For many young people, being diagnosed with cancer just doesn’t compute.
Not so for Nick Armstrong, who recently graduated with a mathematics degree from Grand Valley State University. When the then 26-year-old Armstrong tested positive for colon cancer, it all added up.
In fact, after living with Crohn’s disease for many years, he suspected cancer may become part of the equation.
His medical journey began in single digits—at age 9. He started experiencing stomach pain.
But growing up in a family of four boys in the suburbs of Ada, Michigan, he brushed off the pain as residual from an active lifestyle—a basketball to the gut, an elbow from a brother, or a whack from a street hockey stick. When you’re 9, you don’t think pain could ever be anything life-changing.
“I had a lot of stomach pain and a lot of diarrhea,” Armstrong recalled. “For the first week or so it seemed like it was a really, really bad flu. But looking back on it now as an adult, as I kid, I just didn’t know that wasn’t normal. I have four brothers so there were a lot of bumps and bruises going on in my house.”
But then came the blood. Little 9-year-old Nick told his mom, a nurse at Butterworth Hospital.
“It wasn’t until I had the bleeding issues that I knew it was not normal,” he said. “That was the red flag.”
Doctors diagnosed Nick with Crohn’s disease, a chronic inflammatory bowel disease that affects the digestive tract lining.
He tried to avoid spicy foods and stress. But the disease made it difficult to gain weight. He grew to 6-foot-1, but never crested 130 pounds. Something weighed heavily on his mind.
“With Crohn’s, there is a risk for cancer,” Armstrong said.
Counting on cancer
He endured annual colonoscopies, which all turned out fine, until September 2013, when the risk became a brutal reality.
“About six months before my diagnosis, I had a spot that was kind of troublesome,” he recalled. “I had another colonoscopy scheduled and on the second one a biopsy was taken. It came back positive. It wasn’t that unexpected for me just because I think I prepared myself.”
The alternative to treatment is death. You kind of wholeheartedly accept that.
Computations. Cancer. Chemotherapy. There wasn’t room for it all in a college student’s life. Armstrong took time off from school and moved back in with his parents. Into his old room.
But just as he swiftly solves a math problem, he could see the equation in this. He dealt with facts more than emotion. He kept his eye on a common denominator.
“I come from a family of medical practitioners so I have a lot of confidence in the process of early detection and treatment,” he said. “I had seen my own Crohn’s disease treatment evolve over my lifetime. The effectiveness of those increased so much I was confident I would be in safe hands.”
But the answer wouldn’t be whole without acknowledging at least some fear.
“Anytime you hear the word ‘cancer,’ it is very, very scary,” he said. “It does leave you in a state of shock, no matter who you are. But I just really focused on what we could do next. The nice thing is you have a clear path you have to follow. You can focus more on the immediate that you have right in front of you, like choosing a treatment option and what you have to do after treatment to stay healthy.”
Still brimming with cancer cells, surrounded by loving family, friends and his girlfriend, Samara Napolitan, Armstrong focused on getting better.
Shortly after diagnosis, he had his colon and several lymph nodes removed. He has an ostomy now.
“They removed all of my digestive system below where the small intestine connects to the large intestine,” he said. “That was the safest treatment for colon cancer, especially with Crohn’s disease.”
After surgery, he underwent 12 weeks of chemotherapy.
‘A great prognosis’
He’s been in remission since chemo concluded in May 2014.
“What a wonder and positive attitude he had–even on his worst days,” Dr. Brinker said. “I believe his attitude helped him get through his treatment.”
Dr. Brinker said colon cancer is more typically a disease found in people in their 60s and 70s, but patients with inflammatory bowel disease are at a slightly increased risk for colon cancer.
“Any inflammatory process in the colon can increase the risk for cancer,” Dr. Brinker said. “But not everyone with inflammatory bowel disease is destined for cancer. For Nick, it was caught early enough that he has a great prognosis.”
Nick is resuming life, but he’s still looking for answers. He’s always loved the solid answers math offers. He likes nothing more than to curl up with a good math book at night, and solve “hobby math” problems with a sharp pencil.
“I don’t know why I love math so much,” said Armstrong, who also received a degree in chemistry in 2010 from Kalamazoo College. “I pursued a math degree out of passion for the subject.”
Perhaps the biggest mathematical analogy for Nick’s life right now is the “greater than” sign. Despite a life-changing surgery and an ostomy bag, he trusts his life is greater than it would have been without treatment.
“The alternative to treatment is death,” Armstrong said. “You kind of wholeheartedly accept that. With my surgery, I would have preferred to never have it, but I’m quite happy because the alternative was death. I have a lifting restriction of 30 pounds, which is kind of annoying, but it beats being dead. I think that’s something a lot of people forget.”
‘Changed my world view’
Armstrong said the cancer subtracted life plans for a time, but he’s thankful to be able to resume, with a “greater than” attitude.
“It’s changed my world view drastically,” he said. “It permanently broke the young naive mentality you have of being invincible. I think that disappears at a different time in everyone’s life. That was definitely the moment it got killed off for me.”
Nick isn’t taking anything for granted. He said he feels closer to friends and family. Appreciates them more.
“The cancer helped me clarify my goals and helped me realize the contributions to my family, society and community that I wanted to make in my life.”
He took part in a documentary spearheaded by fellow cancer survivor Judy Bode about the long-term effects of treatments. Armstrong said he feels fortunate. He is not experiencing lingering effects like some others do.
“The documentary does a good job of making it clear that there are a lot of experiences we can’t relate to and it’s important to go out and connect with other people who have different experiences so we can better understand each other,” Armstrong said.
Armstrong has another goal that involves connecting—he wants to marry Samara.
“Everything just kind of gets pushed back when you have cancer,” he said. “It’s like if you had a five-year plan for your life, it becomes a seven-year plan. I think that’s been the hardest aspect of it all. But I’m jumping back in. I’m happy to see all the momentum going forward again.”