Eight years ago, I was 33 years old, and my main health concern was a diagnosis of ankylosing spondylitis, a form of arthritis that causes stiff, painful joints in the spine. Having a chronic disease made me pay close attention to any changes in my health, so when I noticed blood in my stool, I immediately made an appointment with my primary care physician for a checkup. Without giving me a physical examination, he brushed aside my concern and told me that I had hemorrhoids and not to worry.
But I was worried. I continued to see drops of blood in my stool and on the toilet paper, and I was now also feeling fatigued and weak. Having had some experience with the health-care system as a patient with arthritis, I knew the importance of self-advocacy. After insisting that I receive additional testing, my physician prescribed a computed tomography scan of my pelvis, which I was told was negative for any masses or blockages.
Health-care professionals must get the message that cancer isn’t just a disease of the elderly. Concerns from patients of all ages must be taken seriously, so cancers can be found earlier and potentially cured.— BILL THACH
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Still, I couldn’t let go of this feeling that something was seriously wrong with my health. All the symptoms I had been having for weeks were growing worse. Finally, out of desperation, I made an appointment with my rheumatologist, who was treating the arthritis and with whom I had complete trust. He referred me to a gastroenterologist for a colonoscopy. That’s when I finally got the answer to the source of my discomfort, although it definitely wasn’t what I was expecting to hear.
Fighting for My Life
The test found a large tumor in my rectum. An additional imaging scan showed that the cancer had metastasized to one lymph node. A biopsy of the tumor determined that I have neuroendocrine carcinoma of the rectum, a rare cancer representing between 12% and 27% of all gastrointestinal neuroendocrine tumors, and that has an estimated annual incidence of approximately one-to-two cases per 100,000 individuals in the United States.1
Although I was originally told I had stage III cancer, a year later, the disease had spread to my bladder, prostate, and liver. Now, I had stage IV neuroendocrine carcinoma, and I was in for the fight of my life.
Since my diagnosis, I’ve had nine lines of different treatments, including various chemotherapies; participated in four clinical trials; undergone 25 rounds of radiation therapy; endured an 18-hour surgery that left me with two ostomy bags to collect fecal matter and urine; and laparoscopic ablation to treat the tumor in my liver. I’m currently receiving lanreotide, a somatostatin analog, which is keeping the cancer stable for the moment.
I know that this cancer is terminal and I wonder what will kill me first, the cancer or the cumulative side effects from the many treatments I’ve had. What keeps me going is the fact that there are new treatments already in the pipeline and more on the horizon. My goal is to stay alive long enough to get to the next treatment—and the next.
Confronting the Rising Rates of Cancer in Adolescents and Young Adults
Typically, this cancer affects people much older than I, and perhaps that’s why my primary care physician was so quick to dismiss my symptoms. But I’m not ready to let him off the hook that easily. Cancer rates in adolescents and young adults have been rising an average of 0.3% per year over the last decade,2 and that percentage is expected to climb by 30% by 2030.3 Health-care professionals must get the message that cancer isn’t just a disease of the elderly. Concerns from patients of all ages must be taken more seriously, so cancers can be found earlier and potentially cured.
Living My Best Life
Although the last 8 years have been difficult, what has helped me cope and live my best possible life is admitting that there is only so much I can control. I’ve learned to let go of the what-ifs of the future and to concentrate instead on the present.
Staying physically and mentally fit is the tonic that keeps me going. I exercise regularly and eat a healthy diet. Most importantly, I maintain strong relationships with my family and friends. I’ve also become a mentor to other cancer survivors and a member of the leadership team of Man Up to Cancer (https://manuptocancer.org), an organization of over 3,000 men worldwide living with cancer. The experience has kept me grounded and focused on the areas of my life that bring me joy.
Last year, I decided to retire. I made that choice because I need to concentrate on keeping the cancer manageable, while I live the best life I can for as long as I can.
Bill Thach, 40, lives in Houston, Texas.
Editor’s Note: Columns in the Patient’s Corner are based solely on information The ASCO Post received from patients and should be considered anecdotal.
REFERENCES
1. American Cancer Society: Key Statistics About Gastrointestinal Neuroendocrine Tumors. Available at www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/about/key-statistics.html#:~:text=Although%20the%20exact%20number%20isn,common%20in%20women%20than%20men.
2. National Cancer Institute: Adolescents and Young Adults With Cancer. Available at www.cancer.gov/types/aya. Accessed April 23, 2026.
3. Zhao J, Xu L, Sun J: Global trends in incidence, death, burden, and risk factors of early-onset cancer from 1990 to 2019. BMJ Oncol 2(1):e000049, 2023.
