Fighting Stage 4 Colon Cancer, He Leaned on the Power of Hope

Knowing the extensive history of colon cancer in his family and everything he’s endured the past few years, you might have forgiven Joe Gebara if he had decided to just wave the white flag after being diagnosed with stage 4 colon cancer in 2021. But you don’t know Joe Gebara –or the power of hope.

Mr. Gebara describes himself as someone who is “easy-going and likes to tell jokes” and never has a bad day, even when undergoing rigorous treatment for what is usually an incurable cancer. His favorite quote – one he lives his life by every day, he says – is from French writer and philosopher Voltaire: “I have chosen to be happy because it is good for my health.”

(Watch now: Knowing his family history of cancer and all that he has endured the past few years, you might have forgiven Joe Gebara if he had decided to just wave the white flag after being diagnosed himself with stage 4 colon cancer. But you don’t know Joe Gebara – or the power of hope. Video by Carol Higgins at Homestretch Creative.)

What is Stage 4 Cancer?

Stage 4 cancer means the cancer has spread from its original site to other areas of the body. Not so very long ago, any patient with stage 4 colon cancer would have been considered incurable. The recommended treatment would have been palliative, meaning, “Let’s find a way to make your final days more comfortable.”

Today, however, advanced cancer-fighting technologies and therapies available at Baptist Health Miami Cancer Institute are providing stage 4 cancer patients with hope – not just for more time to spend with loved ones but in the case of Mr. Gebara and others like him, an actual cure.

One of the Deadliest Cancers

“Colorectal or colon cancer is one of the most common cancers diagnosed in the United States and worldwide. More than 150,000 new cases are diagnosed each year in the U.S. alone,” says Michael Chuong, M.D., medical director of Miami Cancer Institute’s Department of Radiation Oncology and an integral part of Mr. Gebara’s care team. “It’s also one of the deadliest,” he says.

Michael Chuong, M.D., medical director of Baptist Health Miami Cancer Institute’s Department of Radiation Oncology

According to the American Cancer Society (ACS), “Colon cancer is the third-leading cause of cancer-related deaths in men and the fourth leading cause in women, but it’s the second most common cause of cancer deaths when numbers for men and women are combined.” The ACS estimates that colon cancer will cause about 52,900 deaths in 2025.

Persistent Gastrointestinal Symptoms a Concern

For Mr. Gebara, 50, a Port-au-Prince native and father of two who lives in Cutler Bay with his wife Elba and their five dogs, his arduous cancer journey began in May 2021. He was experiencing gastrointestinal symptoms that just wouldn’t go away – stomach aches, rectal bleeding and bouts of diarrhea alternating with constipation.

However, as the longtime owner of a successful window treatment business, Mr. Gebara was a busy man and reluctant to focus on anything other than his family and his customers. But by August, he became concerned enough by the rectal bleeding that he had his son drive him to the emergency department at Baptist Health Baptist Hospital. Doctors there performed a number of tests, including a colonoscopy.

Mr. Gebara remembers waking up from his colonoscopy and the doctor giving him the bad news: he had colon cancer. A day later, further imaging revealed more bad news. Dr. Chuong’s colleague, Santiago Aparo, M.D., a medical oncologist at Miami Cancer Institute who specializes in treating gastrointestinal cancers, explained to Mr. Gebara that the tumor in his colon was large and had spread to his left lung. He had stage 4 metastatic colon cancer.

Santiago Aparo, M.D., a medical oncologist at Baptist Health Miami Cancer Institute who specializes in treating gastrointestinal cancers

Dr. Aparo offered a glimmer of hope, however, when he told his patient, “There are things we can try. Are you willing to try?” Mr. Gebara was all in. “That was all I needed to hear. I was ready to try anything,” he recalls. “Dr. Aparo offered me what I was about to lose, which was hope. For me, the alternative was, ‘How many weeks do I have and what hospice are we going to use?’”

A Family History of Colon Cancer

Remarkably, Mr. Gebara wasn’t surprised by his cancer diagnosis. “I’m the eighth person in my family to have had colon cancer,” he says. “My mother and my sister passed away from it. Both were diagnosed as stage 4, like me. My aunts and uncles had it, too.”

Given his family history, Mr. Gebara was realistic about the battle he faced. “I understood the ultimate outcome, and the odds were that I probably wouldn’t survive,” he admits, but says that maintaining a positive attitude helped keep him from panicking. Even so, he says he was still consumed by the same fears every patient has when faced with a life-threatening illness.

“When you’re fighting cancer, the toughest times aren’t the pain, the surgeries or even the financial stress. It’s having to manage your emotions and stay positive,” says Mr. Gebara. “For me, it was, ‘Will I get to watch Emilie graduate from high school and walk her down the aisle one day? How many more days do I have with Elba? Will Noah be able to run the business on his own?’ That was the toughest part.”

Aggressive Treatment for Colon Cancer

Dr. Chuong says the thinking on how patients with stage 4 cancers should be managed has evolved over the past two decades. “We now know that for some patients who have small tumors – oligometastatic cancers – that have spread to maybe one or a few areas outside of where the cancer started, can actually achieve long-term survival and even potentially be cured with the appropriate aggressive therapy.”

