The Impact of a Diagnosis Extends Beyond Just the Patient
- “Dawson’s Creek” star James Van Der Beek, 48, went public with his stage 3 colon cancer diagnosis in 2024, and while he has not provided specifics about his treatment plan, at stage 3, surgery to remove the tumor and affected lymph nodes is followed by chemotherapy to eliminate any remaining cancer cells that may have spread beyond the colon, which is the usual standard of care.
- Van Der Beek’s diagnosis has had an emotional impact on people close to him, including “Dawson’s Creek” co-star Kerr Smith, 54, who said on the “Pod Meets World” podcast, Van Der Beek’s diagnosis hit him “kind of hard.”
- Colon cancer is highly treatable and curable when detected early. Screening options include at-home tests like Cologuard, though medical experts recommend a colonoscopy for more effective detection.
- A colonoscopy uses a thin, flexible tube with a camera to inspect the colon and rectum for polyps. Polyps are small, noncancerous growths that can be removed during the procedure to prevent colorectal cancer from developing, according to colorectal cancer surgeon Dr. Zuri Murrell.
- Colorectal screenings are generally advised starting at age 45, but individuals with higher risk factors, such as a family history of colon cancer, may need earlier testing. Consulting a doctor about screening options is recommended.
- According to research in The Journal of the Royal Society of Medicine, chronic illnesses significantly affect family members as well, disrupting emotional balance, social lives, relationships, and finances. The study stated, “Most chronic diseases have similar effects on family members [as they do on the patient].”
“Doing these Cons with him these past couple of years, I’ve really gotten to know James all over again,” Smith shared on the “Pod Meets World” podcast. “This time as 50-something-year-olds, rather than kids.”
“So you can imagine how gutted I was when two stomach viruses conspired to knock me out of commission and keep me grounded at the worst possible moment,” Van Der Beek shared on Instagram.
Although James’ reunion night didn’t go as he had initially planned, his wife, Kimberly, alongside his children, appeared before the crowd. Kimberly described the reunion special as “a gift” in an Instagram story and explained how much she “missed her husband.”
As Van Der Beek re-emerges back into the spotlight, Smith is struck by the strength it’s taken for his friend to navigate cancer while remaining present for his family.
“This whole thing he’s gone through has kind of hit me hard. It’s been tough,” Smith admitted.
“Dawson’s Creek,” which aired from 1998 to 2003, followed Dawson Leery (Van Der Beek) and Joey Potter (Katie Holmes) as they navigated adolescence in a tight-knit circle of friends. Today, that circle still holds.
Van Der Beek’s journey and its impact on friends and family are a reminder that cancer doesn’t just affect the body—it impacts relationships.
Research published in The Journal of the Royal Society of Medicine found that “most chronic diseases have similar effects on family members [as they do on the patient], including psychological and emotional functioning, disruption of leisure activities, effect on interpersonal relationships, and financial resources.”
Parents, siblings, spouses, and others often carry invisible emotional burdens: “helplessness, lack of control, anger, embarrassment,” researchers observed.
The strain can show up in all kinds of ways—disrupted sleep, altered eating habits, and spiritual or cultural searching for meaning. It can limit freedom, deepen fears about death, and leave loved ones desperately seeking support and understanding.
Yet even amid the emotional toll, experts emphasize that a strong support system has the power to bring families closer. The pain of a diagnosis, while devastating, can also strengthen bonds and foster deeper empathy.
More On Colon Cancer
James’ Ongoing Cancer Journey
Van Der Beek, a father of six, first went public with his diagnosis in November 2024, though he was diagnosed in August 2023. Since then, he’s described 2025 as a year of emotional highs and lows. On the Today show, he reflected on the toll of treatment.
“It’s been a journey. There are just so many ups and downs and so many unknowns. Cancer is—I call it a full-time job… It’s a process. It’ll probably be a process for the rest of my life,” Van Der Beek said.
Stage III colon cancer indicates that the disease has spread to nearby lymph nodes, often requiring both surgery and chemotherapy. While Van Der Beek hasn’t publicly detailed his treatment plan, his openness has helped raise awareness about early detection and the realities of living with cancer.
What Treatment Looks Like for Stage 3 Colon Cancer
At this stage 3, the colon cancer has spread to nearby lymph nodes, signaling a more aggressive disease that requires a comprehensive treatment approach.
“Stage 3 means that there’s some cancer in the lymph nodes,” explains Dr. Heather Yeo, a colorectal surgeon and surgical oncologist, in an interview with SurvivorNet. She emphasizes that patients facing this diagnosis should seriously consider chemotherapy as part of their treatment plan.
“Colon cancer patients with stage 3 should at least have a conversation about undergoing chemotherapy,” she says.
WATCH: Stage Three Means Cancer Has Spread Outside the Colon Wall
Despite the seriousness of the diagnosis, there is reason for optimism.
“Stage 3 cancers have probably a 50% to 60% survival at five years,” Dr. Yeo adds, underscoring the potential for long-term recovery when treatment is timely and effective.
