Fighting Advanced Stage Colon Cancer
- Country artist Joshua Ray Walker, 33, is embarking on the next phase of his colon cancer journey as he recently updated his fans that the disease had spread to his lungs and that he was undergoing surgery on Thursday.
- He recorded updates live from the music studio as he pushes to create as much music as he can, noting that he is unsure what his surgery and radiation will do to his voice.
- Colon cancer is very treatable and curable if caught early. However, treatment may become more intense when the cancer is detected in later stages. Chemotherapy is known to improve survival in patients with metastatic or stage 4 colon cancer.
- Though colon cancer at this stage is incurable, it is possible to manage it as a chronic disease and continue living a quality life, but every advanced stage case is different.
- The American Cancer Society recommends that colorectal cancer screening begin at age 45. However, it would be best to discuss your screening timeline with your doctor and get in sooner depending on your risk factor, especially if you have a family history of the disease.
“As long as I’m here, I’m making music. Can’t stop me. I’ll be out of commission for a while after this surgery, but I’ll be back to check in asap,” the Dallas native shared via Instagram this week.
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“I’m blown away by all the love I received,” he added in regard to the support from fans on his GoFundMe fundraiser page.
On September 10, Walker updated fans with his advanced stage health status.
“I’ve got some good and bad news to deliver. The good news is that I’ve finished chemo treatment! It was extremely tough, and I want to thank ya’ll so much for supporting me through this experience. My body handled it reasonably well, and I’ve begun to rebuild my strength and immune system!”
“The bad news is that upon the completion of tests to check on the status of my cancer post treatment, multiple nodes of varying sizes were found in both my lungs.”
Noting that the “odds have definitely shifted,” since his initial December 2023 diagnosis, surgery and chemotherapy treatment, the “Thank You For Listening” singer said he’s not going to “publish them here.”
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“I’ll let you know what they were after I beat them. I’ve always lived life to the fullest and I will continue to do so.”
Learning About Advanced Colon Cancer
Colon cancer is very treatable and curable if caught early. However, treatment may become more intense when the cancer is detected in later stages. Chemotherapy is known to improve survival in patients with metastatic or stage 4 colon cancer.
“Colon cancer most commonly spreads to the lung and to the liver,” Dr. Heather Yeo, a board-certified in general surgery, colon and rectal surgery, and complex general surgical oncology, explains to SurvivorNet.
“We try not to do surgery right away. If you think about it, we can’t cut out all of the disease, and any time you do surgery, you’re actually compromising a patient’s immune system,” Dr. Yeo explains.
WATCH: Not all stage 4 colon cancer patients are the same.
The most common therapy is called FOLFOX, and your doctor may add medications like irinotecan (FOLFIRI) or cetuximab, depending on how well your tumor shrinks with treatment and other specifics about your particular tumor.
“If you respond really well, then we keep you on that until you stop responding really well. But if after a few cycles, your disease has progressed, that’s when we think about adding other additional chemotherapies,” Dr. Yeo said.
Treating Colon Cancer
Your doctor has many ways to treat colon cancer, depending on what stage the cancer is, including:
- Surgery
- Radiation therapy
- Chemotherapy
- Targeted therapy
- Immunotherapy
Surgery
Surgery is the main treatment for most early-stage colon cancers, according to the doctors SurvivorNet spoke with. The surgeon will remove the part of the colon or rectum where there is cancer, along with a small area of healthy tissue around it. Taking out as much of the cancer as possible is important for improving your outcome.
The surgery may be performed through small incisions (laparoscopy), or through a larger incision. Some people may need to wear a special bag (ostomy) to collect wastes after surgery.
Radiation Therapy
This treatment aims high-energy x-rays at the cancer to destroy the abnormal cells. The radiation can come from a machine outside your body, or be placed directly inside your body. Sometimes people get radiation before surgery, to shrink the tumor and make it easier for the surgeon to remove. This is called neoadjuvant radiation.
