Life after colon cancer

March is National Colorectal Cancer Awareness Month, and thankfully there's a growing understanding of the importance of screening, early detection and prompt treatment. As a result, more Americans are now beating the disease. So what's it like to be a cancer survivor?

It's an issue that's only recently getting much attention. In his new book, "The Colon Cancer Survivor's Guide" (Tatra Press, 2005), veteran health writer and editor Curtis Pesmen discusses life after cancer. Diagnosed with advanced colon cancer four years ago, Pesmen is now among the estimated 10 million cancer survivors in the United States.

Recently, MSNBC.com’s Jane Weaver spoke with Pesmen about his journey from cancer patient to survivor.

Question: You were just 43 when you were diagnosed with colon cancer. What went through your mind when you heard the word cancer?

Answer: I was just this side of shocked. I had seemingly done the right thing and been screened at age 40. When I was in my 20s, I was diagnosed with colitis so I knew that somewhere in my past and in my future there was a reason to keep a close watch on my body. My doctors had said, "Don’t wait until you’re 50 [to get screened for colon cancer]." I was at a higher risk for colon cancer than the normal population. I wasn’t biologically a man with a 40-year-old colon and small intestine. I was a man with a 65-year-old colon and small intestine.

Shock hits everybody when they’re diagnosed. In my mind, it streamed back to me what they had told me in my 20s. I was screened and my doctor missed some early-stage cancer apparently. When I was finally diagnosed at 43, the colorectal specialist said it was his belief that I had a slow-growing cancer that had been there at least five years, maybe eight to 10 years. Some doctors would have found it, but not everyone is equally adept at performing a colonoscopy. I don’t say that to scare people out of colonoscopies — well over 95 percent are done accurately. I was in a small percentage of misdiagnoses.

Question: As a health journalist, you’ve covered cancer issues. You even helped launch the pink ribbon campaign for breast cancer awareness. Did any of it help prepare you for what you were facing?

Answer: Yes, it did. I must have written or edited over three dozen stories on breast cancer cases and survivors. I had traveled some of the emotional highways of the disease, if not personally then as a tourist. I once edited a story written by a doctor who wrote about telling his friend she had cancer. He was someone who did breast exams and felt the lump [in his friend]. As an editor I was startled by how emotional it was when he felt something bad. He knew he couldn’t stop. He finished the exam and went back to the tumor area. You could tell and he could tell it was not good news. That image stayed with me. Did my doctor feel this? I was a stage III diagnosis. There are four main stages, and stage IV is the worst.

Question: How does life compare now to before the diagnosis?

Tatra Press The book was inspired by a series of award-winning articles in Esquire magazine about the author's personal battle with colon cancer.

Answer: The biggest change between when I had cancer and now that I am cancer-free is that now I am a dad. So fatherhood has absolutely ripped me out of the world of cancer in the last couple of years, in a good way. It always underscores the notion that there will always be a cloud in my skies. I have had friends who lived with depression whose clouds may be darker than mine are on a day-to-day basis. But no one thinks about the crush of other diseases the way they think about the crush of cancer. We all have something in our past and our future. How do you keep it away from 90 percent of what you do each day?

Question: Some people say the experience of cancer has made them stronger. Do you see it that way?

Answer: I read that in Lance Armstrong’s book ("It's Not About the Bike: My Journey Back to Life"). It was fairly inspirational. Toward the end of the book he said that if he had to choose winning the Tour de France or cancer, he'd choose cancer. He said cancer made him a better person. That’s what I didn’t buy. I didn’t buy it as a journalist or cancer patient that it made him better. I don’t mean to sound haughty, but maybe the difference is I didn’t think I was that bad a guy to begin with. I didn’t believe certain biology could make me better.

It’s made me a stronger person, but not better. If you’ve been in the fire and come out of the fire, does that make you better? There is a difference between being better and stronger. I believe I have become stronger. Hopefully the quirks of my biology didn’t make me better.

Question: In your book, you talk about the transition from being a patient to being a survivor. Where is that point?

Answer:  It has no one answer. The quickest answer is in most cancer research and studies and articles there is the notion of the five-year cure. But, again, cure doesn’t equal survivor. I believe survivor is a more encompassing word. For me, the transition was when all the treatment was done for my first course, second course and third course of chemotherapy. I felt like my course was over and if I’m going to be healthy for the next 30, 40, 50 years, then the survivor starts now, whether or not I’m cured.

Doctors aren’t 100 percent sure if a recurrence happens two to three years later, whether it's the same disease or a new disease. I’ll agree with the five-year cure rate, but I won’t wait for that. I say the survivorship starts now, as soon as the treatment is behind you.

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