A rising concern: Why are young people facing colon cancer?
Imagine being diagnosed with colon cancer just two weeks after a slight belly pain. This is the reality for Umanita, an unfortunate member of a growing club of young adults battling a disease once considered an elderly concern.
"It felt like a nightmare, an unreal experience," Umanita shared, reflecting on her diagnosis.
Researchers have been sounding the alarm about the alarming rise in colorectal cancer among younger individuals. A report by the American Cancer Society revealed that in 2019, people under 55 accounted for a staggering one-fifth of the 145,000 new colorectal cancer diagnoses. This is a significant increase from 1995, where the rate was only half as much. By 2024, colon cancer had become the leading cause of cancer deaths in men under 50 and the second for women in the same age group.
Scientists are now turning their attention to potential causes, particularly diet and ultraprocessed foods. Health Secretary Robert F. Kennedy Jr. has even gone so far as to call these foods "poisonous," contributing to a high incidence of health issues in the country. In a recent move, Kennedy issued new dietary guidelines encouraging a significant reduction in highly processed foods with added salt and sugar.
Boston's academic medical centers are leading the charge in understanding the role of these foods. Researchers are utilizing data from patients like Umanita to investigate why seemingly healthy young adults are developing such devastating cancers.
A recent study by MGB researchers found a connection between the consumption of ultraprocessed foods - think premade foods high in sugar, salt, saturated fat, and additives - and the development of precancerous polyps. Dr. Andrew Chan, one of the study's authors, emphasized the need to explore beyond the known risk factors for older adults.
"There's still so much more to uncover," he added.
Despite these promising findings, experts are still perplexed by the high numbers of colorectal cancer in young adults. While some cancers have clear causes, like smoking and lung cancer or human papillomavirus and cervical cancer, colorectal cancers are likely a result of a complex interplay of various factors.
Everyone close to Umanita seems to have a theory about the cause of her cancer, as she had no obvious genetic predisposition. Some blame her diet, others microplastics, and some even the COVID-19 vaccine.
"Of course, that's not true," Umanita clarified. "But people are searching for answers, trying to understand why a girl my age would get cancer, and I don't have one."
Umanita's journey with cancer didn't truly hit her until she returned home from her initial hospital stay. The hospital was a distraction, with constant tests and blood draws. She was fed through a tube for days, dreaming of simple comforts like grilled cheese and tomato soup.
Once she was able to, Umanita began her cancer treatment. Instead of taking time off, she chose to continue her studies and work as a teaching assistant, refusing to let her diagnosis consume her days.
As a psychology major, Umanita had learned about cancer in her science classes, but now the disease had a new, personal meaning. She saw a dietitian, wrote a paper on the links between cancer and diet, and swore off red and processed meats.
There were moments of purpose, like participating in research at a top academic medical center. She contributed surveys and tissue samples, fitting for her aspirations to become a researcher herself.
Dr. Chan, the MGH physician, remembers a patient who came in with severe abdominal pain about 20 years ago. She was under 40 and had colon cancer. She was caring for young children and an aging mother, a network of people depending on her.
"When a young person faces cancer, it hits you harder," Chan said.
Other doctors also noticed an increase in colon cancer among middle-aged and young adults around that time, but the reasons were unclear.
While screening explains some of the increased diagnoses, it doesn't account for individuals under 45, whose colon cancer rates are also climbing. Younger patients often ignore subtle symptoms, arriving at the oncologist sicker than their elderly counterparts.
Established risk factors for colon cancer include being overweight or physically inactive. In older adults, diets high in red meat and sugar are also linked. But is this the case for younger adults too?
Chan and other researchers are working tirelessly to find answers, studying healthy individuals over their lifetimes and those like Umanita diagnosed with early-onset colon cancer.
In a recently published study in JAMA Oncology, Chan's team found that soda, chips, and other ultraprocessed foods could be partially to blame for the polyps that precede colon cancer. They analyzed the diets of nearly 30,000 women under 50 and discovered that those with the highest intake of ultraprocessed foods had a 45% higher risk of developing precancerous polyps in the colon.
Dr. Lilian Chen, chief of colorectal surgery at Tufts Medical Center, referred to herself as a "surgical plumber" and wasn't surprised by the food-cancer connection.
"Whatever goes into our body, our colon processes it," Chen explained.
However, ultraprocessed foods alone don't explain the rise in colon cancer. Chan sees many patients with healthy diets and active lifestyles.
"These standard risk factors don't apply to everyone," Chan emphasized.
The next question is whether years of unhealthy eating can be undone. This is what Chan plans to explore next.
In March, after surgery and 12 rounds of chemo, Umanita rang the bell at Mass. General, signaling the end of her cancer treatment. She thought the hard part was over, but the transition back to normal life took its toll.
Dr. Aparna Parikh, Umanita's oncologist, recalled their most emotionally challenging visit in October, more than six months after her last chemo cycle.
"We need to support her mental health because she's not okay, even though she's been strong and resilient this entire time," Parikh reflected.
During treatment, Umanita's days were filled with constant activity. But when it ended, she was left with an unexpected void. Few around her could relate to her experience, given her youth.
She survived the unthinkable, but her fears linger. Umanita now sees her life as divided into two parts: before and after cancer.
"For me, it's not the end of a journey," Umanita said. "It's the beginning of something else."
Umanita may never know why she got cancer, but she's made changes to lower her future risk. She exercises regularly, eats more fiber, and avoids red meats, except for special occasions. She understands that there are likely other uncontrollable factors at play.
"It's complicated and multifaceted. Everything is, if you really examine it closely," Umanita shared. "It doesn't bring me solace, but I know it's true."
Contact Marin Wolf at marin.wolf@globe.com.
