People normally associate colorectal cancers with older people. This is true to a certain degree. 80% of newly diagnosed colorectal cancers are in the above 70 age group. These are what surgeons call sporadic cancers.
Of the remaining 20%, about 2/3 affect young people below the age of 50. The remaining 1/3 affect people with chronic inflammatory bowel diseases like Ulcerative Colitis and Crohn’s Disease.
For young people in their 30s and 40s, getting struck with colorectal cancer is simply shocking. At the prime of their lives and at the peak of their careers, they are diagnosed with a potentially fatal disease.
I wrote this article to help shed some light on colorectal cancers in young people. I want to explain the cause and characteristics of this cancer, and what can be done to detect the cancer early.
Young people affected with colorectal cancer have a genetic defect
Hereditary Non-Polyposis Colorectal Cancer (HNPCC) is genetic defect that makes them more prone to colon cancers.
The typical features are:
- Multiple members of the same family affected across generations
- Affected before age of 50
- Affects right side of the colon
- Multiple colon tumors
Some genetic defects not only expose the person to higher risk of colorectal cancers, they also cause increase risk for certain gynecological cancers.
Signs and symptoms are the same as regular colorectal cancers
The signs and symptoms exhibited are the same as regular colorectal cancers. However, young people frequently dismiss their symptoms to something benign like hemorrhoids or indigestion.
They tend not to seek medical attention. Thus, the cancer often presents late and at an advance stage.
Don't dismiss the warning signs
While this condition might be rare, it's potentially fatal. Here's what I'd recommend my patients to do:
Have a high index of suspicion. Both your doctor and yourself should not dismiss seemingly innocuous symptoms if they persist in spite of treatment.
Once there is such a cancer history in the family, the entire family should go for genetic counselling as well as early colonoscopy screening.
If you have a family history of young colorectal cancers, you should go for colonoscopy 10 years earlier than age of the affected case. For example, if one family member is diagnosed at the age of 55, family members should be screened at age 45 instead of waiting till the recommended age of 50.
There's another genetic condition that affects 1 child out of 10,000
Familial Adenomatous Polyposis (FAP) is another genetic condition that puts the patient at great risk of developing colorectal cancer at a young age. It affects one child out of every 10,000.
In this condition, the entire colon is literally carpeted with hundreds of polyps by the time the patient is a teenager. Without surgery, the chance of getting colon cancer is nearly 100% in such patients.
Bleeding, frequent diarrhoea, and pain are common symptoms
Patients typically complain of bleeding during defecation. Frequent diarrhoea, abdominal pain and mucus discharge are also present. In late stages, there will be loss of weight, anemia as well as intestinal obstruction as cancer grows bigger from the polyps.
Cancer screening should start at the age of 10 for people with FAP
Patients with family history of FAP begin screening at the age of 10. If no polyps are found, they are continually screened every year for life.
Once FAP is diagnosed, total removal of the colon and rectum (pan procto-colectomy) is advised as the chance of developing fatal colorectal is a near certainty.
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