Roberto Cowan has a great philosophy for life. When people would ask what he did, he would respond “I run, I drink, I do both with friends.” 

A perfectly healthy 30-year-old, running was the centerpiece of Roberto’s life. The friends he went out to karaoke with or had beer with were people he met in running groups. He ran marathons. Running was everything.

Having had IBS (irritable bowel syndrome), he was used to stomach cramps and occasional blood in his stool. He was so used to it he failed to bring it up in annual physicals. When he finally brought up the blood in anticipation of triathlon training, the PA asked, “How often are you seeing blood?” When he responded, “Multiple times a day,” they told him he needed to get a colonoscopy immediately.

They found a seven-centimeter tumor in his rectum with spread to his local lymph nodes. He was a stage III rectal cancer patient. 

That was March of 2019.

The tumor may have been present for years, as colorectal cancer is typically a slow growing cancer. In hindsight, Roberto recognized symptoms going back a far as 2015. That was when the cramping began in earnest and the bleeding began to increase. Around then, his run times began flagging. He assumed maybe he was getting out of shape, and beer and the bad diet of a twenty-something were having their effect. Colorectal cancer never entered his mind. 

His doctors were of a similar mind. Considering his age and his overall fitness they assumed there must be an underlying driver for the cancer. They assumed Roberto must carry the gene for Lynch Syndrome, a genetic condition that predisposes someone to various types of cancer including colorectal. He would test negative for Lynch.

Treatment started with eight rounds of chemotherapy followed by twenty-eight doses of radiation and immunotherapy (Pembrolizumab, aka Keytruda). A sigmoidectomy would follow with a temporary ileostomy. While the ileostomy would be reversed a few months later, recovery would not be without complications. Roberto developed an E. coli infection at the base of his tailbone and would have to endure an uncomfortable accordion drain for weeks to fight the infection.

Treatments wrapped up in November of 2019. Roberto came out of cancer treatment and recovery right at the start of the Covid pandemic. The shock and trauma of cancer followed by the panic and solitude of the Covid lockdowns significantly affected Roberto. The always gregarious and fun-loving guy who had started writing a joke book in the sixth grade (mostly dad jokes) became a bit of a shut-in homebody. The funk would be short lived.

Roberto would become a member of several colorectal cancer organizations and helped found the University of Texas Southwestern Medical Center’s Dallas Young Adult Cancer Support Committee. As an advocate, Roberto likes to be a person who can help put people who are a bit overwhelmed with being thrust into the world of cancer to get in touch with necessary resources.

He spent 2020 in recovery and getting back in shape for marathon running. Roberto finished his comeback race in four hours and nine minutes. Now he is in the process of starting a running team of cancer survivors.

Roberto’s experience with cancer would also push him in another new direction, that of stand-up comedy. People have a fear of cancer and as far as comedy goes, most people see it as a taboo subject. A friend of his reminded him that throughout his battle with cancer he kept an incredibly positive attitude and constantly joked about his situation as his way of helping defuse the concern others might have. That friend urged him to use his cancer experience in his comedy and for him to “Speak his truth.” 

Roberto’s hope is that by sharing his experience in a humorous way, he can help raise awareness and show that, as a survivor, a cancer diagnosis is not the end of the road.

And besides, everyone can use a good poop joke.

These days, Roberto is three plus years past treatment and is NED (No Evidence of Disease). He works as a marketing manager for a running store and is busy running down his dreams.