14 March 2026
Just over 9 years ago, I went to the foremost colonoscopy center in my hometown (Bloomington, Indiana), expecting the results to be reasonably straightforward. At 57 years old, I had routinely outrun men half my age in races from 5k to 50 miles. There was little reason to think something was seriously wrong with me. Being averse to anesthetics at the time, I had my colonoscopy without it. I was thus watching the same screen as my doctor, Dr. Bret Spier. Less than a minute into the procedure, I saw something and said to my doctor, “That doesn’t look happy.” Without as much as a pause, he replied, “No, that’s cancer.” He scheduled a CT scan for me that same afternoon.
Nothing in my life has been as difficult as telling my wife that I had cancer. She was shocked, but she held it together – sort of. She told our children, who were more shocked and held it together a bit less well. My wife made me promise that first day that if my cancer was at all complicated, I would get in touch with the Simon Cancer Center. It was complicated. There was a tumor in my colon and three metastases in my liver. The chances of a person in this situation living for two years were at that time around 20%. Yet here I am today, nine years after. How did this all happen?
This essay is entitled our cancer journey wo far because that is what it has been – mine and my wife Marion’s, ours and our doctors, ours and our friends, and ours and out supporters. And because it is not over. In the remainder of this essay, I will first summarize my medical treatment over the past 9 years. I will then describe some of the lessons learned during that time. This essay ends with some things for you to know and do regarding your own health management.
Nine years of medical treatment in fewer than 2,000 words:
- We climbed a very steep learning curve in our first year with cancer. We were at the Simon Cancer Center two weeks after my initial diagnosis, meeting with Dr. Patrick Loehrer. He is an outstanding oncologist and Director of the IU Health Melvin and Brin Comprehensive Cancer Center. Medically, my first year was mostly standard: chemotherapy, resections, chemotherapy, heal up. The one part that was not standard was a low-probability, high-impact side effect of my treatment: the tumor in my GI tract swelled up, a result of irritation created by the chemotherapy. I was in a lot of pain. Marion drove me to the emergency room in Indianapolis, breaking speed limits most if not all of the way. I was admitted and have never welcomed painkillers quite as much as I did that day. Dr. El Haj, an endoscopic specialist, was able to reopen my GI tract without surgery, allowing my treatment to proceed according to my oncologist’s plans. This was done using an imaging system found within the State of Indiana only at IU Health and involved running an endoscope down my throat approximately 25 feet, nearly to the other end of my GI tract, to open it up. My resection surgery was a significant undertaking for the surgical team, led by the superb Drs. Bryan Holcomb and Michael House. The surgery lasted more than 8 hours and caused a great deal of worry for my family. Our first year with cancer is detailed in a paper we presented at a computing conference in 2018, titled “Your Good Health is a Workforce Issue.” This paper provides a lot of advice about self-care that remains relevant today. It also lays bare what being sick costs those around you.
- Early in 2018, cancer reappeared in my liver. My care team decided that being really aggressive about another liver resection was the best next step, leaving me with two of the original five lobes of my liver. By August of that year, my cancer was back yet again. The gene sequence of my tumor revealed multiple checkpoint mutations. These make it hard for my immune system to detect the cancer cells and completely rid my body of them. Around this time my doctors abandoned what is called “curative intent.” No more trying to cure me. Our goal became keeping me alive and providing as good a quality of life as possible for as long as possible.
- From 2018 to 2019, I was in a Phase 2 trial with a new combination of monoclonal antibodies. This new treatment helped my immune system fight my cancer. For a year the trial drug combination kept my cancer completely suppressed.
- From very late 2019 to early 2022, I was on maintenance chemotherapy. This kept my cancer in check. In early 2022, Dr. Loehrer said to me something I already knew. I had had a ton of chemo, and you can’t do that forever. So, we just stopped the chemo. Luckily, my cancer is not very ambitious. Left to its own devices, it grows very slowly. In late 2022, Dr. House operated on me again to take out a couple of lymph nodes in the back of my abdomen that clearly had tumor tissue in them.
- In January 2023, a new CT scan showed that my cancer was already back, growing in lymph nodes near the ones that had been removed. My radiation oncologist, Dr. Ryan Rhome, designed a new treatment approach that had not been used in a circumstance like mine but had been used in other tissues. The treatment he designed consisted of two rounds of radiation for 15 days. One round was very intense, aimed at burning out the two new, visibly enlarged lymph nodes. The other pass was much less intense, painting the general area where the recent recurrences had been with a level of radiation designed to kill off cancer cells but not burn holes willy-nilly in my abdominal tissues. This worked brilliantly. As of today, this area of my body remains cancer-free.
