Diagnosed with colorectal cancer: Cris Ross’ story, part 1

By Cris Ross

Editor's note: This is the first in a series of four excerpts from Chapter Two: Inside Out, "Cris Ross's journey from healthcare exec to patient — and back again," from the Mayo Clinic Press book, Diagnosed: An Insider’s Guide for Your Healthcare Journey, by Cris Ross and Ed Marx. Cris Ross is chief information officer at Mayo Clinic. 100% of all author royalties from the sale of every book benefit important medical research at Mayo Clinic Comprehensive Cancer Center.

In early 2018, Mayo Clinic was approaching the most critical stage in the most challenging and risky project I'd ever encountered in my career.

On May 5, we were poised to replace virtually all our technology for medical care and billing at our Rochester, Minnesota, flagship location. In a hospital, everything depends on technology: diagnosis, documentation, treatment, communication with patients, medical devices, billing — ev­erything. We were going to change almost all of it, all at once. A lot was on the line. Our then-CEO called this the biggest project in our 160-year history. But as we approached the big date, I was miserable.

In my teens through my early thirties, I wrestled with what today might be diagnosed as irritable bowel syndrome. I had become accus­tomed to constant gut aches and interruptions to daily life. But now, 20 years later, it seemed to have returned at the worst possible time — I had a huge amount of work to do. I chalked it up to the stress of the project, pressed through it, and committed to getting checked out right after we finished the big technology change.

By early July our mega-project had stabilized. At this point discomfort had changed to real pain. I noticed blood in my stool for the first time. I got in as soon as I could with my primary care doctor, Joanna Rea, on Monday, July 16. By then I was convinced this wasn't just irritable bowel syndrome but something seriously wrong. Mayo moves quickly. Two days later, on Wednesday, July 18, I had a colonoscopy. On Thursday, July 19, I had a CT scan and pathology results from colonoscopy samples.

A cancer diagnosis

The same day as my CT scan I walked over to Dr. Rea's office in an adjacent clinic building, where I was joined by my girlfriend, Anne-Marie, a radiologist at Mayo. We received the news together. "I'm sorry," said Dr. Rea. "You have colorectal cancer."

As a chief information officer, I'm used to bad news — it's not uncommon for me to deal with several real or imagined emergencies per day. Our giant project had had me on high alert for months. My immediate response to this cancer diagnosis was not to be sad or afraid but to treat it as just another big and complex problem that needed to be solved: this cancer needs to be cured, so let's get on with it. It didn't feel personal yet, but it did feel urgent.

I asked many questions: Whom could I talk with? What were the options? What would treatment look like? How could I evaluate this problem, find root causes, make corrections, and move through it successfully? How could I keep my professional and personal life going while attending to this emergency?

Appointments were scheduled with gastroenterology, oncology and surgery. I had an MRI scan of my pelvis on Friday, July 20, the day after receiving my diagnosis. Over the weekend I reached out to many colleagues for advice. All were generous with their time and empathy. I learned that my situation had already been discussed on Friday by a "tumor board," an interdisciplinary group of doctors. On Monday, July 23, I met the oncologist assigned to my case, Dr. Thor Halfdanarson, and radiation oncologist Dr. Michael Haddock. Thor told me that my cancer was stage 3, which is pretty bad. It was a large tumor, but luckily it had not spread elsewhere in my body. (When a cancer has spread to other parts of the body, it is called metastatic cancer; that is stage 4 cancer and can be very hard to cure.) At this meeting Thor said the clinical intent was to cure me of cancer. This surprised me, and I asked, "Don't you intend to cure everyone?" He gently and carefully explained that while some cancers can be cured, others can only be contained. On Tuesday, July 24, I met with my assigned surgeon, Dr. Scott Kelley. On July 27, eleven days after my first consultation with my primary care physician, I had a port placed in my chest and received my first dose of chemotherapy.

My recollection of those 11 days is both crystal clear and a blur. As Ed and I will explore in other chapters, different people respond differently to these kinds of health crises. We believe the only "correct" response is the one that is authentic to you, the person receiving the diagnosis, and to the people closest to you.

My way of responding to this serious diagnosis was pretty simple. First, I wanted to be honest with my family and friends. Anne-Marie had accompanied me to my appointments and was fully informed. I talked via video with my older daughter, Hannah, in Seattle. I sat down with my younger daughter, Emily, who was living with me in St. Paul after recently returning from four years living in Paris. Both took the news quietly and calmly, asked a few questions, were scared, and offered support. I told everyone close to me what I understood as the truth: I had a tumor that was serious but curable. I intended to beat it. I would answer their questions as best I could. I honestly did not feel afraid, perhaps because I was too ignorant to know what to be afraid of, but also because I had seen what Mayo Clinic could do. I believed fully that if I could simply submit to it and persevere through it, I would be cured.

The plan was laid out for me by my doctors, Thor, Michael, and Scott. They would attack the tumor with chemotherapy and radiation therapy to reduce its size and prevent spread, followed by surgery to remove the remaining cancer. I prepared for eight biweekly chemotherapy sessions, radiation therapy sessions for 25 consecutive days, and surgery. I took medical leave and, in the interim, turned over my job to my colleague and friend Mike Ryan.

I don’t know whether it was because of my CIO "take action and solve this problem" stance or from some other source, but I was determined not to let cancer beat me physically, mentally or emotionally. I wanted to step into my role as a cancer patient with integrity and purpose.

I looked around for models. A good friend, Allyson, had a daughter who had been treated twice for leukemia, once as a toddler and then as a kindergartner. Their journey was awful, but both mother and daughter emerged stronger, and each was transformed. Allyson told me she had found the "gift of cancer." She didn’t choose for her daughter to have cancer; all she could do was choose how to respond to it. Her approach was to look for what the cancer journey would teach her and how she might become transformed by going through it.

So I entered cancer treatment seeking two "gifts." The first came from the intensity that goes along with my day job. I figured I had an unparalleled opportunity to see Mayo Clinic as a patient from the inside out, including the good, the bad and the ugly of the comprehensive new software we had just launched. I sought the gift of being a better CIO when I emerged.

Second, I was determined to see how cancer could teach me to truly live life with joy and intention. I meant to keep this aspiration through treatment and survival. Cancer was unwelcome, but I didn't want it to define me. I wanted to appreciate everything I could, for as long and deeply as I could, through my cancer journey and beyond.

Learn more

Learn more about colon and rectal cancer and find a clinical trial at Mayo Clinic.

Join the Colorectal Cancer Support Group on Mayo Clinic Connect, an online community moderated by Mayo Clinic for patients and caregivers.

Also, read these articles:

• Living with cancer: Guidance from Mayo Clinic experts
• Surviving cancer: What to expect after the diagnosis