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Nobody in their 20s, 30s or 40s gets colorectal cancer, right? Wrong. The truth is more young adults are being diagnosed with this type of cancer and more are dying from it.
“Colorectal cancer is considered the silent killer because most of the symptoms are so vague people don’t often realize they have a problem until the disease has reached a critical stage,” said Dr. Lorenc Malellari, Colorectal Surgeon at Mercy and Memorial Hospitals.
According to The American Cancer Society, there has been a 51% increase in colorectal cancer among those under age 50 since 1994. New cases of colorectal cancer in adults under 55 have increased almost 2% every year since the mid-1990s. Colorectal cancer is the second leading cause of cancer-related deaths in the U.S., largely because it typically doesn’t show symptoms until the later stages.
“More people get diagnosed with colorectal cancer than breast cancer or prostate cancer. Most people don’t realize how common it is,” said Dr. Malellari.
So, what is causing the increase? Some experts attribute it to environmental risk factors while others blame diet-related changes in recent decades. Younger people seem to be eating less fiber and eating more processed foods than previous generations. A sedentary lifestyle, high blood sugar, vitamin D deficiency, and eating a lot of red meat have all been associated with the disease.
Experts say prevention is key. The American Cancer Society released updated screening guidelines in 2018. The new guidelines state that adults at average risk should first be tested at age 45- that’s five years younger than the previous recommendations.
“By dropping the screening guidelines to 45, the goal is to catch the disease in younger patients where it may have otherwise gone undiagnosed,” said Dr. Malellari. “This disease is highly curable if we can catch it in the early stages.”
Doctors say the most common symptoms of colorectal cancer are blood in the stool, abdominal cramping, fatigue and weight loss. Young patients may also see changes in the shape of their stool, how often they go to the bathroom, and how difficult it is to have bowel movements.
Colonoscopies are the preferred way to screen for colorectal cancer. A colonoscopy is performed with the patient under conscious sedation. A doctor inserts a flexible tube with a light and camera on the end through the rectum to examine the colon. The tube also allows the doctor to remove any polyps (small bumps on the surface of the colon or rectum) that may be precancerous.
“The colonoscopy is the gold standard for detecting colorectal cancer,” said Dr. Malellari. “It’s not only a diagnostic tool but also a therapeutic tool.”
Short of a colonoscopy, doctors recommend physical rectal exams for anyone who reports a suspicious change in bowel movements. These exams can often discover a suspicious mass in the rectum. Other forms of early detection include a sigmoidoscopy (partial colonoscopy), a stool test that detects blood in fecal matter or a stool DNA test.
The good news is that surgery for both colon and rectal cancers can be highly successful. While the treatment depends on the extent of the cancer, most patients will need surgery to remove the affected part of the colon. Some may need additional chemotherapy and some patients with rectal cancer may need radiation therapy, too.
“Treatment depends on the location and progression of the cancer,” said Dr. Malellari. “We offer many different options including less invasive laparoscopic and robotic surgeries, which mean quicker recovery time for patients.”
Doctor Malellari’s best advice: don’t wait.
“Whenever you have a persistent issue, be it weight loss or problems with your bowel movements, speak to your doctor sooner rather than later. Don’t ignore the symptoms. It doesn’t matter what age you are- it’s better to be safe than sorry.”