No Symptoms, One Screening and a Life Saved

Despite feeling perfectly healthy, Susan Clark refused to delay her colonoscopy any longer. Her January 2020 screening appointment was postponed a few times because of the pandemic, so Clark insisted on keeping the September appointment.

“I don’t know what made me do it because I didn’t have any symptoms, and I didn’t even have polyps before, so I expected everything was going to be wonderful,” says Clark, who is an executive assistant to a department chair at the University of Miami’s Miller School of Medicine and the associate director for education and training at Sylvester Comprehensive Cancer Center, part of the Miller School.

Clark had no stomach pain, changes in bowel habits or family history of colorectal cancer. She’s 69, walks regularly, eats a healthy diet and never imagined a routine colonoscopy would reveal anything concerning.

Instead, she woke up from her colonoscopy at The Lennar Foundation Medical Center to learn the routine screening revealed colorectal cancer.

“I was floored. No one was more surprised than me,” says Clark.

A Cancer Diagnosis with no Warning Signs

While colon cancer can come with symptoms like changes in bowel movements and blood in the stool, many people experience no symptoms at all, especially with early-stage cancer. That’s why screening remains one of the most powerful tools for finding cancer before symptoms appear.

For Clark, her colonoscopy screening was a path to immediate treatment. Within days of her diagnosis, specialists at Sylvester assembled a treatment plan tailored to Clark’s colon cancer.

“We started treatment right away, and that was huge for me emotionally, because I felt like I was doing something,” says Clark.

Her year-long colon cancer treatment began with radiation therapy and oral chemotherapy, followed by surgery and additional chemotherapy. Along the way, her team continually adjusted the plan based on her needs and recovery. What stood out most to Clark was how closely her physicians worked together.

“They very much worked as a team,” she says.

That coordination became especially important when complications required additional interventions. Clark says she always felt her care team was communicating, evaluating options and making decisions together.

“UHealth is really phenomenal. I felt cared for all the time,” she says.

Finding Strength Through Treatment

Clark’s colon cancer journey wasn’t easy. Both treatment and recovery tested her physically and emotionally. Yet she approached each stage with a positive mindset.

“I’m not the kind of person who’s going to sit around and worry that I have cancer. My personality is to give me a plan, and I can do it. If you need to make a change, I’ll do it,” she says.

Clark’s large family played an essential role in her journey. As the ninth of 10 siblings, she says there was rarely a day when someone wasn’t checking in, offering encouragement or lending a hand. Her immediate family took care of her every need, especially her husband.

And when Clark needed to dig deep to summon her own strength, faith carried her through.

“No matter what it was, it was going to be how it was going to be. My job was to do everything I could do,” she says.

Survivorship is More Than Being Cancer-free

Today, Clark has no evidence of cancer, but survivorship comes with its own challenges.

Years after treatment, she still experiences fatigue and digestive issues related to her cancer journey. Cancer-related fatigue (CRF) affects up to 85% of cancer survivors during treatment and up to 50% post-treatment and is associated with worsened quality of life and physical function.

Rather than accepting fatigue as her new normal, Clark continues looking for ways to improve her health and quality of life.

“When I get up, I have all this energy to do all of these things, and then I’m wiped out when I’m done,” she says.

That commitment led her to survivorship programs and research opportunities through the Sylvester Survivorship and Supportive Care Institute.

Building Community After Cancer

Undergoing cancer treatment during the pandemic meant Clark didn’t meet other cancer patients. For each appointment, she called the clinic from the car upon arriving and was taken directly to a treatment room.

“I’d go straight back, receive my treatment and leave without seeing another soul,” she says.

That isolation from others with firsthand cancer experience makes the connections Clark has built as a cancer survivor since then that much more essential. One of the most meaningful experiences Clark has joined has been a Sylvester program called Believe in You. The survivorship fitness and support program created by Tracy Crane, Ph.D., RDN., co-leader of Sylvester’s Cancer Control Research Program, director of digital health and lifestyle medicine for cancer survivorship and associate professor at the Miller School, is designed to offer community and a path to getting stronger and healthier after cancer.

“It was an opportunity to meet other people who understood what it was like not to be 100%, but still want to be there, working toward getting better,” says Clark.

The program brings cancer survivors together on Saturday mornings with a certified oncology exercise trainer to train for the Dolphins Cancer Challenge while building strength, confidence and community. It’s also a chance to raise money for cancer research.

I wake up every day with gratitude in my heart. I feel truly gifted with a new day.
Susan Clark

“I wanted to do something to give back to other cancer patients, and this was one way for me to do so,” says Clark.

The group quickly became more than an exercise program. Participants train together, share experiences and support one another long after the formal program ends. Many continue meeting weekly.

“It’s just all positive,” says Clark.

Dr. Crane says that the sense of connection is one of the program’s greatest strengths. The initiative began four years ago with fewer than a dozen participants and has grown into a thriving survivor community of over 200 that helps people regain strength and confidence after treatment.

“Sometimes people just don’t know where to begin, so having a place where you can start, with other people around you also doing it, can provide just the boost needed to try something new,” says Dr. Crane.

Advancing Survivorship Through Research

After years of working with cancer researchers at Sylvester, Clark understood how important clinical research trials are to both participants and scientific progress. She joined two clinical trials as a cancer survivor, including the Precision Oncology Interventions in Nutrition and Training (OnPOINT) program and a study examining cancer-related fatigue, Exploring an Objective Measure of Physiologic Cancer-Related Fatigue through Kinematic Analysis.

Exercise is one of the best antidotes to fatigue.

“Fatigue is the No. 1 symptom people have during and after cancer treatment, so the best tool I give sounds counterintuitive, but it’s taking a 10-minute walk, especially outside,” says Dr. Crane.

The ONPOINT study explores whether a tailored intervention on diet and physical activity can improve quality of life, physical function, nutrition and body composition for people diagnosed with breast, prostate, colorectal or lymphoma cancers.

The fatigue study from Dr. Crane’s doctoral student, Madalyn Wheeler in the Department of Kinesiology and Sport Sciences, explores whether artificial intelligence-based movement analysis can help researchers measure fatigue more objectively.

“Fatigue is hard to measure. People definitely have it, but how do you quantify it?” says Dr. Crane.

Grateful for Every New Day

Looking back, Clark remains grateful she kept her colonoscopy screening appointment. Since her colon cancer diagnosis and treatment, she has welcomed three additional grandchildren, celebrated two sons’ marriages, completed the Dolphins Cancer Challenge and tackled personal goals she wasn’t sure she’d get to pursue. Each milestone feels different now.

“I wake up every day with gratitude in my heart. I feel truly gifted with a new day,” she says.

Tags: cancer research, cancer survivorship, chemotherapy, colon cancer, colonoscopy, colorectal cancer, Dolphins Cancer Challenge, Dr. Tracy Crane, exercise during cancer treatment, gastroenterologist, Lennar Foundation Medical Center, radiation therapy, Survivorship, Sylvester Comprehensive Cancer Center, Sylvester Survivorship and Supportive Care Institute