When oncologist Dr Raed Al-Rajabi first visited cancer patients fourteen years ago, he expected much of what he would see would be ‘terrible’.
But he didn’t expect the work to grow into what it is today: treating dying twenty-year-olds.
Since Dr. Al-Rajabi became a cancer specialist, the percentage of patients under 55 with colorectal cancer has increased almost doubled. One of his patients was only 14 years old.
About 70 percent of these young people are so sick – because they have gone undiagnosed for far too long – that doctors can now do little to help.
Dr. Al-Rajabi is an associate professor of medical oncology at the University of Kansas Medical Center and leads the field of colorectal cancer treatment. The cases he treats at the hospital are, he told DailyMail.com, “heartbreaking.”
The chart above shows the increase in colorectal cancer in young Americans from 1999 through 2020. The numbers dropped briefly during Covid, likely due to missed screenings and diagnoses, but have risen since then.
Evan White is pictured above with his fiancée Katie Briggs and their dog Lola. Evan is just one of millions of people diagnosed with colon cancer at a young age. Evan was not a patient of Dr. Al-Rajabi
More than 150,000 Americans are diagnosed with colorectal cancer every year – and estimates suggest that about 50,000 of them will die from the disease. Colorectal Cancer Alliance.
People are on average 66 years old when they are diagnosed, but the age has become lower.
About 20 percent of people diagnosed with colorectal cancer in 2019 were under the age of 55. That’s almost double the percentage from 1995, when 11 percent of colorectal cancer patients were younger than 55, according to American Cancer Society (ACS).
If you detect colon cancer early, before it spreads to other parts of the body, your chances of survival are high. About 90 percent of people were diagnosed early within the next five years.
In the late stages, when the disease has spread, the chances of survival are slim: Only about 13 to 18 percent of people with advanced colon or rectal cancer live five years after they are diagnosed.
But it can be difficult to spot it early because many of the symptoms of the disease are similar to those you would get with common digestive complaints like irritable bowel syndrome, which affects about one in twenty Americans.
These include abdominal pain, changes in bowel habits, unexpected weight loss, fatigue, changes in appetite, constipation, bloating and blood in the stool.
The above graph shows the change in cancer rates around the world
The above graph shows the change in cancer death rates around the world
Unfortunately, Dr. Al-Rajabi told this website, late detection is the case for the majority of young people he sees.
But he said his clinic isn’t the only place to see this change; colleagues across the country and around the world are increasingly diagnosing a younger target group.
One patient, 21-year-old Dominique McShain from New Zealand, was studying to become a psychologist while working a part-time job in human resources when she was diagnosed with stage four colon cancer earlier this year, she said in a TikTok.
New Zealand has the second highest rate of cancer among people under the age of 50.
The doctors told her that the cancer was probably incurable because it had taken over her liver. They predicted she had one to five years to live.
About two weeks after her diagnosis, she started chemotherapy, lost her hair and dropped out of college.
Evan White, 24, from Dallas, Texas, had just graduated from the University of Arkansas with a degree in finance when he was diagnosed with colon cancer after ignoring his main symptom – fatigue – for months.
The tumor was not noticed until it had spread and was in stage three, making it much more difficult to treat. Mr. White was on track to marry his girlfriend and move to California, but his dreams were cut short when he died after a four-year battle with the disease.
And Marisa Maddox, a legal assistant from Delaware, was robbed of the chance to have the large family she had always hoped for after a colon cancer diagnosis at age 29 left her infertile.
Dr. Raed Al-Rajabi is an associate professor of medicine in the department of medical oncology at the University of Kansas Medical Center and leads the GI medical oncology group. He treats patients and researches possible new therapies
This is a “devastating” diagnosis for anyone, Dr. Al-Rajabi said, but especially for younger patients “it turns their whole lives upside down.”
First, many younger people are less financially stable than their older counterparts, which can lead them to fall into debt and seek treatment.
In addition, many of the patients he sees have to give up plans they have looked forward to all their lives, such as having a family or a career.
These factors only add to the brutal symptoms of gastrointestinal cancer and its treatment, with patients often having difficulty eating, going to the toilet and having energy.
It is difficult to watch patients go through this, especially those who had their lives ahead of them, Dr Al-Rajabi told DailyMail.com.
Younger patients often do not know that they have the disease for a long time.
They tend to delay visiting the doctor for gastrointestinal symptoms because they assume their condition will go away on its own, because they are less financially stable or because they don’t have insurance, Dr. Al-Rajabi said.
Even when they seek help from doctors, the doctors themselves usually do not suspect colon cancer. Most instead think that their patient’s symptoms are caused by “normal things” like diet, hemorrhoids or the irritable bowel system, he added.
‘Doctors simply don’t consider bowel cancer to be a possibility in this young age group,’ the doctor told DailyMail.com.
This means that the average young colon cancer patient visits at least two doctors before being diagnosed.
In the weeks or months it often takes to deal with these logistics, the cancer has had more time to spread.
Scientists do not yet agree on why this trend is increasing.
Some theorize this is due to food, blaming a modern diet high in sugar and low in fiber.
Others theorize that environmental factors, such as the use of pesticides or microplastics, contribute.
Marisa Maddox (photo; not a patient of Dr. Al-Rajabi) was diagnosed with colon cancer at the age of 29. It left her infertile and robbed her of the chance to have the big family she always wanted
Joe Faratzis, 34, from Los Angeles, is pictured above in his 20s before his stage four colon cancer was discovered (left) and during treatment that began in 2020 (right). He was not a patient of Dr. Al-Rajabi
Dr. Al-Rajabi personally believes that some societal or environmental factor could play a role, as the sharp increase in younger patients is similar to past cancer trends driven by factors such as tobacco use.
However, he cautioned that research has yet to prove this.
Whatever the cause of this increase, the key to fighting back against it, Dr. Al-Rajabi said, is to become your own advocate.
This means taking the time to learn about the history of digestive cancer in your family and paying close attention to your own colorectal symptoms.
If someone in your family has colorectal cancer, you are much more likely to develop the disease. About 33 percent of people with colon cancer also have a family member who has had the disease.
Although official US recommendations say screening for colon cancer should start at age 45, Dr Al-Rajabi said this changes if you have a family history of the disease.
You should be screened about ten years earlier than the age your family member was diagnosed with cancer.
During these routine checkups, doctors look for small abnormalities in your intestines, called polyps. If you have polyps removed and checked, your risk of developing cancer decreases by 80 percent. according to Cleveland Clinic.
This is why checkups and family history are crucial, Dr Al-Rajabi said.
If you notice a change in the way your intestines behave, seek out a doctor and make sure they understand your family’s history with the disease.
It is crucial that even if it bothers you, you are firm in describing your predicament to your doctor if you have any concerns.
Dr. Al-Rajabi said: ‘If something doesn’t feel right and you have persistent symptoms, such as stomach pain [or] blood in your stool, don’t think it’s something benign, always be your own advocate, go back to your doctor and discuss it again.’