Facing Cancer as a Parent
- “Dawson’s Creek” star James Van Der Beek has revealed he underwent a vasectomy [a surgical procedure where tubes called the vas deferens are cut and sealed, making it a permanent form of male birth control] years before getting diagnosed with stage three colorectal cancer in August 2023.
- When it comes to colon cancer treatment, extraordinary physicians and institutions will often offer various courses of treatment, like watchful waiting to active surveillance, as well as surgery, chemotherapy, radiation, immunotherapy, and/or targeted therapy.
- Dr. Heather Yeo, a colorectal surgeon at Weill Cornell Medicine and SurvivorNet medical advisor, warns, “A small percent [of colorectal cancer patients] present with incurable disease – these patients may have been cured after surgery or surgery and chemotherapy and are now incurable.”
- Colon cancers start out as a polyp, or small growth, in the colon that causes no symptoms. Although polyps can’t be felt, they can be picked up by screening tests before they cause a problem. It takes up to 10 years for a colon polyp to become a full-blown cancer, which gives doctors time to remove the polyp before it causes a problem.
- The U.S. Preventive Services Task Force recommends state colon cancer screenings should begin at 45-years-old. This is in response to a rise in colon cancer diagnoses in younger adults. In the past, the disease had predominantly been found in adults 50-years or older, but for those predisposed to get it at a younger age, these new guidelines could potentially help catch it at an earlier stage.
While discussing his cancer diagnosis, which he received on August 31, 2023, he told People magazine he and his wife are not planning to have any more children. He admitted, “Well, we love having kids, but we didn’t really plan it out. It just happened … We had one planned child.”
Read More“I joke, and I laugh, but like, yeah, we really just kind of got lucky that way.”
Van Der Beek explained further, “I figured the only way we’re going to stop this is if we have some medical intervention.”
He recounting telling his children he had “some surgery on his private parts.”
View this post on Instagram
According to Johns Hopkins Medicine, during a vasectomy, tubes called the vas deferens are cut and sealed. “The vas deferens carry sperm from the testicles to the urethra. The urethra is the tube inside the penis. Once they are cut, sperm can’t get into the semen or out of the body. The testes still make sperm, but the sperm die and are absorbed by the body.
“A person who has had a vasectomy still makes semen and is able to ejaculate. But the semen doesn’t contain sperm. The testosterone level and all other male sex traits stay the same. For most people, the ability to have an erection is unchanged. There is a procedure to reverse a vasectomy, but it doesn’t always work.”
RELATED: Sex and Cancer: How to Communicate Your Desires & Fears and Create New Sexual Experiences
There are two types of vasectomies: conventional and no scalpel. A conventional vasectomy is when “small cuts are made on each side of the scrotum to reach the vas deferens,” and a no scalpel vasectomy is a “method done through a single tiny hole or two tiny holes in the skin. A tool is used to gently stretch the skin opening so that the vas deferens can be reached. It heals quickly with little or no scarring,” as per Johns Hopkins.
It’s also important to note that vasectomies are safe procedures that don’t damage organs or lead to cancer.
Despite Van Der Beek and his wife having six children [five of them unplanned], him and his wife still experienced five miscarriages.
His wife said, “Two of them were late-term, near-death experiences. We’ve weathered a lot of storms together. This has been a really difficult year, but there’s been this underlying way that we savor life differently.
RELATED: Five Ways Male Cancer Survivors Can Restore Sexual Function
“It feels like we understand what real true presence is, what savoring life feels like, finding the beauty in all of it.”
As for his wife’s ongoing support throughout their hardships, including cancer, Van Der Beek added, “There’s no way to get through this without her. As much as it sucked this past year, there’s not a moment that I ever would have wanted to trade with her watching me go through this.
Guidance for Cancer Caregivers
“To every caregiver out there, man, God bless you and thank you.”
View this post on Instagram
Understanding Colon Cancer & Van Der Beek’s Diagnosis
James Van Der Beek learned he had colorectal cancer last year after getting a colonoscopy done. He told People in his tell-all interview that his bowel issues led him to get checked.
“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 better get this checked out,'” he told People.
