Coping With Advanced Colon Cancer
- Texas singer-songwriter Joshua Ray Walker, who was diagnosed with Stage3B colon cancer earlier this year and underwent six months of chemotherapy, has revealed his cancer has spread to his lungs and he’s now prepared to get a lung biopsy and begin radiation.
- Metastatic or Stage 4 colon cancer means that the cancer has spread from the colon to other organs. The most common sites for colon cancer to metastasize are the liver, lungs, and peritoneum (the lining in your abdomen).
- Chemotherapy is often the first line of treatment for metastatic colon cancer. Surgery or a combination of therapies may be recommended depending on where the cancer is located and how widespread it is.
- Dr. Dana Chase, a gynecologic oncologist at Arizona Oncology, also advocates for cancer warriors to prioritize their mental health. She noted that emotional well-being has been studied as a factor in patient outcomes.
- “We know from good studies that emotional health is associated with survival, meaning better quality of life is associated with better outcomes,” Dr. Chase tells SurvivorNet.
Texas singer-songwriter Joshua Ray Walker has taken to social media to inform his fans and loved ones that his colon cancer has spread to his lungs, but he insists he's going to fight his "hardest" as will soon get a lung biopsy and begin radiation. The announcement comes months after Walker said "
localized cancer " was discovered in his colon in December 2023 and he needed surgery to remove it. He was later diagnosed with Stage 3B colon cancer in January 2024, prompting him to undergo six months of chemotherapy. Walker wrote in a lengthy Instagram
post this week, "Hey y’all! Once again, 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 y’all 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."
The Texas-native continued, "Before I started chemo, I was told I had a 90% chance of having clear tests post treatment. So to find completely new growth in a new organ was something for which I was not prepared. This unfortunately means my cancer will likely be restaged to stage 4. I will get a lung biopsy, and start radiation soon. "I wish I had more information to share but I’m still waiting to meet with a radiology oncologist following my biopsy surgery. I will keep y’all as updated as possible, and I will continue to fight my hardest. The odds have definitely shifted, but I’m not going to publish them here. It seems defeatist, and unnecessary. 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."
MORE: All Americans Should Begin Colorectal Cancer Screening at Age 45, According to New Guidelines; Previous Age Was 50 He then addressed his financial situation and why he has chosen to create a
GoFundMe, which has since raised more approximately $32,474 of it's $300,000 goal. "When times are hard my instinct is to figure out how to survive financially. I work harder to ensure that me and my loved ones will have basic necessities. This trait has been very useful in life, but it makes it hard to rest when life’s difficulties aren’t solely monetary," Walker explains. "I have a hard time asking for help, even when I believe it will be given happily. I’m launching a GoFundMe that will allow me to focus exclusively on my health and relationships during this precious time. I thank everyone so much in advance for their continued love and support. Love y’all so much."
Walker went into more detail on his GoFunMe page, confirming the crowdfunding website will help him raise money for his "cost of living and out-of-pocket health expenses while I continue to fight cancer."
Expert Resources on Colorectal Cancer
He explained via GoFundMe, "I was diagnosed with Stage 3B colon cancer in January of 2024. Since then, I’ve undergone an extensive surgery, 6 months of chemotherapy, and a ton of tests, procedures, and doctor's visits. "Unfortunately, I was recently informed that my cancer has unexpectedly spread to both of my lungs, and it will likely be re-staged to Stage 4 upon an upcoming lung biopsy. Radiation and other potential treatment options will follow." He admitted that with his ongoing treatment, more and more medical costs are not included in his medical insurance. "Your support of this campaign would allow me to dedicate 100% of my time to my health and well-being, allow me to pay my out-of-pocket medical expenses, and most important of all, it would allow me to be present with family and friends during this precious time," he concluded. "It has been very important to me that I continue to work as much as possible throughout my cancer fight and remain financially independent, but there are many unknowns moving forward with treatment. It's unclear what kind of effect radiation will have on my lungs, but it is certainly worrisome for someone whose livelihood depends heavily on singing. I admit that my pride is what kept me from asking for help sooner, but given this latest unexpected turn in my cancer status, I’m ready to accept your support if you have the means to help."
Coping With 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. 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.
WATCH: Not all stage 4 colon cancer patients are the same. Colon cancer screenings can involve at-home tests such as Cologuard, but a colonoscopy is more effective, according to SurvivorNet experts. A colonoscopy involves examining the colon and rectum with a long, thin tube attached to a camera. If no
polyps are discovered, the next screening won’t be needed for ten years. Polyps are small growths in the colon that are not yet cancerous but can potentially develop into cancer. “When we see a polyp, we actually physically take the polyp out through the colonoscope,”
Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center,
explained. 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. 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.
WATCH: Colon cancer symptoms. The most poignant signature of colon cancer includes a change in bowel habits. This may include constipation or diarrhea due to changes in the size or shape of bowel movements. A change in stool color, particularly black or tarry stools, can indicate bleeding from a tumor that lies 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.
Which Treatments are Best for You?
Your doctor has many ways to treat colon cancer, depending on what stage the cancer is, including:
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 Finding Joy Outside of Cancer
When faced with a cancer battle it can be hard to focus on life outside of your disease, especially when it comes to working your job at the same time, like Joshua Ray Walker is doing by continuing to perform amid treatment. But it’s important to remember that your mental state can actually impact your success as a patient.
Determination & Hope Despite Setbacks Prevail in ‘Climbing Blind’ “I’m pretty good at telling what kind of patients are going to still have this attitude and probably going to live the longest, even with bad, bad disease,”
Dr. Zuri Murrell , a colorectal surgeon at Cedars-Sinai Medical Center, previously told SurvivorNet. “And those are patients who, they have gratitude in life.”
RELATED: Stay Positive, It Matters Dr. Dana Chase , a gynecologic oncologist at Arizona Oncology, also advocates for cancer warriors to prioritize their mental health. She noted that emotional well-being has been studied as a factor in patient outcomes. “We know from good studies that emotional health is associated with survival, meaning better quality of life is associated with better outcomes,” Dr. Chase told SurvivorNet in an earlier interview.
What Still Brings You Joy? Your Emotional Health is So Important “So, working on your emotional health, your physical well-being, your social environment [and] your emotional well-being are important and can impact your survival,” Dr. Chase explained. “If that’s related to what activities you do that bring you joy, then you should try to do more of those activities.” She recommends writing down ten things that make you happy and intentionally making the time to do those activities throughout the day.
Contributing: SurvivorNet Staff 
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