OUR HEALTH: Colon Cancer

Too Young For Colon Cancer

“Stunned. Shocked. Numb.” That’s how Greg Myers describes his reaction when he learned what was causing his pain. “I guess the best way to describe it is numb – it was hard to process it all at one time. I went from being a normal kid at the gym to this.”

When we caught up with Greg Myers recently, he had already walked the 2.5-mile round trip up and down the side of the highway three times that day and was embarking on a fourth trip as part of his job with a construction management firm. He didn’t think it was anything that remarkable for a 23-year-old to walk 10 miles or more in a day, and for most people in their 20’s it might not be, until you consider that four years ago, Greg didn’t know if he would even live to see this day.

“I was at my work truck and suddenly had this pain in my stomach that was really, really bad,” he explains when asked how he first knew something was wrong. “I went to the bathroom and there was nothing but blood.”

Greg’s initial thought was that maybe the pain and blood had something to do with a hernia because he does a lot of weight lifting. The real cause of his pain, however, would turn out to be a much, much worse diagnosis, one that even he could not have imagined. At just 20 years old and in his last semester at Virginia Western Community College with his whole life seemingly ahead of him, Greg was diagnosed with rectal cancer.

Who’s at Risk? Everyone

It is young, but not unheard of to be diagnosed with colorectal cancer at that age, Dr. Keith Munson agrees. He’s a colon and rectal surgeon at Jefferson Surgical Clinic in Roanoke and treated Greg. “There are maybe two or three people out of 100,000 diagnosed annually with colorectal cancer in that age group, so it is low. Interestingly enough, when you run into people like that, it’s usually about a year before their symptoms are taken seriously. Their problems are blamed on hemorrhoids or a fissure because the incidence of colorectal cancer in that age group is so low.”

Part of the challenge in diagnosing colon cancer is that for the majority of sufferers, there are no symptoms until it’s late in the disease’s progression. “People should be concerned about changes in bowel habits, such as blood in their stool, diarrhea, constipation, unexplained weight loss – those are all warning signs,” Dr. Munson explains. “The majority of people that have colon cancer don’t have those signs until the cancer is advanced.”

Colon cancer, which doesn’t stand out among a particular race or sex, is the third most common cancer for both men and women with the incidence between the sexes being about equal. In approximately 85 percent of the cases, its causes aren’t known, while in the remaining 10 to 15 percent of cases genetics are thought to play a role. “There is not a strong correlation between smoking, alcohol consumption, diet and colon cancer rates,” Dr. Munson explains, “but a high fat, low-roughage diet may play into it. By and large the best advice is to eat a high-fiber diet and avoid animal fat. In America, that’s hard to do.”

Colorectal cancer is unique among cancers in that proper screening can actually help prevent cancer from forming in the first place, unlike breast and prostate screening that don’t reduce the incidence of cancer but rather alert patients to its presence. A colonoscopy will indicate the presence or absence of polyps. There are a variety of polyp types, with the majority having the potential to become cancerous to varying degrees.

“Not everyone has polyps, but if you do find them you will tend to grow more of them and it’s advised to have them removed,” Dr. Munson explains. “You can’t tell if the polyps are cancerous without removing them and examining them under a microscope. “

Removing the polyps reduces the incidence of cancer by 80 percent, Dr. Munson says, because polyps usually begin as pre-cancerous but as they sit for a few years they turn cancerous and are responsible for the majority of new cases of colorectal cancer.

Preventive Steps – Colonoscopy, Family History, Diet

Age 50 is the blanket recommendation for most people to have their first colonoscopy, Dr. Munson explains. That recommendation changes though if there is a “first-degree relative” who’s been diagnosed with colon cancer. A first-degree relative is defined as sharing about 50 percent of their genes with a family member, such as siblings, offspring and parents. It’s recommended that people with first degree relatives diagnosed with colon cancer should have their first colonoscopy at age 40. Dr. Munson goes a step further and says that someone with a first-degree relative who’s had colon cancer should consider getting their first colonoscopy 10 years before the age that the relative was first diagnosed. For example, if your parent was diagnosed with colon cancer at age 40, then you should have your first colonoscopy at age 30.

“Ten percent of cancers take place in people under age 50,” he explains, and recommends a more aggressive schedule when it comes to colonoscopies. The standard thinking is that with no family history present, a colonoscopy should be performed every 10 years beginning at age 50, and if there is a family history, that number drops to every five years. Dr. Munson recommends every five years regardless of family history. “You wouldn’t wait a decade for your second breast or prostate screening so why would you wait this long between colonoscopies,” he asks.

Greg Myers had a family history of colon cancer – he just didn’t know about it until he started asking questions. “Three or four of my cousins had stage one colon cancer and several others had pre-cancerous polyps, and some of them were under 40 years old,” Myers explains. “I ended up having genetic testing done and learned that I was predisposed to contracting cancer.”

Dr. Munson’s recommendation to increase the amount of fiber in your diet isn’t just to help prevent colorectal cancer but to improve the colon’s well-being overall. “The more fiber and bulk you consume, the more frequent your bowel movements,” he explains. “This moves things through the colon faster, giving potential toxins less of a dwell time in the colon and less exposure to the colon, while at the same time, the fiber acts to absorb potential toxins.” The end result is less constipation, fewer hemorrhoids and anal fissures, and a healthier colon.


Looking Ahead

After undergoing more than a year of treatment, including around the clock chemotherapy, radiation and surgeries, Greg Myers is finally back to where he wants to be, four years later. “I’m in as pretty good a shape as I can be,” he says. He’s also nearing an important milestone in his fight against cancer. Dr. Munson says that Greg is now four years out from his cancer’s disappearance, which is an important time frame because if a patient is cancer free at five years, they’re essentially considered cured of the disease.

“I feel great,” Myers says. “I go to the gym five days a week. I run. I feel like I made a full recovery.”

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