Colorectal cancer happens when polyps are not removed and become cancerous. It can take up to 10 years for a colon polyp to become cancerous, according to SurvivorNet experts.
“We know that colon cancers can be prevented when polyps are found early,” Dr. Heather Yeo, a surgical oncologist who specializes in colorectal cancers at Weill Cornell Medicine, told SurvivorNet.
“Lowering the screening age helps somewhat with this, but access to care is a real problem,” Dr. Yeo added.
Expert Resources on Colorectal Cancer
- ‘You Shouldn’t Die From Embarrassment’: Colon Cancer Can Be Prevented
- Anxiety Around Colon Cancer Diagnosis
- Biomarkers in Colon Cancer: Understanding KRAS, BRAF, and HER2
- A Coffee Enema Will Not Prevent Colon Cancer
- Can Sitting The Wrong Way While You Poop Increase Your Risk Of Bowel Or Colon Cancer? Assessing The Risks Of Sitting Vs Squatting
- 5 Possible Signs of Colon Cancer; Don’t Be Afraid to Look in the Toilet!
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.”
The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on colonoscopy before they develop or when the polyps are small enough to be removed without surgery.
Looking for Polyps During Colonoscopy
The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.
The U.S. Preventive Services Task Force recommends guidelines that state colon cancer screenings should begin at 45 years old. This is in response to the increase we see in colon cancer diagnoses in younger adults.
However, many insurance companies still do not cover the cost of screenings for those under 50. In the past, the disease had predominantly been found in adults 50 years or older, but for those predisposed to getting it at a younger age, these new guidelines could help catch it earlier.
Debating Over Treatment of Colorectal Cancer
A few years back, research suggested that some colorectal cancer patients may be able to choose several years of close follow-up rather than surgery after successfully undergoing radiochemotherapy, while some doctors question whether close observation is really enough.
Dr. Heather Yeo, a colorectal surgeon at Weill Cornell Medicine and SurvivorNet medical advisor, warns, “A small percent [of colorectal cancer patients] present with incurable disease – these patients may have been cured after surgery or surgery and chemotherapy and are now incurable.”
Findings, published in The Lancet Oncology in 2021, suggest that up to 70% of rectal cancer patients might be able to avoid colostomies and other major surgeries by undergoing a multi-year period of intense observation.
RELATED: The Debate and Evidence About Watch and Wait
The period of observation, known as the “watch and wait” protocol, would regularly check these patients, who have already successfully undergone radiochemotherapy, for any potential sign of cancerous regrowth.
Additionally, the research claims that this monitoring period might be as short as one to three years, saying that, after a single year with no regrowth, the risk of rectal cancer recurring or spreading drops dramatically.
“Our results suggest that achieving a complete clinical recovery and sustaining it for one year is the most relevant protective factor in patients with rectal cancer, placing them in an excellent prognostic stage,” concluded Dr. Laura Fernandez, the study’s lead author.
Deciding When to Operate on Colon Cancer
Ultimately, the “watch and wait” protocol is a treatment option that those fighting colorectal cancer should discuss with their medical team. Colorectal oncologists like Dr. Yeo can help patients weigh the benefits and risks of this approach and craft the best treatment plan for them.
“This is an important conversation to have with patients. We shouldn’t give false hope, as 30% of patients do not respond to these treatments and may not have salvage as an option,” Dr. Yeo tells SurvivorNet.
“Those that do are taking a risk of losing an opportunity for cure (a low risk, but one that still should be discussed).”
Colon Cancer: A Silent Killer
Dr. Heather Yeo, a colorectal surgeon and surgical oncologist at Weill Cornell Medicine and New York-Presbyterian, previously told SurvivorNet, “Colon cancer is considered a silent and deadly killer.
RELATED: How Does a Colon Polyp Turn Into Cancer?
“What happens is people often don’t know that they have colon cancer. They don’t have any symptoms. That’s why we screen for colon cancer in the United States.”
The Rate of Colon Cancer is Increasing in Those Under 50
“You should be screened for colon cancer, even if you have no family history. Once you have your initial screening colonoscopy, if there are no polyps and you have no high-risk factors, usually once every 10 years is fine,” she advises.