Chemotherapy
This treatment uses strong medicine to stop cancer cells from dividing, no matter where they are in your body. You may get a combination of chemotherapy drugs as your first treatment. Chemotherapy has been very well studied for colorectal cancer, and it is known to improve survival.
The most common therapy is a combination of chemo drugs called FOLFOX:
FOL = leucovorin calcium (folinic acid)
F = fluorouracil
OX = oxaliplatin
Your doctor may add medications like irinotecan (FOLFIRI) or cetuximab, depending on how well your tumor shrinks with treatment and other specifics about your particular cancer. For FOLFOX, the medications are given through the vein and require regular doctor visits.
Managing Colon Cancer as a Disease
To determine exactly which chemotherapy regimen you get, your doctor will consider your age and how well you might tolerate the side effects of chemotherapy. Gene mutations (for example, BRAF and KRAS) and the location of the primary colon tumor also factor into the decision.
You can also get chemotherapy before colon cancer surgery, which is called neoadjuvant chemotherapy. Getting chemo first helps to shrink the tumor, which can make both the surgery and recovery easier, according to SurvivorNet’s experts. Chemo is also a treatment for cancer that returns after therapy.
Targeted Therapy
This treatment targets substances like proteins or genes that the cancer needs to grow. This makes targeted therapy more precise than chemotherapy, and less likely to damage healthy cells. One example of targeted therapy is bevacizumab (Avastin), which stops the growth of new blood vessels that feed tumors. Another group of targeted therapies are called epidermal growth factor receptor (EGFR) inhibitors, which block the cancer from growing.
Immunotherapy
This treatment makes your own immune system a more efficient cancer fighter. A group of drugs called checkpoint inhibitors, which includes pembrolizumab (Keytruda) and nivolumab (Opdivo), work by preventing cancer cells from hiding from your immune system. Checkpoint inhibitors may extend the amount of time before the cancer spreads.
What Increases Your Risk for Colon Cancer?
Risk factors are things that make you more likely to get colon cancer. They don’t mean that you’ll definitely get this cancer — only that you’re slightly more likely to be diagnosed.
You may be at greater risk for colon cancer if you:
- Are older. About 90% of cases are in people age 50 or older, according to the U.S. Centers for Disease Control & Prevention (CDC). Yet it is possible to get this cancer earlier in life.
- Have inflammatory bowel disease. Crohn’s disease or ulcerative colitis can, over time, cause cells in your intestines to turn cancerous.
- Have a family history of this cancer. Just under one-third of people who get colon cancer have family members with the disease.
- Have a gene mutation. About 5% of colorectal cancers are caused by an inherited genetic mutation that causes syndromes such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (Lynch syndrome).
- Don’t exercise very often. Staying active can lower your risk.
- Eat a diet that’s high in meat. Regularly eating red meats like burgers and steaks, and processed meats such as hot dogs and bacon might put you at higher risk. Eating more fruits, vegetables, and whole grains instead might lower your risk.
- Are overweight or obese. Having too much weight increases your risk of both getting colon cancer, and of dying from it.
- Drink a lot of alcohol. Limiting alcohol to one drink a day for women and two drinks daily for men could help lower your risk.
- Use tobacco. Long-term smokers are more likely to get this cancer than are nonsmokers.
Understanding the Signs of Colon Cancer
Colon cancer starts when polyps grow in the colon or rectum. If you don’t have these polyps removed, they can sometimes change into cancer. It takes up to 10 years for a colon polyp to become cancerous.
“We know that colon cancers can be prevented when polyps are found early, Dr. Yeo explained.
The American Cancer Society and the American Gastrointestinal Association recommend that colorectal cancer screening begin at age 45. However, it would be best to discuss your screening timeline with your doctor.
Colon cancer symptoms and warning signs include:
- Change in bowel movement
- Bloody stool
- Diarrhea, constipation, or feeling the bowel does not empty completely
- Unexplained weight loss
- Constant abdominal pain or cramps
If you notice symptoms or changes in your body that aren’t going away, it’s crucial to promptly discuss them with your doctor.
Contributing by SurvivorNet staff.
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