James Van Der Beek was 'doing everything' for his health. One subtle symptom revealed he had stage 3 colon cancer at 46.

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For years, James Van Der Beek was invested in optimizing his health.
"I was doing everything," Van Der Beek, 48, told Business Insider. "I was doing sauna, cold plunge, weightlifting, Pilates. I would dance and also do football training."
The "Dawson's Creek" actor balanced strength training with cardio and ate mostly organic food, "doing all the biohacking things" to stay fit, he said.
Then, he started experiencing changes in his bowel movements, a common symptom of colon cancer. He stopped drinking coffee to see whether the issue would resolve itself.
"It didn't feel like a real symptom of anything," he said. "It wasn't anything that made me rush off to go get screened."
When it persisted, he got a colonoscopy. At 46, he was diagnosed with stage 3 colon cancer. He waited more than a year into treatment before sharing the news publicly in late 2024.
With his diagnosis, Van Der Beek joined an alarming number of young people being diagnosed with advanced cancers. Many, like him, had subtle symptoms and healthy lifestyles.
While he wishes he'd gotten screened sooner, he said that even in 2023, his options were more limited. It wasn't until 2024 that the Shield blood test, a test that can spot colon cancer signs from a simple blood draw, was FDA-approved.
Van Der Beek, who said he'd most likely be dealing with cancer for the rest of his life, is now a spokesperson for Guardant Health to promote the Shield blood test. His goal, he said, is to encourage people to get screened earlier, especially as colon cancer cases are rising in patients under the age of 50. He also hopes to raise awareness around symptoms and urge people to get screened as soon as they hit 45, the recommended screening age.
"The 'could have, should have' train is a black hole," Van Der Beek said. "But don't let my 'could haves' become yours. That's my biggest message."
More young people are being diagnosed with colon cancer.
Business Insider is telling their stories and helping readers understand how to prevent the disease and what could be causing the spike.
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A shocking start to a new life
In 2020, Van Der Beek and his family moved from Los Angeles to Austin. He took a break from acting for a few years and kept busy raising six children alongside his wife, Kimberly.
It took time to get settled. While Van Der Beek qualified for an annual colon cancer screening at 45, he said he didn't get a colonoscopy at that point because he was still sorting out his new healthcare situation. He also didn't know that the screening guidelines had changed in 2021, lowering the recommended age from 50 to 45.
Getting diagnosed with late-stage cancer in 2023 was a shock, Van Der Beek said, one he's still processing two years later. "It really took a while to set in," he said. "The reality still sets in stages; there are so many unknowns."
"All these beautiful things that I love, and I used to define myself as — a father, a provider, a husband — all that got taken away, or at least paused."
Stage 3 cancer, in which cancer cells have spread to the lymph nodes but no other organs, typically requires chemotherapy and surgery to treat.
Balancing fatherhood and work with treatment
Van Der Beek said his "lowest point" in treatment was feeling like he was losing core parts of his identity.
"All these beautiful things that I love, and I used to define myself as — a father, a provider, a husband — all that got taken away, or at least paused," he said. "I had to sit there and say, 'Well, what am I?' And it was, 'I'm still worthy of love.'"
Van Der Beek said in addition to dealing with the treatment itself, he also had to take on "the full-time job of medical portals and appointments and medication, supplements, tests — trying to organize all that."
The actor said asking for help was hard for him, even though he really needed it.
"I don't know how anyone does this alone," he said. "It's been amazing to really see my friends come through in ways that I just never allowed them to before."
A month after he publicly announced his colon cancer diagnosis in 2024, Van Der Beek appeared in "The Real Full Monty," a televised special in which he and five other male celebrities stripped to raise cancer awareness. He said filming the special was the first time he shared the news with anyone outside his inner circle.
"It was so life-affirming to see the immediate support and the empathy and just the energy that I got back from it," he said. "I think anytime you push past what's uncomfortable and you get to the other side of fear, there's always some kind of reward."
While he used to have a "very tricky relationship" with fame, he looks at it very differently now.
"It's been a real blessing, actually, because now I get people telling me they're praying for me all over the place, and I really feel like it helps and I need it, and I am grateful for it," he said. "It connects me to so many people I otherwise would never get to connect with."
He wants younger people to get screened
Colon cancer cases are rising worldwide, particularly among people around or below the recommended screening age, which the US has dropped to meet the growing rate among younger patients.
In addition to wanting to raise general awareness about when to get screened or what symptoms to look for, Van Der Beek is passionate about alternative screening options.
While colonoscopies are considered the gold standard in testing because doctors can remove precancerous polyps, they can be expensive, time-consuming, and uncomfortable, involving laxatives and anesthesia.
"I did not find a colonoscopy to be all that pleasant," Van Der Beek said. "For people who are in a job where they can't take that kind of time off of work, it can be a challenge."
Increasingly, there are less invasive at-home tests that can provide answers. For example, Cologuard and FIT are widely used at-home tests that detect the presence of cancer in stool samples.
The Shield test is a blood test performed on people of average risk who are 45 and older. If the result is positive, a colonoscopy is the next step. Shield's research found that when their blood draw was offered to patients, colon cancer screening rates more than doubled.
The tests can miss cancer or present false positives. While those chances decrease the more advanced the cancer is, the margin of error is the reason doctors recommend colonoscopies as a first line of defense.
"I would still choose a colonoscopy for myself," Dr. Tim Cannon, a medical oncologist who directs the gastrointestinal cancer program at the Inova Schar Cancer Institute, told BI in a previous story about the new industry of less invasive tests like Shield.
Caught in its earlier stages, colon cancer is very treatable. It's why Van Der Beek hopes more people get screened, however they choose to do it.
He still remembers one of his first reactions when he got diagnosed. He wondered about the best thing that could come of his situation.
"What's the thing that I'm going to look back on this in 20 years and say, 'Thank God that happened?" he said. "So what can I do to make that the case?"
So far, raising awareness has given him a lot of purpose throughout his ongoing treatment. "I've learned a lot," he said. "If I can save anyone from having to go through this, that's magic."
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