When oncologist Dr Raed Al-Rajabi first began seeing cancer patients 14 years ago, he expected a lot of what he’d see would be ‘horrible.’
But he didn’t envision the job would turn into what it has today: Treating dying 20-year-olds.
Since Dr Al-Rajabi became a cancer specialist, the percentage of patients under 55 with colorectal cancer has nearly doubled. One of his patients was just 14 years old.
Approximately 70 percent of these young people are so unwell — having gone undiagnosed for far too long — there is now little doctors can do to help.
Dr Al-Rajabi is an associate professor of medical oncology at the University of Kansas Medical Center and leads the colorectal cancer treatment, and cases he tends to at the hospital are, he told DailyMail.com, ‘heartbreaking.’
The above graph shows the rise of colorectal cancer in young Americans from 1999 through 2020. Rates briefly declined during Covid, likely due to missed screenings and diagnoses, but have been on the rise since
Evan White is pictured above with his fiancée Katie Briggs and their dog Lola. Evan is just one of millions being 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 each year – and approximately 50,000 of them will die from the disease, according to the Colorectal Cancer Alliance.
People are on average 66 years old when they’re diagnosed but the age has been shifting lower.
Approximately 20 percent of people diagnosed with colorectal cancer in 2019 were under 55. That’s nearly double the rate from 1995, where 11 percent of colorectal cancer patients were under 55, according to American Cancer Society (ACS).
If you detect colon cancer early, before it’s spread to other parts of the body, your odds of survival are high. Roughly 90 percent of people diagnosed early live through the next five years.
At late stages, when the disease has spread, the survival odds are slim – only about 13 to 18 percent of people with advanced colon or rectal cancer live five years after they are diagnosed.
But catching it early can be difficult because many of the symptoms of the disease are similar to those you’d get from common digestive complaints like irritable bowel syndrome, which affects roughly one in 20 Americans.
These include abdominal pain, changes in bowel movements, unexpected weight loss, fatigue, appetite changes, constipation, bloating and blood in the stool.
The above graph shows the change in cancer case rates around the world
The above graph shows the change in cancer death rates around the world
Sadly, Dr Al-Rajabi told this website, late detection is the case for the majority of the young people he sees.
But he said his clinic isn’t the only place seeing this change – colleagues across the country and world have been increasingly diagnosing a younger demographic.
One patient, 21-year-old Dominique McShain from New Zealand, was studying to be 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 rates of cancer in people under 50.
The doctors told her since the cancer had taken over her liver, it was likely incurable. They predicted she had between one and five years left to live.
About two weeks after her diagnosis, she began chemotherapy, lost her hair and stopped going to 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 dismissing his main symptom – tiredness – for months.
The tumor was not spotted until it had spread and was stage three, making it much harder to treat. Mr White had been 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 paralegal from Delaware, was robbed of the chance of having the big family she had always hoped for after a colon cancer diagnosis at 29 made her infertile.
Dr Raed Al-Rajabi is an Associate Professor of medicine in the division of medical oncology at the University of Kansas Medical Center and leads the GI medical oncology group. He treats patients and researches potential new therapies
This is a ‘devastating’ diagnosis for anyone, Dr Al-Rajabi said, but for younger patients especially, ‘it turns their whole life upside down.’
For one, many younger people are less financially stable than their older counterparts – which can cause them to go into debt seeking treatment.
For another, many of the patients he sees have to give up on plans they’ve looked forward to for their whole life – like having a family or career.
These factors merely add to the brutal symptoms of GI cancer and treatment – where patients often struggle to eat, use the bathroom and have energy.
It’s 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 go a long time without knowing they have the disease.
They tend to delay going to the doctor for GI symptoms because they assume their condition will resolve itself, they are less financially stable or they lack insurance, Dr Al-Rajabi said.
Even when they do seek care from doctors, the doctors themselves don’t usually suspect colon cancer. Most instead think their patient’s symptoms are caused by ‘normal things’ like diet, hemorrhoids or irritable bowel system, he added.
‘Doctors just don’t feel that colon cancer is a possibility in that young age group,’ the physician told DailyMail.com.
This means the average young colorectal cancer patient sees at least two doctors before getting diagnosed.
In the weeks or months it often takes to deal with these logistics – the cancer has had more time to spread.
Scientists haven’t come to a consensus about why this trend is increasing.
Some theorize it’s because of food – blaming a modern diet that’s high in sugar and low in fiber.
Others theorize environmental factors, like pesticide use or microplastics, are contributing.
Marisa Maddox (pictured; not a patient of Dr Al-Rajabi) was diagnosed with colon cancer at age 29. It made her infertile, robbing her of the chance to have the large family she always wanted
Joe Faratzis, 34, from Los Angeles, is pictured above in his twenties before his stage-four colon cancer was detected (left) and during treatment which began in 2020 (right). He was not a patient of Dr Al-Rajabi
Dr Al-Rajabi personally believes some societal or environmental factor might be playing a role, since the sharp uptick in younger patients is similar to past cancer trends caused by factors such as tobacco use.
However, he cautioned, research has yet to prove this.
Whatever the cause of this increase is, the key to fighting back against it, Dr Al-Rajabi said, is becoming your own advocate.
This means taking the time to learn about your family’s history of digestive cancers and paying painstaking attention to your own colorectal symptoms.
If someone in your family had colorectal cancer, your odds of developing the disease are much higher. Roughly 33 percent of people with colon cancer also have a family member who had the disease.
Though the official US recommendations say colon cancer screening should start at age 45, Dr Al-Rajabi said that shifts if you have a familial history of the disease.
You should get screened about 10 years ahead of the age that your family member was when they were diagnosed with their cancer.
In these routine checkups, doctors look for little abnormalities in your gut, called polyps. If you get polyps removed and monitored, your risk of developing cancer drops 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 gut is behaving, then seek out a doctor and make sure they understand your family’s history with the disease.
It’s crucial, even if you feel like a bother, to be firm in describing your predicament to your doctor if you’re concerned.
Dr Al-Rajabi said: ‘If something doesn’t feel right, and you have persistent symptoms like abdominal 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.’