The standard protocol for stage 3 colon cancer typically begins with surgery to remove the tumor and affected lymph nodes. This is followed by adjuvant chemotherapy—treatment administered after surgery to eliminate any remaining cancer cells that may have spread beyond the colon.
Adjuvant chemotherapy usually begins within six to eight weeks after surgery, once the patient has recovered. One of the most widely used regimens is FOLFOX, a combination of fluorouracil, oxaliplatin, and leucovorin. However, other chemotherapy options may be considered based on individual patient needs and emerging research.
“Now, for the chemotherapy, there certainly are newer agents and newer choices that could be integrated into a clinical trial,” notes Dr. Daniel Labow, Chief of the Surgical Oncology Division at Mount Sinai Health System. He adds, “Patients with stage 3 are often cured, with both surgery and chemotherapy.”
Even with successful treatment, vigilance remains essential. The risk of recurrence within five years is estimated to be between 20% and 25%, making follow-up care and monitoring a vital part of survivorship.
Chemotherapy After Surgery: A Critical Step in Treating Stage 3 Colon Cancer
The goal: reduce the risk of recurrence and improve long-term survival.
“Once a person completes that chemotherapy, we expect that they’re done,” says Dr. Paul Oberstein, a medical oncologist specializing in gastrointestinal cancers.
“They need to be watched very closely so that if there are signs that this has come back, we detect it early.”
WATCH: Using Chemo to Treat Stage 3 Colon Cancer
Post-surgical chemotherapy typically lasts between three and six months and involves a regimen of medications proven in clinical trials to be most effective at preventing the cancer from returning. The most widely used combination is known as FOLFOX—a protocol that includes three drugs:
- 5-fluorouracil (5-FU)
- Leucovorin
- Oxaliplatin
These medications are administered intravenously, usually every two weeks. Patients are connected to an IV pole during treatment sessions, which take place in a clinical setting. The process may feel routine, but its impact is anything but.
FOLFOX works by attacking cancer cells at multiple levels—disrupting DNA synthesis, enhancing drug effectiveness, and damaging cancer cell structures. While side effects like fatigue, neuropathy, and nausea are common, the regimen remains a cornerstone of colon cancer care due to its proven ability to reduce recurrence and extend survival.
Bowel Issues Prompted Van Der Beek’s Cancer Discovery
Van Der Beek started having bowel issues. However, he attributed the abnormality to his coffee habit.
“I thought maybe I needed to stop coffee. Or maybe not put cream in the coffee. But when I cut that out and it didn’t improve, I thought, ‘All right, I’d better get this checked out,’” Van Der Beek told People Magazine.
Van Der Beek went to see his doctor and received a colonoscopy, which checks for signs of cancer in the colon, to see if his atypical bowel habits could be something else. It turned out it was.
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“It is cancer,” Van Der Beek said in a social media post sharing part of his cancer journey and warning others to stay on top of their health.
Van Der Beek admitted he had been struggling with who and how to share his diagnosis.
“I’ve been dealing with this privately until now, getting treatment and dialing in my overall health with greater focus than ever before. I’m in a good place and feeling strong. It’s been quite the initiation, and I’ll tell you more when I’m ready.
WATCH: Sharing a Diagnosis
Some people battling a disease or cancer are open to sharing their experiences as much as they can, while others prefer to keep it to themselves or close loved ones. SurvivorNet experts say both approaches, and everything in between, are valid.
“Patients who have just been diagnosed with cancer sometimes wonder how they are going to handle the diagnosis of cancer in social situations,” psychiatrist Dr. Lori Plutchik explains.
Plutchik says patients consider questions like “How much information should they share and with whom should they share the information?”
Dr. Plutchik explains, “There is no one right way to handle this diagnosis. People should do what feels right to them.”
A cancer journey can last months to years, which means cancer warriors may be experiencing a lot of uncertainty until they fully understand where their health stands. This uncertainty can influence when a cancer patient is ready to share their diagnosis, Dr. Plutchik further explained.
Dr. Plutchik stresses that those close to a person going through cancer should be respectful of their wishes when it comes to disclosing their diagnosis and seeking support.
Colon Cancer Is Treatable and Curable When Caught Early
Colon cancer is very treatable and curable if caught early. Colon cancer screenings can involve at-home tests such as Cologuard, but a colonoscopy is more effective, according to SurvivorNet experts.
The cancer starts when abnormal lumps called polyps grow in the colon or rectum. It takes up to 10 years for a colon polyp to become full-blown cancer, according to SurvivorNet experts.
When you have a colonoscopy, the gastroenterologist looks for polyps inside your intestine. Although polyps can’t be felt, they can be picked up by screening tests before they cause a problem, such as colon or rectal (colorectal) cancer.
A polyp found during a colonoscopy can be removed, which can prevent the development of cancer. Almost all polyps that are removed are precancerous, meaning that they have not yet progressed to cancer.
The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45. However, experts recommend screening earlier for some people who may be at an increased risk of developing colon cancer, such as those with a family history of the disease.
WATCH: Debunking misconceptions about colon cancer.
