When oncologist Dr. Raed Al-Rajabi began treating cancer patients 14 years ago, he anticipated encountering many ‘horrible’ cases.
However, he never imagined his work would come to this: treating dying 20-year-olds.
Since Dr. Al-Rajabi became a cancer specialist, the percentage of colorectal cancer patients under 55 has nearly doubled. One of his patients was just 14 years old.
Approximately 70 percent of these young patients are so unwell due to late diagnoses that there is now little doctors can do to help.
Dr. Raed Al-Rajabi, an associate professor of medical oncology at the University of Kansas Medical Center and leader of colorectal cancer treatment, describes the cases he sees at the hospital as ‘heartbreaking,’ he told DailyMail.com.
The graph above illustrates the increase in colorectal cancer among young Americans from 1999 to 2020. Although rates briefly declined during COVID, likely due to missed screenings and diagnoses, they have been rising since.
@dominiquemcshain So nervous posting this but if you want to follow my journey with colorectal cancer I will be sharing parts of my life here. #cancer #colorectalcancer #incurable #youngcancerfighter
Evan White is shown above with his fiancée Katie Briggs and their dog Lola. Evan is one of the many young individuals being diagnosed with colon cancer. He was not a patient of Dr. Al-Rajabi.
Each year, over 150,000 Americans are diagnosed with colorectal cancer, with approximately 50,000 succumbing to the disease, according to the Colorectal Cancer Alliance.
While the average age of diagnosis is 66, this figure is trending lower. In 2019, about 20 percent of colorectal cancer patients were under 55, nearly double the 11 percent reported in 1995, according to the American Cancer Society (ACS).
Early detection significantly improves survival rates, with around 90 percent of patients diagnosed early living for at least five more years. However, for those diagnosed at later stages, survival rates drop dramatically to just 13 to 18 percent.
Early detection is challenging because the symptoms of colorectal cancer often mimic common digestive issues like irritable bowel syndrome, which affects about one in 20 Americans. These symptoms include abdominal pain, changes in bowel movements, unexpected weight loss, fatigue, appetite changes, constipation, bloating, and blood in the stool.
The graph above depicts the global trends in cancer case rates over time.
The graph above illustrates the global trends in cancer death rates over time.
Sadly, Dr. Al-Rajabi shared with this website that late detection is common among the young patients he treats.
However, his clinic is not alone in observing this trend—colleagues across the country and the world are increasingly diagnosing younger demographics.
One such patient, 21-year-old Dominique McShain from New Zealand, was studying psychology and working part-time in human resources when she was diagnosed with stage four colon cancer earlier this year. In a TikTok video, she explained that New Zealand has the second highest cancer rates in people under 50. Doctors informed her that the cancer had spread to her liver and was likely incurable, giving her a prognosis of one to five years. About two weeks after her diagnosis, she began chemotherapy, lost her hair, and had to leave college.
Evan White, 24, from Dallas, Texas, had just graduated from the University of Arkansas with a degree in finance when he was diagnosed with colon cancer after months of dismissing his main symptom—fatigue. His tumor was not discovered until it had reached stage three, making treatment much more difficult. Evan had planned to marry his girlfriend and move to California, but his dreams were cut short when he passed away after a four-year battle with the disease.
Marisa Maddox, a paralegal from Delaware, was devastated when a colon cancer diagnosis at 29 left her infertile, depriving her of the chance to have the large family she had always hoped for.
“This is a ‘devastating’ diagnosis for anyone,” Dr. Al-Rajabi said, “but for younger patients especially, it turns their whole life upside down.”
Younger individuals are often less financially stable than older patients, leading them into debt as they seek treatment. Additionally, many have to abandon lifelong plans such as starting a family or building a career.
These challenges add to the brutal symptoms of gastrointestinal (GI) cancer and its treatment, which often include difficulties with eating, using the bathroom, and maintaining energy.
“It’s difficult to watch patients go through this, especially those who had their lives ahead of them,” Dr. Al-Rajabi told DailyMail.com.
Younger patients often remain unaware of their disease for a long time. They tend to delay seeking medical help for GI symptoms, assuming the issues will resolve on their own, and many lack financial stability or insurance.
Even when they do visit a doctor, their symptoms are often misattributed to more common issues such as diet, hemorrhoids, or irritable bowel syndrome, rather than colon cancer.
“Doctors just don’t feel that colon cancer is a possibility in that young age group,” Dr. Al-Rajabi told DailyMail.com.
As a result, the average young colorectal cancer patient consults at least two doctors before receiving a diagnosis. During the weeks or months spent navigating this process, the cancer has more time to spread.
Scientists have not reached a consensus on why this trend is increasing. Some theorize that it is due to modern diets high in sugar and low in fiber, while others point to environmental factors like pesticide use or microplastics as potential contributors.
Marisa Maddox (pictured; not under Dr. Al-Rajabi’s care) received a diagnosis of colon cancer at the age of 29. The illness rendered her infertile, depriving her of the opportunity to fulfill her dream of having a large family.
Joe Faratzis, 34, from Los Angeles, is shown above in his twenties before his stage-four colon cancer diagnosis (left) and during treatment that commenced in 2020 (right). He was not under the care of Dr. Al-Rajabi.
Dr. Al-Rajabi personally speculates that some societal or environmental factor might be contributing to the sharp increase in younger patients, akin to past cancer trends linked to factors like tobacco use. However, he stressed that research has yet to confirm this.
Regardless of the cause, Dr. Al-Rajabi emphasized that the key to combatting this rise is to become one’s own advocate. This involves educating oneself about the family history of digestive cancers and meticulously monitoring any colorectal symptoms.
Having a family history of colorectal cancer significantly increases your risk of developing the disease. Approximately 33 percent of individuals diagnosed with colon cancer have a family member who has also been affected.
While official US recommendations suggest colon cancer screening should commence at age 45, Dr. Al-Rajabi advises adjustments for those with familial histories of the disease. In such cases, screening should begin approximately 10 years earlier than the age at which the family member was diagnosed.
During these screenings, doctors search for small abnormalities in the gut known as polyps. Removing and monitoring these polyps can reduce the risk of cancer by up to 80 percent, according to the Cleveland Clinic. This underscores the importance of regular checkups and understanding one’s family history, as emphasized by Dr. Al-Rajabi.
If you observe any changes in your gut’s behavior, it’s essential to consult a doctor and ensure they are aware of your family’s cancer history. Dr. Al-Rajabi stresses the importance of being assertive in describing your symptoms, even if you feel like you may be bothering your doctor.
He advises, “If something doesn’t feel right, and you have persistent symptoms like abdominal pain [or] blood in your stool, don’t dismiss it as benign. Always advocate for yourself, revisit your doctor, and discuss your concerns.”
