‘I can’t have anything serious; I’m only 25’: Colon cancer on the rise in young people

Shannon Lee-Sin graduated from the Design and Architecture Senior High (DASH), an award-winning magnet school in Miami’s Design District, and was accepted to Pratt Institute — the design school in New York City.

She had few concerns.

“I was perfectly healthy except for the extra weight,” she said, noting she was about 30 pounds overweight.

But when she was in her 20s, Lee-Sin developed a slew of symptoms, including diarrhea, constipation, nausea, vomiting, blood in her stools and fever. She saw about 20 different doctors and had multiple ER visits, yet no one could figure out what was ailing her.

Several doctors told her she likely just had hemorrhoids.

“I was told I was an oddball and that I was a weird case,” she said.

Finally, at the age of 29, she wound up in emergency exploratory surgery at the South Florida Surgery Bariatric Institute. The surgery lasted 10 hours.

The result: She found out she had stage IIIC colon cancer. Lee-Sin’s young age explained why many doctors missed the disease even when she had all the symptoms

More young people contracting colon cancer

Colorectal cancer (CRC) has long been considered “an old man’s disease,” but a study published in March by the American Cancer Society shows that over the last several years, the number of young people diagnosed with CRC has risen, including among women, who are generally less susceptible to the disease.

Diagnoses have declined in older people.

Colorectal cancer is the second-most common cause of U.S. cancer deaths, according to the American Cancer Society.

“I went through this alone, but I’m not alone,” said Lee-Sin, now 38. “There are many others out there just like me.”

Today, Lee-Sin, a construction manager with Miami-Dade County, is involved with the Colon Club, which supports those diagnosed under 45.

Lee-Sin had about 12 inches of her colon removed. A year and a half later, she had surgery that enabled her to have normal bowel movements.

“I want young people to know that you can have colon cancer and still live a full life after,” she said. “Cancer didn’t kill me, and it didn’t kill my dreams either.”

Dr. Laurence Sand, chief of colorectal surgery at the University of Miami Health System, said he’s seen an increase in younger people with CRC in his own practice, too.

“They come in and they say, ‘I can’t have anything serious; I’m only 25,’ ” he said. “But you can’t just assume that everyone’s cause of rectal bleeding is related to hemorrhoids.

“There’s nothing more disheartening than to see a 35-year-old guy come in with his wife and baby and to see that the cancer has metastasized,” said Sands.

And younger people who develop CRC often have a later stage of cancer and a worse prognosis; he theorizes that the nature of the cancer is more aggressive in younger people.

Causes and Prevention

CRC is considered preventable and can be screened for with a colonoscopy. The American Cancer Society recommends that all adults, starting at age 45, get a colonoscopy every 10 years.

But those who exhibit symptoms like Lee-Sin’s should get a colonoscopy at the onset of the symptoms. If polyps are found during the colonoscopy, the frequency of screening should be every five to seven years. Polyps can be pre-cancerous, although they can take 10-12 years to develop into cancer, Sands said.

People whose family has a history of the disease should be screened when they are 10 years younger than their family members were when they were diagnosed.

Those with irritable bowel disease — which include Crohn’s and ulcerative colitis — are at a higher risk of developing CRC, and should get a colonoscopy every one to two years.

Doctors don’t know for sure what’s causing the disease in seemingly healthy younger people, but some have theories.

“Younger people are eating more processed foods than in the past, that’s one theory,” said Dr. Steven Wexner, director of the digestive disease center and chair of the Department of Colorectal Surgery at Cleveland Clinic Florida.

Wexner also cited a population study that showed that people living in Sub-Saharan Africa — a place with few processed foods — have a much lower incidence of colon cancer.

“They are also not sitting on the couch watching TV all day,” he said, acknowledging that the lower rates in rural and underdeveloped parts of the world can be the result of a multitude of factors.

Dr. Mike Cusnir, chief of medical oncology at Mount Sinai Medical Center in Miami Beach, agrees with some of Wexner’s theories.

“We don’t know for sure,” he said, “but we think there could be a change in the epidemiology.”

Cusnir, 49, said he knew of the increase of CRC among younger people long before the study came out because developing trends are often discussed at medical conferences.

“We were like, ‘Oh my God — we’re reaching the age of 50 and we’re seeing so many patients in their 40s with advanced cancers,’ ” he said.

“The takeaway message is that younger people can develop colon cancer, too,” he said.