What Young Patients Should Know About Colon Cancer
There are good reasons why the United States Preventive Services Task Force has recommended lowering the screening age for colon cancer from 50 to 45. According to the American Cancer Society, those under 50 now account for 12% of all colon cancer cases, a big (and concerning) jump in recent years. Here is what cancer experts—and a patient who’s been through treatment herself—think you should know.
Colon Cancer Doesn’t Have to Run in Your Family
Most younger people who get colon cancer do not have a hereditary predisposition, says Hao Xie, M.D., an oncologist in the department of gastrointestinal oncology at the Moffitt Cancer Center in Tampa, FL. “Actually most of the [younger] patients we see in our clinic don't really have a family history. And they don't really have a specific risk factor,” he says, like smoking or even obesity.
But Just in Case...
Know your family’s medical history. If numerous relatives have had colon or even other types of cancer, it could signal a genetic predisposition or Lynch syndrome, which is genetic condition that puts you at a greater risk of developing colorectal cancer (and other types) before you turn 50, says Dr. Xie. Knowing about the risk can make you more proactive if, say, you have changes in your bowel habits or other early symptoms of colon cancer.
Learn What Early Symptoms Look Like
Trish Lannon, an elementary-school assistant principal in Maryland who was diagnosed at 39 with stage 3 colon cancer, says she wishes she had been more alert to symptoms. “If I had paid better attention to what my body was trying to tell me, I would have realized that the black bowel movements were that color because there was blood in my stool,” she says. Dr. Xie says that “In general, younger patients should not have any new symptoms, like alternating constipation and diarrhea, or blood in the stool.”
Don’t Shrug off Weight Loss
Lannon was overjoyed when she dropped a dress size in a month, and then another three sizes in the next three months. “I was thrilled to be weighing less than I did in high school. What I did not know was that my rapid weight loss was a sign that there was something seriously wrong,” she says. So was her constant fatigue, which no amount of sleep could fix. Cancer cells change the way your body uses up energy. In fact, 40% of cancer patients cite unexplained weight loss as an early sign.
It’s Good to Be a “Difficult” Patient
“Don’t be afraid to question your doctors, challenge them, and even get a second opinion,” says Lannon, who was frequently told by doctors she was over-reacting. “Taking control of your health can have positive mental side effects because it’s empowering and healing to feel seen, listened to, and acknowledged,” says Allison Forti, Ph.D., who works with cancer patients and is the associate director of the Department of Counseling Online Programs at Wake Forest University in Winston-Salem, NC. “So if you don't connect with your oncologist, find one that you do work well with.”
Acknowledge Regrets so You Can Move on
“No matter what age you are or your diagnosis, there's always something to look back on and wish that you did differently. And that is completely normal,” says Marlee Kiel, LMSW, an oncology social worker with CancerCare, a nonprofit that provides free services to patients and their families. If that’s you, you may want to find a counselor or therapist who’ll help you process anger and frustration so you can focus on what you can control—not the past, she says.
Speaking of What You Can Control...
It can be as basic as deciding that you’re going to make time to exercise, says Kiel. Or it could be planning for the future by completing advanced directives and other legal paperwork, says Forti. “One of the biggest worries that younger cancer survivors with children have is the ‘What happens to my kids if I die or find myself unable to take care of them?’ Having their paperwork in place can actually be a comfort rather than something scary.”
Consider a Support Group
Having cancer is isolating. “Even the people who love you the most may want to understand but they can’t,” says Forti. Talking with people who share your experiences can make you feel less alone. There are online groups specifically for younger folks, like Colon Talk, where you can ask questions and find help, says Lannon. CancerCare also has a young adult patient support group specifically for people between 20 and 39, says Kiel. If you don’t find a group helpful, don’t write off the idea completely, she suggests. Wait a bit and try again.
Put Someone Else in Charge of Updates
Your loved ones are rooting for you, but keeping friends and family informed about your treatment can be draining and overwhelming sometimes, says Forti. To conserve your physical and emotional energy, “Assign that role to somebody else, whether it’s on social media or CaringBridge,” she suggests. To avoid energy vampires, surround yourself with people who lift you up. How to tell? Ask yourself if you feel better and energized after being with that person or do you feel depleted and anxious? If it’s the latter, avoid them.
Be Kind to Yourself
There’s a lot to worry about when you have cancer: Will anyone want to date you again or will you be a burden to your spouse or a bad parent or work colleague? When your anxiety begins to spiral, practice self-compassion, Forti suggests. Write yourself a letter or repeat a mantra that can fight these thoughts. Some examples: “It’s okay for me to make mistakes” or “I’m still a good person if I make mistakes” or “It’s okay for me to have needs.” Or write down the kindhearted things you’d tell yourself before you started your cancer journey.
Rise in Colon Cancer in People Under 50: CA: A Cancer Journal for Clinicians (2020). “Colorectal cancer statistics, 2020.” acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21601
“Colorectal Cancer Facts and Figures,” PDF, cancer.org/research/cancer-facts-statistics/colorectal-cancer-facts-figures.html
Reasons for Weight Loss in Cancer: Cancer.net/American Society of Clinical Oncology (2020). “Weight Loss.” cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/weight-loss