Five years ago, Laura Webb had her eyes on a finish line.
Any time the 32-year-old spent away from work involved one of three activities: swimming, biking or running. Success would come once all three added up to 140.6 miles and the finish line of an Ironman triathlon.
The Tampa insurance company owner had failed in her first Ironman attempt, but that's not uncommon in the extreme world of triathlon racing. Webb was training hard, with long runs and 60-mile bike rides every weekend.
Then a persistent stitch in her side distracted her laser-like focus.
"Walk it off Webb," she would say each time the pain got intense. But the aches she attributed to grueling training were far worse than anyone imagined. Webb eventually was diagnosed with metastatic colon cancer. Within weeks of her initial colonoscopy, she'd replaced her daily workouts with surgery and months of painful chemotherapy treatments.
Webb's Ironman dream evaporated.
"Now looking back, there were red flags," says Webb, now 37, of her illness. "But I had a race to do, I wasn't paying attention."
Like anyone diagnosed with cancer, Webb's world was turned upside down as soon as she heard the diagnosis. Priorities shifted from long-term goals to short-term survival. Discussions about financial planning or retirement were laughable.
"You don't plan when something like this happens," the insurance agent says.
Colon cancer, the third most-common cancer in the United States, is very treatable when caught in its early stages, when polyps are localized. However, Webb's young age, and the cancer's presence in her colon and liver, reduced the odds of surviving five years to about 20 percent, National Cancer Institute research says.
She knew those odds, but Webb attacked her surgery and nearly three years of follow-up treatments with the same determination she used to train for triathlons, says David Wright, her lead oncologist at Florida Cancer Specialists.
Chemotherapy isn't for sissies, but Webb's focus and her great physical shape at the time of her diagnosis were enormous assets.
"She is a force," says Wright, chief of oncology at Tampa General Hospital. "She's been like that since day one."
Webb says she set her focus the first six months on surgery and her initial chemotherapy. Then she adjusted her work around more chemotherapy infusions, spending alternating Fridays hooked up to a potent IV solution. Weekends that used to be filled with long runs and epic bike rides were spent in bed.
"She was upbeat and positive even though the treatment kicked her butt," Wright says.
Every cancer patient faces disease differently, says Sophie Dessureault, a Moffitt Cancer Center oncologist who did not treat Webb. It's important physicians take the patient's lead.
"It's like financial advice. Some people want to know the nitty gritty; others don't," she says. "They all have different fears and goals."
The Ironman goal still nagged, and time added confidence, Webb says. Nearly nine months after her initial diagnosis, she returned to the gym, but with nowhere near her old physique. Her muscles had atrophied, so her trainer suggested a little cardio and lifting with 3-pound weights.
The longtime runner and triathlete spent months training to walk a half marathon, a sliver of her Ironman goal.
"It felt good to just finish," she says. "But it didn't feel good physically."
Webb was still undergoing biweekly chemotherapy treatments when she registered for the 2009 Ironman Florida. Her swims, cycling and training runs would have to work around the treatments, just like her career. "I was more determined" than before the cancer diagnosis, she says.
Two years and three months after her diagnosis, Webb returned to an Ironman race. She was ready, and set realistic goals, still, every stage was emotional. It took 16 hours, 47 minutes and 46 seconds before her eyes locked on the finish line.
"I kept thinking about running down the chute," Webb says. "I wanted to hear my name called."
Wright, who has a framed picture of Webb crossing the finish line in his office, calls her Ironman race "a ridiculous feat."
"I don't think I could walk that far," he says, "much less be in treatment at the same time."
Webb's says she felt extraordinary completing the Ironman, but her perspective has changed. Finish lines are less important than anniversaries, these days. That's especially true as she nears a critical survival milestone – five years.
Cancer patients who survive five years after diagnosis are unlikely to experience a reoccurrence, says Dessureault, the Moffitt oncologist. The National Cancer Institute estimates 65 percent of all colon cancer patients will survive that length of time or better.
Long-time survivors help oncologists better understand cancer treatments, whether it's a vaccine, chemotherapy or medications. The risk of cancer returning, however, always remains a possibility, Dessureault says.
"Five-year survival is great no matter what the diagnosis was and the treatment was," she says. "But it's still no guarantee."
Webb says her five-year anniversary in August will be bittersweet. She knows she beat extreme odds to reach it. But she'll remember other colon cancer patients she met who didn't reach the same milestone.
Webb will continue to monitor her health, and undergo regular colonscopies. The race now is about helping others value their health. Her experience shows that hearing the word cancer doesn't mean the end of the road, Webb says.
"It gives hope to people with this diagnosis."
Colon cancer, by the numbers:
101,340: Diagnosed cases a year
49,380: Annual deaths
50 and older: Age when 90 percent of cases are diagnosed
65 percent: 5-year survival rate