Peoria Standard

Check your expectations at the door when it comes to colorectal cancer

“Why should I worry?” “I watch what I eat, I’m relatively active, and I’m only in my forties. Colorectal cancer screenings, like colonoscopies, are important if you have a family history, or are getting up there in age. But that’s not me, right doc!?”

Not necessarily.

Truth is colorectal cancer doesn’t always play by the rules. Early-onset colorectal cancer appears to be on the rise and to make matters worse, it’s presenting at a more advanced stage when identified. The worrisome trend is affecting patients nationwide.

“Absolutely, I’ve personally been noticing increasing instances of early onset solid tumors (cancer) in younger people for the past few years and recent data seems to echo this new trend,” Bhanu Vakkalanka, MD, medical oncology, Carle Cancer Institute Normal, says. Dr. Vakkalanka, who previously practiced in Bloomington-Normal from 2012 to 2016, recently returned to the area joining the Cancer Institute in Normal as a medical oncologist. In addition to being an active participant in the multidisciplinary cancer clinics at the practice, his arrival expands access to clinical trials and offers those diagnosed with cancer or blood diseases a new option for their care in the area.

Although it is too early to know exactly what is behind the rising incidence of colorectal cancer among young people, one message is clear. It’s essential that adults of all ages pay attention to changes in their bowel habits and talk with their doctors about symptoms that persist or get worse -- even if they don’t think their bodies would ever betray them.

March is National Colorectal Cancer Awareness Month and brings awareness to this disease and the value of accessing life-saving resources that prevent, detect, and treat it. According to the American Cancer Society, about 1 in 23 men and 1 in 24 women will develop colorectal cancer at some point in their lives. Their recently published 2023-2025 Colorectal Cancer Facts & Figures report indicates that declining incidence is confined to ages 65 and older, incidence rates are stable since 2011 among those 50-64 years of age, and incidence rates are increasing by 2% per year among those younger than 50 as well as in people ages 50-54 years of age.

The U.S. Preventive Services Task Force (USPSTF) Colorectal Cancer Guidelines now suggest most Americans receive screening for colorectal cancer at age 45, down from the previously recommended age of 50, and continue with screenings periodically until age 75.

“The earlier colorectal cancer is found, the better the outcome for the patient,” explains Dr. Vakkalanka. “Early diagnosis reduces the risk of spread to other parts of the body and limits the impact felt by the patient’s entire family. Later-stage cancers can result in a considerable financial burden as it can limit the patient’s ability to continue to contribute to the family financially.” 

Diagnosed patients can seek treatment and support from either of Carle’s multidisciplinary colorectal cancer clinics at Carle Cancer Institute Normal or Urbana where medical professionals meet regularly to develop a comprehensive and individualized cancer treatment plan after carefully considering all treatment options.

“A cancer diagnosis is both stressful and overwhelming,” explains Darryl Fernandes, MD, general and colorectal surgeon and member of the multidisciplinary colorectal cancer team at Carle Cancer Institute Normal. “Our multidisciplinary colorectal cancer teams are designed to make the process easier for patients by bringing the care team together in one place to save them time, travel and confusion. The surgeon, medical oncologist and depending on the individual case, potentially the radiation oncologist, meet to discuss each case prior to meeting with the patient later that same day. Patients are also assigned a nurse navigator who is there to answer questions and connect patients to a variety of services such as support groups, genetic and nutrition counseling and mental health counseling. The multidisciplinary approach is a major benefit for patients.”

Guidelines from The American College of Gastroenterology identify the following risk factors for colorectal cancer:

• Age. The majority of colorectal cancers occur in people older than age 50, but due to emerging trends, everyone should begin screening for colorectal cancer at age 45 if they haven’t already done so due to being in a low-risk category.
•  A family history of colon or rectal cancer. Having a parent, sibling, child or multiple other relatives with colorectal cancer places people at an increased risk of colorectal cancer and may warrant earlier and more frequent colonoscopy screening. 
• Inflammatory Bowel Diseases.  Ulcerative colitis or Crohn's disease can increase your risk of colon or rectal cancer.

“In the past, we were thinking that most early onset cancers might have some genetic predisposition. But, increasingly we are realizing there are really no predictable patterns for some of these cancers, and colorectal cancer, in particular, seems to be one of the cancers on the rise in a younger age group that doesn’t fit the typical inherited risk profile,” Dr. Vakkalanka shares.

Unfortunately, most early colorectal cancer may not produce any noticeable symptoms. However, symptoms like the ones listed below should prompt a conversation with your doctor.

• Rectal bleeding or anemia. Typically, the most common initial symptom and associated with cancers from the left side of the colon. In later stages, constipation, abdominal pain, and obstructive symptoms may appear.
• Changing bowel movements. This can include diarrhea and/or constipation, a change in the consistency of your stool, or narrow caliber stool that lasts for more than a few days.
• Vague abdominal aching usually without a change in bowel habits or obstructive symptoms, more closely associated with right-side colon cancers.
• Unexplained fatigue or weakness.
• Unexplained weight loss.

On the brighter side, the earlier experts can detect colon cancer, the easier it is to treat. If experiencing symptoms, don’t ignore them or assume it couldn’t be colorectal cancer. Contact your primary care provider and get checked out. Your doctor can suggest the right test for you.

If you were born before today’s date in 1978, it’s time to get screened!

Original source can be found here