterns. False grit is not the answer when fighting cancer. You have to commit to the long haul and avoid placing a definite timer limit on reaching your goal of beating it. Don’t overestimate how difficult the journey is, and recognize that progress isn’t linear or always obvious.

If I was to give one piece of advice to a loved one who had cancer, it would be to allow yourself to be lifted by those around you. You don’t get through your dark times alone.

Don’t be ashamed to need help. Like a soldier storming a wall, you have a mission to accomplish. And if you’ve been wounded and need a comrade to pull you up. So what? ― Marcus Aurelius, Meditations

The support I had from everyone was unbelievable. It’s given me an appreciation for a lot of things that I’ve always had, but that I overlooked as I went about my day-to-day life. Starting radiation with a powerful circle of super supporters allowed me to deal with my feelings and frustrations in a positive way.

Going through radiation is exhausting, but also provided some instant relief. My tumor was a large13cm mass. Radiation reduced the tumor to 1/4th the size. A small win to start a long journey.

Next up was Chemotherapy. First off, let’s bust a myth. Not all chemotherapy drugs cause hair loss. As someone with a shaved head, this was one of the most common comments — “At least you don’t have to worry about hair loss.” Chemo treatment has also evolved to the point that nausea can be limited.

While I didn’t have to worry about hair loss, the other side effects are grueling — constant tiredness and Neuropathy (numbness or tingling in the hands and/or feet). After each IV session, my nerves were fried and my cold sensitivity was through the roof. After my first session, I remember biting into a tomato and instantly feeling like my throat was closing. Touching anything out of the refrigerator, or freezer, or walking on cold tiles set off numbness and tingling. The sensation would lessen after a couple of days but took longer to dissipate after each chemo cycle. Not only did I have to avoid cold drinks, but I was dressed like a snowman in California. I even slept with a stocking hat and socks to limit the effects. A year later, the side effects have lessened, but you won’t find me in cold environments anytime soon.

Unlike radiation, there were no easy wins with chemo. I had to commit to the journey and find ways to cope. To combat sadness creeping in, I made a conscious effort to deal with my emotions in a positive way. For me, that’s exercise, quality time, and new experiences. I didn’t pick up an extreme sport, but I did enjoy many amazing memories with friends and family. Those activities helped me extinguish negative thoughts. Reframe and find the silver lining.

Next up was my surgery. I honestly didn’t know what to expect going in. And if I’m truthful, I didn’t want to know. Cancer treatment is easier when you stay present and do not overthink. Overthinking can lead to anxiety, stress, frustration, and more.

I went under for my surgery at 7 am on October 21st, 2021 for what was supposed to be a 5 to 7-hour robotic procedure. I woke up around 6 am the next day.

It ended up being a 17-hour operation, more than double the expected time. Thankfully, I had the best UCLA medical team. I made the top ten list for a list you don’t want to be on — One of the most difficult surgeries done by one of the top colorectal surgeons in the nation.

And one side note — avoid scheduling surgery on International Shakeout Day. Juggling earthquake drills at the hospital was far from ideal for my wife.

The tumor mass was larger than expected, despite all the radiation and chemo. The MRI underappreciated the tumor, and my surgeon had to go beyond the normal plane of dissection to be confident that he was getting a clear margin. The surgery was further complicated by urethral injury during the dissection of the fibrotic tumor from the prostate. At the end of the day, I had 12 inches of my colon removed and needed a catheter while my urethra wall healed.

I was a wreck. It took me 3 days to get out of bed, my left calf sustained a serious cramp during the surgery positioning, and the pain throughout my body was intense. My wife was there for the whole surgery, but my mom was the first person I remember seeing post-surgery. I gave her the biggest smile as she spilled her coffee on the hospital floor. The pain meds kept me feeling like a rockstar while looking like Sloth from Goonies.

The surgery had a full impact on my body and some permanent lasting effects. Furthermore, we didn’t know if all cancer had been removed. I was just thankful to be alive. Thankful to see my family.

It was not until one week later, on my 40th birthday, that I received the news. “The pathology report came back with no evidence of cancer.”

Now the real work began. Recovery was slow, but with the help of physical therapy was able to gradually build up my strength. After six weeks, I was able to walk a mile and after 102 days my catheter was finally removed. Then on day 104, I started working out again with Street Parking. I was learning to adjust to life with an ostomy bag while appreciating the difficulties of the journey. Life with a stoma isn’t so scary, and having one is nothing to be ashamed of. It is however a lot of work.

I was deflated, but not defeated. Every day we get a fresh start in life, and while my body will never be the same, every day has value and new experiences. Not all ileostomies can be reversed. So when it came my time, I was thankful.

After my ileostomy takedown surgery on April 5th, 2022 I was ready to move forward. The end of treatment can be both exciting and stressful. Your new life won’t look like your old life, and it can be hard to not look back at what your life was like pre-diagnosis. I wasn’t emotionally prepared for how much my body had changed.

Now that I am 6 months out from my last surgery, I’m trying to not focus on “getting my old self back”. Instead, I am trying to focus on how much life I have to live. I’ll be able to see my daughters grow up. I’ll check off my bucket list of adventures with my wife. And I’ll experience many more moments with friends and family. The smallest joys in life have new meaning.

I try to recognize how delicate life can be and appreciate the day-to-day more, savoring all the small moments and having more gratitude each day.

Just as you need to take care of your body after treatment, you need to take care of your emotions. Mentally, I am not the same due to the trauma, fatigue, and physical changes. Focusing on health, well-being, and mental state is a constant goal.

Managing stress is a big one for me. I’ve spent the last 40 years in growth mode. Focused on chasing financial or career success, anything to have evidence in the world I’ve succeeded, but at the end of the day none of that matters. My real success is beating back cancer.

This has been an inward journey just as much as a physical one. The struggle is real (at least in my head). I’m learning to let go of the ALL OR NOTHING and adapt to the MORE THAN NOTHING mentality. It’s about just keep showing up. Change doesn’t always look like change. Sometimes change is simply doing more than nothing. Healing is about changing perceptions and knowing you are right where you are supposed to be.

I am also acknowledging it’s hard to make changes when you’ve conditioned yourself to hustle harder. I need to better balance my entrepreneurial drive without losing sight of what matters. Understanding the pressures that drag me toward the hustle and countering them by being deliberate about gratitude. Permitting myself to move at a pace to live life to the fullest, with increased happiness, better relationships, less stress, and new opportunities that give me energy.

Going through something like this has made me understand all my blessings. Life is different now. In some ways, it’s better. Hopefully, people don’t have to go through what I did but can apply some of these lessons when experiencing pain, sorrow, or dealing with hard things in life.

If you ever want to share your health journey or have tips for self-renewal, let me know. I’m all ears.