The most poignant signature of colon cancer is a change in bowel habits. Changes in the size or shape of bowel movements may cause constipation or diarrhea. A change in stool color, particularly black or tarry stools, can indicate bleeding from a tumor deep in the colon.
Other symptoms can be harder to pinpoint, such as abdominal pain and unintentional weight loss. Finally, some tumors bleed a small amount over a long period of time, resulting in anemia (low red blood cell count) that is picked up on blood work.
A Colonoscopy Explained
A colonoscopy is a procedure doctors use to screen for colon cancer by looking inside the colon.
This procedure requires your colon to be “cleaned out.” To clear out your colon, your doctor will prescribe a “bowel prep,” a liquid you drink the night before the procedure. The prep acts as a laxative that causes you to have multiple loose stools before your procedure.
Once your colon is cleared, the gastroenterologist performing the procedure can have a clear look to evaluate if any polyps or masses are present.
Depending on the size and number of polyps found, it is recommended that patients undergo a repeat colonoscopy within three to five years.
WATCH: What Doctors Look for During Colonoscopies
Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center, previously explained the colonoscopy procedure to SurvivorNet.
“When we see a polyp, we actually physically take the polyp out through the colonoscope,” he explained.
“What does that mean? That means we basically put a wire through with a little bit of a flange at the end, and we pull the polyp out. Now, note there is no pain with that. Inside the colon, there are no pain fibers. So there’s no pain,” Dr. Murrell added.
The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on a colonoscopy before they develop or when the polyps are small enough to be removed without surgery.
What Treatment Options Exist for Colon Cancer?
“There are a lot of advances being made in colorectal cancer,” Dr. Yeo previously told SurvivorNet.
Colon cancer treatment is more targeted, meaning doctors often test for specific changes or genetic mutations that cause cancer growth.
Biomarkers are key to tailoring specific treatments. Biomarkers are molecular patterns becoming more commonly used in colon cancer diagnosis, prognosis, and management. According to the National Cancer Institute, a biomarker is “a biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or a condition or disease,” such as cancer.
“In colon cancer, we’re starting to look more and more at people’s biomarkers, so we’re starting to take the cancers, sequence them, understand where the different mutations are to figure out whether or not someone has a normal gene here or an abnormal gene,” Dr. Yeo explained.
“Those are the areas that people want to be able to target a little bit more. We’re getting close to more of what we would call precision medicine, meaning we can start looking at people’s genetic mutations and think about how they might respond to different drugs.”
There are different types of biomarkers, including DNA, proteins, and genetic mutations found in blood, tumor tissue, or other body fluids. The biomarkers most commonly used in colon cancer management are:
- Genetic mutations within the tumor, such as MMR/MSI, KRAS, BRAF, and HER2
- Bloodstream carcinoembryonic antigen (CEA)
CEA is a protein produced by most tumor cells (but not all) and can be picked up in the bloodstream. High CEA levels do not establish a colon cancer diagnosis. However, higher CEA levels correlate with a worse prognosis and potential metastasis. Carcinoembryonic antigen is important for post-treatment follow-up to ensure the cancer hasn’t returned. Be sure to check with your doctor before treatment starts to ensure a CEA blood sample has been obtained.
More on Treating Colon Cancer
Surgery and chemotherapy are common approaches to colorectal cancer.
Some examples of Food and Drug Administration (FDA) approved chemotherapy drug treatments include:
- FOLFOX: leucovorin, 5-FU, and oxaliplatin (Eloxatin)
- FOLFIRI: leucovorin, 5-FU, and irinotecan (Camptosar)
- CAPEOX or CAPOX: capecitabine (Xeloda) and oxaliplatin
- FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and irinotecan
- Trifluridine and tipiracil (Lonsurf)
WATCH: Understanding Your Options with Metastatic Colon Cancer
Among metastatic colon cancer patients, multiple treatment options exist, including surgical and non-surgical options.
One treatment option includes an oral treatment called Fruquintinib, which is a targeted therapy for adults with metastatic colorectal cancer who have tried other treatments. Results from a trial published last year showed the drug improved overall survival and progression-free survival, which measures the amount of time before the cancer returns or spreads. It works by blocking the growth of blood vessels, which increases tumor growth.
Once you get to the metastatic setting, many patients “just run out of options,” Jennifer Elliott, head of solid tumors at Takeda, explained to SurvivorNet at the ASCO Annual Meeting. So it was critically important for Takeda to do this deal to in-license fruquintinib. We hope to give patients another option.”
Fruquintinib has been approved in China since 2018 and was originally developed by the Chinese biopharmaceutical company HUTCHMED. In January 2023, Takeda Oncology acquired the exclusive worldwide license for the drug outside of mainland China, Hong Kong, and Macau.
Questions to Ask Your Doctor
If you are facing a colon cancer diagnosis, here are some questions you may ask your doctor.
- What are my treatment options based on my diagnosis?
- If I’m worried about managing the costs of cancer care, who can help me?
- What support services are available to me? To my family?
- Could this treatment affect my sex life? If so, how and for how long?
- What are the risks and possible side effects of treatment?
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Contributing: SurvivorNet Staff
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