WASHINGTON • Black Panther star Chadwick Boseman’s death from colon cancer at the age of 43 has highlighted the growing rate of this disease among younger adults, who are often diagnosed at later stages.

According to Dr Kimmie Ng, director of Dana-Farber’s Young-Onset Colorectal Cancer Centre in Boston, it shows how important it is for more research into what is driving the rise, as well as greater awareness and screening. “We are losing way too many young lives to this disease without a clear understanding of what the causes are,” she said.

The suspicion is that environmental factors, such as shifts in diets and lifestyle, could be behind the increase.

While studies are under way, statistics in the United States are alarming and the trend is similar in Europe.

Since 1994, US cases of youngonset colorectal cancer – defined as a diagnosis before the age of 50 – have increased by 50 per cent.

Colorectal cancers will affect more than 140,000 Americans this year, with under-50s accounting for about 11 per cent of colon cancers and 18 per cent of rectal cancers. By 2030, the rates among this age group are expected to double and quadruple respectively.

As a result, the American Cancer Society recently updated its advice, saying most people should get screened at 45, not 50.

Symptoms to watch for include changes to bowel habits that last more than a few days, such as diarrhoea, constipation or narrow stool.

They also include feelings of having to pass stool that do not go away by doing so, rectal bleeding or blood in the stool, abdominal pain, weakness, fatigue and weight loss.

For Mr David Thau, it took shooting pain in the abdomen – the worst he had ever felt in his life – for him to go see his primary care doctor in June last year.

The Washington-based political consultant, then 34, had been ignoring the blood that had recently been appearing in his stool.

“I’ve always been the kind of person who just says, ‘Well, I don’t need to go to the doctor,'” he said .

A former high school athlete, he was otherwise healthy with no family history of colon cancer.

Mr Thau’s doctor told him he might have an ulcer or appendicitis, so he checked into an emergency room.

A CT scan detected a 7.5cm mass that almost completely blocked his colon. He was diagnosed as having stage 3C cancer, the last before a cancer has metastasised, and days later had surgery to remove the tumour.

Fortunately, surgeons were able to extract it using small incisions and he did not require an ileostomy – a surgical opening to a bag that holds stool. For the next six months, he travelled to Boston every other week for chemotherapy.

“I had to freeze my sperm,” added Mr Thau, since he and his wife were planning to have children and the treatment can cause sterility.

In February, doctors said his cancer was gone, but he still requires routine check-ups.

Ms Ghazala Siddiqui, from Houston, went to an emergency room in March 2018 after finding it impossible to pass stool despite using laxatives.

Doctors performed an X-ray on the mother of two, then 41, but misdiagnosed her case as severe constipation and sent her home.

It was not until she approached a specialist that colon cancer was identified. She needed 23 gruelling radiation sessions at MD Anderson Cancer Centre to shrink the stage 3 tumour down to size before it could be removed. She also needed an ileostomy and a stool bag.

Next came months of chemotherapy and uncertainty as to whether her bowels would ever recover enough for the bag to be removed.

Fortunately, it did, and in February last year, the colon was surgically closed.

Ms Siddiqui said the hardest aspect was that the radiation caused her to go through early menopause, causing hot flushes, loss of sex drive and ongoing anxiety.

After her experience, her four sisters underwent screening. One had polyps the size of almonds which doctors were able to remove early, “which goes to show that screening is important”, she said.

Dr Ng emphasised it is critical to catch growths early and to consider screening even earlier than 45 if there is family history of colon cancer or advanced polyps.

Colonoscopies are considered the gold standard of screening, but their invasive nature can discourage some people. For this reason, Dr Ng’s centre is working on what it hopes will be the next generation of blood and stool tests that might catch growths sooner.

Ultimately though, “the best screening test is the screening test that gets done”, she said. “If somebody is having symptoms concerning colon cancer, they need to seek medical attention.”

AGENCE FRANCE-PRESSE

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