- After my radiation treatment ended in March 2023, I enjoyed 2 and a half years of freedom from treatment with nothing other than periodic CT scans. There is no way to put into words how much my family and I enjoyed this time.
- In late 2025, tumor growth was visible again, near my liver, in a lymph node, and wrapped around my hepatic artery where that artery enters my liver. Twice already, Dr. House had stripped cancerous tissue from this spot. He told us in our pre-surgical meeting that this would be tricky. After my surgery, Dr. House met with my wife and then went home. Marion said he looked like hell. And this is one of the best abdominal cancer surgeons in the US. When sheep have trouble sleeping, they count him. The third time is the last time for this particular surgery. Each time Dr. House stripped cancer away from the hepatic artery, it thinned the covering a bit. One more time might well result in a rupture.
- One door closes, another door opens wide. Carrie Newcomer, one of my favorite folk singers, wrote this wonderful lyric. We now know that my tumor genetics have not changed – but the drugs have! There is a new drug in trial that targets one of the mutations that has always been present in my cancer genome. For now we wait and I enjoy another period of time with no treatment. When cancer comes back, there will be a new treatment option.
Some of the things I have learned:
- There is little, perhaps nothing, in this world that is so bad that there is not some good available within it, and little, perhaps nothing, in this world that is so good that there is not something bad in it. I spent my whole career trying to enable the creation of discoveries, new scholarship, and new art. In that process, I was so driven that I did not pay enough attention to my own body. My efforts to be healthy were not good enough because I ignored things I should not have ignored. But much good has come from my relationship with cancer. I have led cancer support groups and I serve as an informal “person to talk to” for many cancer patients. I have been better able to support my church and fellow churchgoers because of my experience with cancer.
- Without the help and love of my wife, Marion, I would be dead. From the moment I was diagnosed to today, it has been Marion’s influence – sometimes gentle, sometimes not – that has helped us make good decisions and seek the right medical care. And more than that, she has made life worth living.
- Without my family, I would be dead. My entire family has been my greatest source of support and my greatest reason for wanting to live. Support has come from my wife, also our children, grandchildren, nephews, nieces, great nieces, siblings, in-laws, and my mother. My daughter Kai is, well, my daughter, and the relationship between any man and his daughter is wonderful and inscrutable. My son Tony is deeply thoughtful and was with me at almost every chemo or immunotherapy session. Grandchildren, nieces, nephews, and great nieces have been fantastic support. Now my goal is to stay alive to be there when the younger of my new great-nieces enters kindergarten – five years from now.
- Without the expert care of the doctors, nurses, and technicians at the Simon Cancer Center and IU Health, I would be dead. Over and over again, the difference between me being alive and me being dead is the expert care I have received. This starts with the doctors who have treated me, each among the best in the Midwest. But it is not just the doctors. It’s the nurses, technicians, and every staff member whose care and commitment have helped keep me alive. I owe my life to everyone involved in my care – doctors, nurses, the staff who greet me as I check in, the technicians, and the people who bring me food and clean my room when I am in the hospital.
- Without immigrants, I would be dead. Very many of the nurses and technicians who have cared for me have been immigrants. Dr. El Hajj, who was critical to my treatment, was an immigrant. My wife is as well.
- Without biomedical research, I would be dead. One of the things my oncologist told me was that had I had cancer and been diagnosed in 2012 rather than 2017, my cancer would have been a death sentence enforced on a short time scale. Research has and continues to keep me alive, including the year I was provided as a result of participation in a Phase II drug trial. Note that my belief in research and medical treatment is consistent with – not contradictory to – my faith. Whatever the nature of the power that created us in this universe, that power gave us brains. It would be sinful not to make use of the work of those brains.
- Without keeping my mind and body active, I would be dead. I have enjoyed a lifetime of activity in sports and outdoor activities, even though my skill levels have never been impressive. My physical fitness has been a critical factor in my survival. Much credit goes to the BARA, SYRG, and YMCA running groups, Brian Holzhausen and the DINO trail racing community, and the Mag 7 racing community. Learning the Chinese mind-body practice Qi Gong has been essential to my mental health. Keeping my mind active has been critical to my health and to any value I get to add while I am still here on earth.
- Without my friends and professional colleagues, I would be dead. My friends and professional colleagues have always put up with a lot. Always. And yet my professional colleagues were always there for me. I am forever in their debt.
- My sources of support have sources of support. It’s a lot of work having a cancer patient in the family. My wife’s circle of friends has been a tremendous source of support for her. The not-for-profit Fair Haven Foundation has provided housing and care for her time after time during my hospital stays.
