Colon Cancer Is Increasingly Common Among Younger People

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At first, it seemed like a stomach virus. But the pain kept getting worse. Then, on what was supposed to be a business trip to Miami, Jenny Arnold instead ended up in a hospital, where a physician thought she might have diverticulitis. A blood test for tumor markers didn’t set off any alarms, so cancer didn't seem likely — until Arnold underwent a colonoscopy a few months later.

“It became clear that this was probably something more serious than diverticulitis,” says Arnold, a Lawrenceville resident. “I got the diagnosis right after the colonoscopy that it looked like it was cancer.”

Surgery revealed that Arnold had stage III-B colon cancer, with the disease having spread to her lymph nodes. It was a stunning diagnosis for an otherwise healthy 47-year-old who found herself part of a concerning trend: people developing colorectal cancer at younger ages.

Although Arnold rebounded quickly after her surgery and ensuing chemotherapy, within six months the cancer had come back — and it had spread to her liver and lungs.

“It’s baffling,” says Arnold, who works in content acquisition for an entertainment company. “I don’t have a history. We did the genetic testing, and I don’t have the specific markers that would make me more at risk. I wasn't a smoker. I wasn't chronically overweight. So when my surgeon warned me, ‘This looks very suspicious,’ I was shocked. And when I came out of surgery, it shook my world. I just was not expecting that, especially at my age and being a relatively healthy person.”

Winship Cancer Institute of Emory University Offers A Comprehensive, Coordinate Approach To Care

According to the American Cancer Society, Colorectal cancer is the third-most common form of cancer among both American men and women, with an estimated 148,000 new diagnoses expected in 2020. In the last year, there have been 53,000 deaths in the U.S. related to colon cancer. In Georgia, 4,500 new cases will be diagnosed this year. The good news is that colonoscopies and other screening techniques allow doctors to catch the disease very early — sometimes even in the form of polyps that have yet to become cancerous.

There are some clear risk factors, according to Dr. Christina Wu, a medical oncologist with Winship Cancer Institute of Emory University. “Almost 30 percent of our patients who have colorectal cancer have some sort of family history,” she says. African Americans carry a higher risk, as do people with a history of inflammatory bowel disease, and those who are overweight, smoke, drink heavily or eat lots of processed or red meat.

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Symptoms can run the gamut, Dr. Wu says. “It can just initially be a change in bowel movement, where if you were someone who was very regular, and suddenly you can have constipation where it's difficult to have a bowel movement, where you're straining. Or it can even go the other way, where you suddenly have very loose stools, watery stools, and frequent. So, it's not always clear as to what kind of symptoms you have.”

Winship at Emory combats colorectal cancer with a comprehensive, coordinated approach that incorporates all available therapies — providing patients with the latest and most effective practices for care. Emory’s researchers and specialists develop groundbreaking strategies that produce better outcomes, strategies that are often later adopted by other leading cancer centers. Options vary from surgery, chemotherapy and radiation to more-targeted therapies involving specific proteins and immunotherapy.

“Every time I go in, we are trying something new,” says Arnold, a married mother of four. “Maybe it doesn't work the way we want it to work, but there's another option right there. So I feel like we're still full of options. I don't feel like we've come to the end of a road or anything. There are still options available to me to help manage this.”

Winship At Emory Offers Patients Options And "A Lot Of Support"

Cases such as Arnold’s, where colorectal cancer appears prior to age 50, are of special concern to physicians. “We are seeing that younger patients are being diagnosed with colorectal cancer,” Wu says, “and we're really still trying to figure that out.”

High-fat diets, smoking and heavy alcohol use are all potential culprits. Wu says researchers are also exploring the possibility of changes in microbiomes — the naturally occurring bacteria in your gut — and whether something there triggers colon cancer. Whatever the cause, the trend has been enough for the American Cancer Society to lower its recommended age for beginning colon cancer screenings from 50 to 45.

“It's scary, because there are even younger people in their 20s and 30s who are getting it,” Arnold says. “And for those who are younger, we're probably all in the midst of a certain point in our careers and having children. You're really in the middle of your life, and then you get this bomb that goes off.”

Arnold tries to stay positive and keep her mind occupied through art therapy and knitting. She remains on a chemotherapy regimen as she manages the disease. “I have a lot of support through my team at Winship,” she says. “But also, I'm realistic in that I'm stage IV now, and we're just managing this. There's not a lot of talk of going into full remission or anything like that. It's really just, 'OK, how do we get this stable enough so I can have a quality of life?'”

Considering the current trends, Arnold wouldn’t mind seeing the recommended screening age for colorectal cancer dropped even lower. “You have a lot of time to catch it before it gets to where I was when we caught it,” she adds. “There are so many chances to catch these little things when they're tiny. So it really behooves us to start them at a younger age, especially for anybody that’s had problems with their bowel movements or anything suspicious going on with their stomach.”

As with all treatments, individual patient results vary. It is important to discuss your cancer treatment options with your physician.

Learn More About Emory Winship Cancer Institute's Personalized Colorectal Treatment Programs