“Appropriate aggressive therapy” includes a combination of chemotherapy with local treatment such as radiation therapy, percutaneous ablation, and/or surgery, Dr. Chuong explains. “This is a different approach than what was once routine, where patients with stage 4 cancers – even those with only one or just a few metastases – were offered palliative chemotherapy only and not considered for potentially curative local treatment as well.”

To shrink the tumor in Mr. Gebara’s colon and control his rectal bleeding, he was treated with a sophisticated form of radiation therapy called intensity-modulated radiation therapy (IMRT). “IMRT allows us to be very precise with the radiation dose,” explains Dr. Chuong. “By delivering it directly to the tumor we can avoid exposing surrounding areas to large amounts of radiation, so we’re able to decrease the risk of side effects.” He adds that Mr. Gebara “sailed through his radiation treatment” without any major side effects.

Upon completing his radiation therapy, Mr. Gebara was fitted for a port and began his chemotherapy, which entailed coming to Miami Cancer Institute twice a week for several months and wearing a chemo pump that delivered his medication automatically while at home.

“The chemotherapy was brutal, but it worked,” admits Mr. Gebara. “I developed severe neuropathy both in my hands and feet. I struggled to walk. I lost my balance at all times. For a year and a half, I couldn’t work, but I was fortunate that my son was able to step up and keep the business going. He now runs our business.”

Shrinking the Tumor Prior to Surgery

Once he had finished his more than two dozen rounds of chemotherapy, Mr. Gebara’s tumor was small enough that he was then able to undergo a total colostomy, a procedure in which his entire large intestine was removed. “I had made it this far and I didn’t want to risk the cancer coming back. I now have a colostomy bag for the rest of my life and I absolutely love it,” he says, flashing his trademark “thumbs up” sign.

The final step in Mr. Gebara’s cancer journey came in July 2023, when John DeRosimo, M.D., a thoracic surgeon at Miami Cancer Institute, removed the part of his left lung where his cancer had spread. “That was the last bit of cancer in my body,” Mr. Gebara says. “I’ve now been cancer-free now for nearly two years.”

John DeRosimo, M.D., a thoracic surgeon at Baptist Health Miami Cancer Institute

The Importance of Hope and Positivity in Fighting Cancer

When he first got his diagnosis, Mr. Gebara says he understood what his likely outcome would be and accepted it. “But I wasn’t giving up,” he emphasizes. He adds that the hope offered by his care team at Miami Cancer Institute played an essential role in getting him through his cancer journey and in providing a successful outcome.

“Not losing hope meant that, psychologically, I could go on for another day,” he says. “Hope comes from everyone around you and I’m fortunate that everyone around me understood this. If you allow negative thoughts around you, they will permeate the level of hope you have.”

Dr. Chuong is extremely pleased with his patient’s success. “I’m excited Mr. Gebara had such an excellent outcome. Our team of specialists here were very enthusiastic about finding a way to get him to a cure,” he says. “Mr. Gebara is a man who is so full of life and has such a positive attitude, and that is so important when you’re fighting cancer. Hope can be an amazing thing and it definitely made a difference in his case.”

A Seamless Experience at Miami Cancer Institute

Mr. Gebara says that, beyond his doctors, every individual at Miami Cancer Institute helped him in his cancer journey. “Everyone I ever came into contact with in that building played a role in helping me get through this,” he says. “When I was battling cancer, my biggest fear was navigating the healthcare bureaucracy. But the people there made navigating treatments, scheduling appointments and dealing with insurance absolutely seamless.”

Today, Mr. Gebara says he is relieved his treatment worked but says it was the peace of mind he found at Miami Cancer Institute that allowed him to focus on his healing. “I knew I was at the right institute at the right time. Being cancer-free is proof,” he says, adding that “life is good” and he feels “so fortunate to be on the other side of it now.”

Mr. Gebara did indeed get to watch his daughter graduate – not just from high school but also from college just this past year – and he and Elba (“the chief of my village,” he says) recently celebrated their 25^th anniversary. And his son Noah, who was in college and working part-time for his father, not only stepped up to keep the business running during his father’s illness, he has since made it his full-time job. “He actually helped advance the operational side of the business in ways I never would have thought of,” Mr. Gebara says.

Stage 4 colon cancer survivor Joe Gebara with his son, Noah, who now works full-time at his window treatment business

Another favorite quote of Mr. Gebara’s – one from Muhammad Ali that is now painted on a wall at his home – reads, “Don’t count the days. Make the days count.” Says Mr. Gebara of his cancer journey: “You really learn to enjoy the little things. My goals aren’t five years out anymore. It’s literally, ‘What can I do today?’ with a cautious eye towards the future. I’m just focused on living each day and on being healthy.”

Get Your Colon Cancer Screening

The right screening, done on time, can catch colorectal cancer early, even before symptoms appear. Don't put it off any longer. Talk to your doctor today and find out which screening option is right for you. Visit BaptistHealth.net/ColorectalTest.