Inti St Clair Getty Images  Kimmie Ng, MD, an Boston-based oncologist, noticed an alarming trend in her work a few years ago: Men in their twenties, thirties, and forties-runners, CrossFitter, and lifelong non-smokers-rushed through their door at the Dana-Farber Cancer Institute, all of them vibrant and strong-and yet they fought colon cancer, a family of diseases in the colon or rectum and typically associated with older people and with risk factors such as family history and obesity.
Most worrying was that many of them suffered from advanced metastatic disease, one patient, 46-year-old Dan Luers, an Ironman. Finisher, who trained for nearly two hours a day, received a stage IV diagnosis, and Dr. Ng's anxiety grew every year until 2017, when a healthy-looking Mar Inesoldat showed up in her office, but the problem was not completely solved. The only 29-year-old "he was the youngest person I've ever treated for this type of cancer, who did not have a family history and model of perfect health – extremely fit and active and a healthy eater." But he had done Stage IV colorectal cancer. For people whose cancers have spread to distant parts of the body, the five-year survival rate is about 14 percent.
Luers and so many other young patients from Dr. Ng have asked an urgent question: "How could I have prevented that? "She and dozens of researchers across the country are madly trying to find the answer. As I watched so many young men being beaten suddenly, Dr. Ng: "I was determined to do something about it."
Why colon cancer is so alarming at an early stage
Colon cancer is the third most common cancer in men (right behind the prostate and lungs). And while they are declining for older men, rates are rising among younger Americans. What doctors have picked up on in their daily work is only now fully captured in medical research and news. In 2017, a large NIH-funded study on invasive colorectal cancer revealed that people born around 1990 have twice the risk of developing colon cancer and four times the risk of developing rectal cancer compared to people who have Born about 1950, the Cancer Society lowers the recommended screening age for people with an average risk of colorectal cancer from 50 to 45 years. If the trend continues, the rate of colorectal cancer will increase by 90 percent by 2030 and that of rectal cancer by an astonishing 124 percent in people aged 20-34, according to a study by JAMA Surgery .
It gets even worse: new research suggests that colorectal cancers in the early stages have distinctly different characteristics to those to which physicians are accustomed.
These cancers usually start elsewhere and mutate differently. "This gives us the clue that even with the first steps of this
carcinogenesis, something can be different about them," says Scott Kopetz, MD,
. Ph.D., an oncologist at the MD Anderson Cancer Center. It's "fair to say," he adds, that some of them could be a new version of the disease. For those who keep track, this means that there may be new reasons for the development of these cancers. new reasons why young men are vulnerable; and a new need for alternative therapies.
Together with Dr. Kopetz is trying to find out what drives these changes for research teams from the Memorial Sloan Kettering Cancer Center and the new Young Onset Colorectal Cancer Center in Dana-Farber. One of the most intriguing traces is the microbiome, the diverse, teeming community of microorganisms that live in us. Among the few things that we know are constantly evolving. Some changes may "lead to a benefit or insult to the surrounding cells," notes Dana-Farber's doctor and scientist, Marios Giannakis, M.D., Ph.D. This means that the microbiome can affect the cells it touches and possibly contribute to the development of diseases.
Researchers are investigating everything that could alter the microbiome and affect these cancers. Right now, they know that what you eat and what medications you take is at least part of it. Killing bacteria with antibiotics can disrupt the balance of the microbiome. May eat too much added sugar. (Going for a maximum of 36 grams per day for overall health.) "With everything that modulates the microbiome," Dr. Giannakis, "the question is whether it's good or bad." We just do not know it yet. "A new $ 25 million five-year study, conducted by Dana Farber researchers, aims to find some answers.
Until the research comes in, doctors say the things you generally do are healthy probably help – maintain a healthy weight, eat a diet full of good-friendly, fiber-rich vegetables and whole grains, avoid tobacco and processed meat, limit sugar, stay active, but here's the essentials that men often do not : Watch for symptoms, especially persistent changes in bowel habits, and have them examined immediately.
Which Colorectal Cancer Symptoms Should Be Considered?
The vast majority of early onset colorectal cancers begin in the rectum, the lowest part of the bowel cancer Colon, which can be associated with symptoms such as rectal bleeding and constipation, says Robin Me Nelson, MD, gastroenterologist and researcher at the MSK Center for Young Onset Colorectal Cancer. If you see blood in your chair or on the toilet paper; if you notice the stool is narrowing or the consistency is changing; or if you have nausea, abdominal pain or bloating – a new or strange symptom that lasts for more than a few weeks, do not write it off. If you receive a pushback on the subject of testing from your doctor due to a recent Colorectal Cancer Alliance (CCA) survey and up to 17 percent of colorectal cancer patients are misdiagnosed, you should perform this pushback. "If we recognize these cancers early, we can treat them more effectively," says Dr. Mendelsohn.
The CCA survey found that 71 percent of patients with early-stage colon cancer receive a diagnosis of stage III or IV. According to the latest available federal data, only about 19 percent of early-stage patients with stage IV cancer survive five years. But some therapies seem to work. Surgery, chemotherapy and radiation have eliminated Luer's disease and a clean health certificate was issued to him earlier this year. Greg Mancini, 42, another patient of Dr. med. Ng, at age 38, experienced his colon cancer. The father of two children from Scarborough, Maine, was in terrible shape, and cancer spread to his spine when he started inhibitors in 2015 with immunotherapy at two checkpoints. Within weeks, Mancini says the cancer has been withdrawn. "I had bulging tumors on my neck that melted like ice cubes. It was amazing. "But until this is the standard response to treatment at this stage, or until these cancers begin, Dr. Giving her and her colleagues some of their secrets by paying attention to and talking about your body could help change that trend.