“Colon cancer is a slowly progressing cancer. If you have any family history of colon cancer, you should be screened about 10 years before your family member had colon cancer. So if you have a family member that was 53, you should be screened at 43.”
Dr. Paul Oberstein Explains Common Colon Cancer Symptoms
What Increases Your Risk for Developing Colon Cancer?
For some people, certain risk factors can influence their risk of getting colon cancer. They include the following:
- Are older. About 90% of cases are in people aged 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.
- You are overweight or obese. Having too much weight increases your risk of both getting colon cancer and dying from it.
- Drink a lot of alcohol. Limiting alcohol to one drink daily 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 nonsmokers.
Understanding Treatment Options
Although, Van Der Beek has chosen to keep the details of his colon cancer journey and treatment process private, it’s important to understand that 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.
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.
Dr. Paul Oberstein, on which treatments doctors use to turn stage 4 colon cancer into a chronic but manageable disease
Battling Cancer as a Parent
Remember, opening up about cancer diagnosis with children can be really difficult task. It’s important to be honest with them and you want them to be prepared for what might happen, but at the same time you want to protect them, and be as gentle as possible.
John Duberstein, who lost his wife Nina to cancer, explains that he and his wife tried to take a progressive approach and be as open with their kids as possible. But as honest as they were, they ran into some issues with their kids understanding the disease. When Nina started to look healthier, for example, the kids assumed she was getting better, but that wasn’t the case.
Talking to Kids About Cancer: Be Open as Much as You Can
“It was a real eye-opening moment for two people who felt like they were dealing really head-on with this stuff, talking to the kids,” Duberstein told SurvivorNet in an earlier interview.
“So I think it’s important to be open with the kids as much as you can, as much as you feel like they can handle. But it’s also important to revisit it and not make assumptions. At the end of the night, what Nina had to tell them was, ‘I’m not ever going to get better. My cancer is not ever going to go away,’ it was hard for them to hear even though they’d already been prepared.”
Meanwhile, breast cancer survivor Gina de Givenchy previously spoke with SurvivorNet about going through cancer treatment as the mother of a 12-year-old girl.
“I felt it was important to mask it because I really wanted her to know that I was going to be OK. I didn’t want her to see me weak and sickly,” she said. “When it comes to your kids, I think you always want to sort of protect them.”
Telling Your Kids You Have Cancer ‘When it Comes to Your Kids, You Want to Protect Them’
The pressures of parenthood can be daunting during a cancer journey, but having little ones that depend on you can also provide another source of motivation to fight for your life.
Jovannie Lorenzo also knows this to be true. When she was diagnosed with colon cancer at 32, she felt an immense amount of fear because she was a single parent of her three kids. Going into her cancer battle, Lorenzo knew she would do everything in her power to be around to raise them.
“I knew that I had to do everything possible to be here for my children,” Lorenzo told SurvivorNet. “They are my saving grace. They are the reason I wake up every morning. They are the reason why I fight every single day and I make a choice to be positive, to be happy, and to move forward.”
Obviously, not every parent feels comfortable sharing so much about their diagnosis with their children. Some survivors have even told us that they were afraid to tell their family members, but as for Duberstein, de Givenchy, and Lorenzo, honesty was the best policy.
Licensed clinical psychologist Dr. Marianna Strongin encourages people with sick parents “to talk about your feelings with your immediate family as well as your parents.” She’s previously talked about the importance of expressing your feelings in her advice column for SurvivorNet.
“Talking about difficult things does not cause more anxiety,” Dr. Strongin said. “It is NOT talking about the very thing that we are all afraid or worried about that causes our body to feel dysregulated (unable to manage emotional responses or keep them within an acceptable range of typical emotional reactions) and anxious.”
Specifically, with patients who may be scared to talk to their children about a diagnosis, Strongin said children can pick up on their emotions, so it may help to check in with yourself beforehand.
“Having these conversations may bring up deep emotions you may have stowed away. There is nothing wrong with showing our emotions to children as long as we can remain calm and give them a sense of safety,” Dr. Strongin said.
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
