Colon Cancer in Adolescence: A Woman’s Story

By Dennis Thompson HealthDay reporter

(health day)

WEDNESDAY, March 15, 2023 (HealthDay News) — Tatiana Gonzalez had just quit her job as a mail carrier, and with it the 12 miles a day she walked delivering people’s mail.

So Gonzalez, then 39, figured that was why she suddenly became so constipated that she needed laxatives to go to the bathroom.

“I thought maybe it has something to do with the fact that I don’t exercise anymore,” she said. “But in a few months I’ll see blood in my stool.”

It turns out that Gonzalez, who is now 42 and lives in Clifton, NJ, did in fact have stage 3 colon cancer — which she found out via a colonoscopy.

“It was devastating,” she recalled of her diagnosis. “Waking up in a doctor’s office and he just walks up to you and suddenly tells you you have colon cancer. I could not believe it. And I said to him, ‘I’m sorry, can you repeat that?’ He said, “You have colon cancer.” It was devastating because I never thought this would happen to me.”

Colorectal cancer is considered a disease of old age, and it’s true that a person’s risk increases as they age, said Dr. Andrew Jennis, Gonzalez Cancer Specialist of Hackensack Meridian Health in Hackensack, NJ

But the number of young adults diagnosed with colon cancer has nearly doubled since 1995, said Dr. Steven Lee-Kong, chief of colorectal surgery at Hackensack University Medical Center.

Today, 1 in 5 cases of colon cancer occurs in someone age 45 or younger, Lee-Kong said.

“A 38-year-old who is bleeding could often blame hemorrhoids and not even do the proper tests to look for colon or rectal cancer,” Jennis said. “I think there’s increasing awareness, but there’s still a kind of prejudice that younger people shouldn’t get colon cancer. And sometimes it leads to some delay in diagnosis when patients put off telling their doctor, just assuming I’m young and there must be some other harmless reason.”

After her diagnosis, Gonzalez immediately began four months of chemotherapy, followed by six weeks of combined chemo/radiation therapy that ran from May through October 2019, Jennis said.

She then had surgery in January 2020 to remove the remaining cancer, Jennis said.

Gonzalez had to wear an ileostomy bag for a short time after her surgery while she recovered, she said. But that has reversed, and she has been cancer-free since her surgery.

However, that doesn’t mean everything has returned to normal.

“I thought I would be the same person as before, able to eat anything, but no. For some reason I am lactose intolerant. I can’t have cake. I can’t have cheese. I can’t have beans. I can not eat broccoli, rice. There are a lot of things I can’t eat,” Gonzalez said. “My stomach is very different now than it was before.”

Researchers can’t say for sure why the number of young people with colon cancer has increased, Jennis and Lee-Kong said.

“They represent an increasing number of patients with colon cancer for reasons that remain a little unclear,” Jennis said. “We don’t know why this age shift is happening, but it is happening.”

Some risk factors for colon cancer include obesity, lack of exercise, excessive alcohol consumption, smoking and a diet high in red meat, smoked meat and saturated fats, he said.

There could also be changes in gut bacteria or genetics that contribute to increased rates in young people, Lee-Kong said.

Gonzalez said her great-aunt had both colon and breast cancer.

“Maybe it has something to do with that,” she said. “To be honest, I don’t know.”

Although she’s been cancer-free for a few years, Gonzalez said she’ll need to be monitored for another seven or eight years before she can be declared in remission.

“I have to be very careful because the cancer can come back at any time,” she said. “It affects me every day. I mean, I have three kids and it’s hard.”

The American Cancer Society and the US Preventive Services Task Force recommend people begin regular colon cancer screening at age 45.

But young adults who have changes in their bowel habits or find blood in their stools should see a doctor, Jennis said.

“Although most of the time stool bleeding isn’t due to cancer, don’t assume you know the explanation,” he said. “They should do the appropriate testing for that specific circumstance to make sure the reason for the bleeding or change in bowel habits is identified, and not just assume it’s not something serious.”

Gonzalez also cautions young adults against ignoring bathroom issues.

“Listen to your body. Your body gives you signals,” Gonzalez said. “Don’t wait until the end. Go to the doctor, talk to your GI [specialist]. Ask her to do a colonoscopy. I know some people think a colonoscopy is difficult, but it saves your life if you find out sooner that something is wrong with you.”

SOURCES: Tatiana Gonzalez, Clifton, NJ; Andrew Jennis, MD, oncologist/hematologist, Hackensack Meridian Health, Hackensack, NJ; Steven Lee-Kong, MD, Chief, Colon Surgery, Hackensack University Medical Center, Hackensack, NJ

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