‘This is stage 3 rectal cancer, and I can do this’

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Judy Caswell’s sons used to joke that her first-aid kit was comprised of duct tape, hockey tape and super glue.

And for a long time, that was pretty accurate, she says with a laugh.

“I only ever went to the doctor when absolutely necessary — for vaccinations or when I was pregnant,” Judy recalls. “I was always one who felt that my health was my responsibility. I ate well. I exercised and, usually, I never got anything more than a cold.”

Then, in 2012, she started to experience changes in her body — digestive issues, bleeding and nausea. At the time, she was 53 years old and training to run a marathon with her son. She quickly explained away the symptoms as the byproduct of age and exertion.

When Judy ran the marathon on Mother’s Day weekend in Fargo, North Dakota, and beat her 21-year-old son by a full minute, she felt invigorated — and validated.

“I can’t be sick,” she recalls thinking at the time, “because you don’t run marathons and beat kids if you’re sick.”

Judy eventually would find out she was wrong.

Over the next three years, the wife and mother of two took on new adventures with her sons — learning how to wake surf, doing obstacle races. The symptoms were still there, but it was manageable.

In 2016, she decided to do another marathon with her son — a rematch of sorts. Judy had a victory to defend; her son had a shot at redemption.

“Then, things took a little bit of a turn,” Judy recalls.

Her symptoms became intense, affecting everything from her running to her work. She started dropping weight dramatically. And in May — after 20-some years without seeing a doctor — she went in to Novant Health Presbyterian Medical Center to get checked. That’s when she got her diagnosis: Judy had stage 3 rectal cancer.

“I have to say, I was extremely angry. I looked at it like, ‘I don’t have time for this.’ My husband had recently retired, and I was working half-time. And then the thing that really kept coming back was, ‘I shouldn’t be getting cancer. I’ve done what I’m supposed to do.’”

She didn’t want to have a doctor lecture her about all the checkups and screenings she’d avoided over the years. She didn’t want to be told she had to “take it easy” from here on out. She didn’t want to be a bystander in the process of improving her health.

“I had a very bad attitude. My first appointment after my diagnosis, and first cancer-related one, was with colorectal surgeon, Dr. Robert Stevens. I promised my husband I would listen. That was it. And there was a good chance I wasn’t going to follow through,” Judy recalls.

But that first meeting changed everything.

“He spent such a long time explaining rectal cancer, my specifics, where it was, what it meant, the treatments and then what to expect at the different phases,” she recalls. “There was no computer screen in front of him. It was very conversational, and he was very calm. It made me feel very comfortable. I got this sense of confidence and trust.”

She also took note of one small gesture that made a huge impact.

“On his notepad, he wrote, ‘Training for a marathon,’” Judy recalls. “He picked up on that and knew that all these activities I wanted to do with my boys were a priority.”

Her treatment plan was designed with that priority foremost in mind.

“He gave me strategies to deal with the side effects of both radiation and chemotherapy, as well as accommodating the new changes in my body,” she recalls. “I was so concerned about this loss of control and people telling me what to do, but instead, it was like, ‘I’m in control. I’m part of this team.’ I walked out of the office like, ‘This is stage 3 rectal cancer, and I can do this.’”

Judy started off with daily chemo and radiation for six weeks. Then came surgery with a lower pelvic resection and ileostomy. Her medical team designed the plan around the ERAS — enhanced recovery after surgery — protocol, which allows early recovery and long term benefits for patients undergoing major surgery. After that surgery came another six months of chemo.

Throughout everything, she kept training.

“Age and cancer don’t mean you have to slow down,” she explains. “This whole thing has taken me a direction I never expected to go, but I put it back on what my team did for me. I always say, instead of rose-colored glasses, I see things through my aubergine-colored glasses.”

Judy had her final surgery in 2017. Since then, she has completed 45 races — 20 in 2019 alone. And she’s running faster than ever before, routinely placing in the top of her age group.

“I’ve done snowshoe challenges and hiking challenges with my boys — stuff beyond what I ever did before. And in January, I’m going to do my first 50K race,” she says.

She’s also giving back to the team of healthcare professionals who made it be possible for her to be both cancer survivor and ultramarathoner. So, she asked the team at Novant Health Presbyterian Medical Center Foundation what they needed most.

“Especially in the beginning of your cancer journey, you don’t want to be there — particularly in a colorectal surgery practice. You’re having these discussions where you just had a fairly intrusive exam. It’s very awkward, very uncomfortable,” Judy explains. “So, the idea they came up with was a family-friendly consultation room. And the more we talked about it, the more I could see it and particularly how it would positively improve the patient’s experience.”  

Now, her donation is helping to bring that room to life at Novant Health Charlotte Colon & Rectal Surgery clinic, which she credits with much more than just curing her cancer.

“I was sure they were going to tell me to take it easy, but instead, I got the opposite. And it gave me a lot of confidence in myself,” she says. “I always have one more challenge because I see now that I don’t know what my limits are. They made me feel more confident in myself.”