The actor learned he had stage 3 colorectal cancer at 46. Now he’s managing the diagnosis by leaning on the love of his family and making positive changes

James Van Der Beek revealed on Nov. 3 that he’d been diagnosed with stage 3 colorectal cancer at age 46. Now, the actor is opening up about his health journey in the hope of raising awareness about a disease that’s becoming more common in otherwise healthy adults under 55.

“That’s one of the reasons I want to talk about it and the reason I’m talking about it so openly,” Van Der Beek, 47, tells PEOPLE in this week’s cover story.

“I’ve been dealing with this pretty much in secret for a while, and in the past, I’ve found it helpful and cathartic to share things publicly,” says the actor, who lives on a ranch in Texas with his wife Kimberly, 42, and their six kids, Olivia, 14, Joshua, 12, Annabel,10, Emilia, 8, Gwen, 6, and Jeremiah, 3.

“And I’ve found a lot of support that way. But more than that, I really wanted to raise awareness.”

According to the American Cancer Society, 1 in 5 new colorectal cancer diagnoses are among people under the age of 55, up from 1 in 10 in 1995.

Van Der Beek says that he had no reason to suspect that he would face such a scary diagnosis at this stage in his life. He had no family history of cancer and he took care of his body through exercise and nutrition.

“I’d always associated cancer with age and with unhealthy, sedentary lifestyles. But I was in amazing cardiovascular shape. I tried to eat healthy — or as far as I knew it at the time.”

But in the summer of 2023, he noticed changes in his bowel movements. He assumed his diet was to blame.

“I thought maybe I needed to stop coffee,” he says. “Or maybe not put cream in the coffee. But when I cut that out and it didn’t improve, I thought, ‘All right, I better get this checked out.’”

Following his colonoscopy, he wasn’t worried. “I felt really good coming out of anesthesia, that I’d finally done it,” he says. “Then the gastroenterologist said — in his most pleasant bedside manner — that it was cancer. I think I went into shock.”

Van Der Beek dove into treatments, which typically include surgery and chemotherapy. And while he doesn’t want to share specific details about his medical regimen yet, he says, “If you’ve heard about it, I’ve probably touched on it.”

“This has been a crash course in the mastery of mind, body, and spirit,” he explains. “I thought, ‘This is either going to take me out of the body, or it’s going to teach me how to truly live in it.’”

While he tries to stay positive, he admits it can be hard sometimes.

“The trickiest thing is there are so many unknowns with cancer,” he says. “You think, ‘How do I fix this? Is this healing me? Is this hurting me? Is this working? Is it coming back?’ As someone who likes answers, not knowing is one of the hardest things.”

As for his current health, he doesn’t want to talk about stages of recovery or remission. But he says he’s feeling good.

“I’m very cautiously optimistic. I’m in a place of healing, my energy levels are great. When I’ve been out of the woods completely for what feels like a responsible amount of time, I’ll circle back and let you know.”

He adds, “I have a lot to live for.”