- My faith has helped me maintain hope and find meaning in all of this. There have been very dark times in the last nine years. During those times, my faith was one of the things that helped me through. Cards, prayers, and gifts of reading material have lifted my spirits throughout this process. One friend sent me several books. One was entitled “Living in two worlds” by Ohiyesa, a First Nations citizen born in the 1800s in the northern plains who later took on the name Charles Eastman. This book explained First Nations’ approaches to prayer, which were comforting to me without seeming selfish. Furthermore, I am always mindful of what the 24th Psalm says and what it does not. It says that we are never far removed from divine support and thus should not fear. What it does not say is that we won’t hurt. The eventual outcome of the activity of my cancer cells will someday be to kill me. My job, meanwhile, is to do as much good as I can, have as much fun as I can, and learn all I can. I’m not glad I have cancer, nor am I glad for anyone else who receives a diagnosis of cancer or other serious disease. But I will wring what good I can from this situation.
What keeps me going now
- Friends, faith, and community – those helping me and those I can help. My friends – from Chile to Germany and beyond – have all been critical to my happiness, my quality of life, and the fun I get to have while I am still on this earth. Aid goes both ways. When I was first diagnosed, I became very aware of the stigma and silence around cancer. I decided to be very open about what was happening to me. This approach, supported by my wife, has put me in the position of helping many people dealing with cancer or other grave diseases. I have helped many friends who were diagnosed with cancer. I have made many friends because I was in a position to help people deal with cancer. As long as I live, there will be a constant stream of such people for me to help as they deal with their own unique situation. Sometimes I can help a little, sometimes more than that. In all cases, the opportunity to use my situation to help others is central to my faith and my sense of self. That faith, and many, call for us to help others – without qualification.
- Young people in my life. The young people of the world are its future. Marion and I have been lucky to have young people in our lives: great nieces, the youngest of whom is just a few weeks old; high school and university students who have lived with us; graduate students in classes I take at IU; and young colleagues who are still kind enough to engage me in research projects. I was honored last fall to be part of the wedding of one of the graduate students who had lived with us. From Chile to Germany and beyond, young people we have known stay in touch with us. Through many of the darkest times, the IU Women’s Basketball Team gave me reason to keep going and filled me with hope, joy, and Hoosier pride. Win or lose, they always remember that the things that matter most in life are teamwork and dedication to a good cause. The young people in my life help me feel relevant and, on a good day, vital.
What you need to know
- About half of the people reading this will experience cancer during their life. If you are lucky enough never to be diagnosed with cancer, good. If you are diagnosed with cancer, get the very best care you can get and stay positive. A positive attitude is highly correlated with good outcomes in cancer. A positive attitude helps you make the thousands of little and big decisions that lead to a longer, healthier life. If you are diagnosed with cancer, remember that your diagnosis is a start, not an end.
- Stay active. No matter how graceful you are or are not, stay involved in some sort of sport or physical activity on an ongoing basis.
- Colon cancer is on the rise. Each year more people are being diagnosed – younger and yet at more advanced stages of this disease. We now regularly hear of public figures dying of colon cancer in their 30s and early 40s. Start checking yourself with over-the-counter tests when you turn 30. Get to a doctor right away if anything shows up in those tests. My recommendation is that you get your first colonoscopy when you are 35.This is a decade more proactive than current US guidelines but a precaution against a situation in which the problem is getting worse and guidelines lag. Even if you must pay for it yourself, a colonoscopy is way cheaper than cancer.
- Think about your family. The one thing for which I will never be able to forgive myself is the pain I have caused those who care about me. Take care of yourself for the sake of the people who care about you, if not for yourself.
Let me close with wise words from Mike Winter: “Each day is important and it is essential to approach it with a good deal of cheer and gratitude.” Mike died as a result of ALS in 2019. I do my best to follow his wisdom.
Thanks to:
• my family, most of all my wife, for being with me on this journey. It’s not over yet.
• my Doctors and advisors: Dr. Patrick Loehrer (the svelte and handsome captain of my care team; he led the Simon Cancer Center to its certification as the 51st comprehensive cancer center in the US); Drs. Brett Spier, Bryan Holcomb, Tracy Gunter, Michael House, Ihab El Hajj, Susannah Ellsworth, Milan Radovic, Bryan Schneider, Ryan Rhome, Paul Herscu, Kimbre Zahn, Clark Brittain and nurse Diana Bayes (and the organizational and emotional foundation of my care team); thanks also to the many radiologists and anesthesiologists involved.
• the excellent leadership of IU that I was honored to follow during my professional career as I served IU and the State of Indiana; and my academic homes at IU: the Office for the VP of Information Technology, and the Departments of Biology, Mathematics, Computer Science, and most recently Germanic Studies at IU Bloomington; the Department of Medical and Molecular Genetics at IUPUI.
• Dave, Marc, and everyone else currently dealing with cancer – we’re all in this together.