Beating the odds: Surviving colon cancer at 21 years old

Fourteen people stretched their arms toward the sky. Their hands rose above a sea of over 400 people.

It was Sunday, April 14, and Sentara’s 11th annual Don’t Sit on Colon Cancer 5K/Survivor Walk was about to begin. Survivors were asked to raise their hands to be recognized.

“It was nice not feeling alone, like to know there’s people that have gone through what I’m going through,” said Peter Votaw, who at just 21 was diagnosed with stage 2 colon cancer on Jan. 9.

Votaw completed the survivor walk, showing no sign that his entire colon had been removed at Sentara Virginia Beach General Hospital a month earlier.

“By mile two, my stomach was hurting a bit,” said Votaw, laughing. “I was speed walking at the start, and I probably could have just been a little more chill.”

Living with an increased risk of colon cancer

When Votaw was 8 years old, he was diagnosed with Crohn's disease, a type of inflammatory bowel disease (IBD) that causes inflammation in the digestive tract.

“After about eight years of having the disease, the incidence of cancer goes up by about 2% per year in inflammatory bowel disease,” said William Rudolph, M.D., a colorectal surgeon with Sentara Surgery Specialists. “The chronic inflammation alters the DNA in the cells and produces dysplasia, or pre-cancerous changes, and that eventually can lead to cancer in some patients with IBD.”

Votaw describes his regular Crohn's disease symptoms as pain and increased bathroom trips. However, in January of this year, he started to feel excessively tired and like he never got all his stool out. He was also waking up at odd times during the night to use the bathroom.

“They did a colonoscopy and found four polyps and one mass, and soon after I got the call that it was cancer,” said Votaw. “I didn’t realize it was going to be as hard to tell people I love that I have cancer. It was rough.”

Peter Votaw (center) walked in Sentara’s Don’t Sit On Colon Cancer 5K/Survivor Week just a month after having his entire colon removed.

Prior to his surgery with Dr. Rudolph, Votaw did a deep dive on the internet to find as much information as he could. Many of the articles he came across gave the impression that after surgery most people ended up with an ostomy bag, a pouch that collects your poop when your bowel is removed or diseased. That ended up not being the case for Votaw.

“In order to minimize the risk of further cancer and Crohn's flares, we removed the whole colon and hooked the small intestine down to the rectum,” said Dr. Rudolph. “His rectum did not have any evidence of Crohn's disease, so we left it to improve his quality of life knowing that he’s going to have frequent surveillance.”

Dr. Rudolph says that even if a patient does end up with an ostomy bag, it doesn’t limit your lifestyle. For example, he performed an ostomy on a goalie in an adult soccer league who still plays. You can do pretty much anything with an ostomy. You just have to ensure the bag is protected. 

Rise in colorectal cancer among younger adults

“People have to know colorectal cancer is becoming a younger person’s disease,” said Dr. Rudolph. “Rectal cancer in specific used to be an older person’s disease and now about 50% of the patients I see in my office for rectal cancer are under the age of 50. I’ve been seeing it for the past ten years.”

Dr. Rudolph notes that if patients have any symptoms consistent with colorectal cancer, including abdominal pain, change in bowel habits, rectal bleeding, rapid weight loss, they need to get evaluated by their doctor who can then determine if they need to be referred to a gastroenterologist. 

“The biggest issue I see is when young people come in with rectal bleeding and the primary care physician said it was just hemorrhoids and it turned out to be rectal cancer.”

Colorectal cancer is expected to be the leading cause of cancer-related deaths by 2030 in 20-49-year-olds, according to JAMA Network. 

Patients under 50 are more likely to experience four symptoms — abdominal pain, rectal bleeding, diarrhea, and iron deficiency — in the three-month to two-year period before a colorectal cancer diagnosis, according to research in the Journal of the National Cancer Institute.

"The hardest part of my job is when I have to share bad news; it hits me emotionally," said Patty Wang, M.D., a gastroenterologist with Capital Digestive Care who diagnosed Votaw's cancer. "It's always still a shock when a young person presents with symptoms. This is why the screening age was brought down from 50 to 45 because of the increasing incidences of colon cancer in younger people."

Almost 1 out of 3 people diagnosed with colorectal cancer before age 50 have a family history or genetic predisposition. People who know they have a family history should begin colorectal cancer screening before age 45.

“A colonoscopy is a lot better than a colectomy,” said Votaw. “I don’t want to see anybody that I love in the same position as me, especially when we have the advantage of having this knowledge.”

Support makes a world of difference

Shortly after Votaw’s diagnosis, his older sister Melody Dyer was out to dinner with friends when she decided that she should run a 5K race. 

“My friends and I started scrolling and we ended up finding the colon cancer 5K and we were like, ‘Wow, that’s absolutely perfect,'” said Dyer. “I just felt like it was the best way to stay positive and show him that there are other survivors and it’s not the end of the world.”

(Left to right) Votaw’s girlfriend, CeCe Quarles; mom, Amanda Votaw; and sister, Melody Dyer are Votaw’s biggest support system.

Sentara’s Don’t Sit on Colon Cancer 5K was originally scheduled a week after Votaw’s surgery; however, due to bad weather it was postponed 3 weeks and Votaw was able to participate with his friends and family. Votaw’s team name was, “Peter’s Prevention Posse.”

“I view him as this big, tall, strong guy so it’s hard to see him go through something so tough,” said CeCe Quarles, Votaw’s girlfriend. “It’s definitely brought us closer.”

“CeCe has been amazing in supporting him with eating healthier,” said Dyer. “She makes him these delicious nutritious meals, not letting him eat Wendy’s every day.”

Votaw (far right) at a boxing tournament with his coach and teammate in Alaska.

Prior to relocating to Virginia Beach, Va., in 2023, Votaw was living in Sitka, Alaska, where he did Muay Thai and boxing. When Votaw’s boxing coach found out he had colon cancer, he set up a fundraiser and made special colon cancer boxing club shirts. They ended up raising $2K for Votaw’s care.

“You can’t cure his cancer but the one thing you can do is be there for him,” said Dyer. “Being positive, taking everything with a grain of salt, knowing it’s not the end of the world, it’s just a little detour on his path.”

Colorectal cancer is 90% preventable

Votaw is now living cancer-free and will continue to get routine screenings. He looks forward to starting Brazilian jiu jitsu and says that exercise and eating healthy are some of the best ways to keep your gut healthy.

“I would definitely say start doing light workouts to get in shape if you don’t already,” said Votaw. “Walking also gets everything in your bowels moving.”

Gradon Nielsen, M.D., a medical oncologist with Virginia Oncology Associates, says for all cancer types the best thing you can do is maintain a healthy weight, eat lots of fresh fruits and vegetables, get plenty of fiber, and stay active.

“We’d probably see about a 50% reduction in cancer diagnoses if everyone made lifestyle and dietary changes,” said Dr. Nielsen, who also recommends thirty minutes of cardio five days a week. 

“When you hear the word ‘cancer’, don’t think it’s the end of the world,” said Votaw. “You still have a life, right. It’s made me stronger. I want to be a voice and I want to help, but at the same time I don’t want cancer to define me.”

Among his friends, Votaw is known not only for his strength and resilience, but also his laid-back nature. He enjoys spending time with his girlfriend and being a great cat-dad to Majin, Milo, and Loki.

“I just want to tell people to not give up,” said Votaw. “Keep going. It’s hard, but you’re going to get through it, and having people around you makes the journey ten times easier.”