By Sara Bondell - October 16, 2020
Because Chadwick Boseman battled colon cancer out of the public eye, it shocked the world when the actor died from the disease in August. He was only 43 years old.
For Moffitt Cancer Center patient Jennifer, the shock cut a little deeper. “I couldn’t shake the feeling that I could be next,” she said.
Jennifer was diagnosed with colon cancer in 2016, the same year as Boseman. Both were in their 30s, well below the age screenings are recommended to start. Jennifer also has no family history of the disease, which can increase your risk.
Bad abdominal pain sent Jennifer to the emergency room, where scans showed a tumor on her ovary. A week later, she had a hysterectomy, but when she awoke from surgery doctors told her she actually had stage 4 colon cancer that had spread. Surgeons not only performed a full hysterectomy, but also removed a foot of her colon and her appendix.
“From there, my cancer journey started,” said Jennifer. “I remember thinking, isn’t colon cancer something old people get?”
Even though more than 90% of colorectal cases occur in people older than 50, colorectal cancer is on the rise in young adults. An American Cancer Society study found colorectal cancer incidence among adults younger than 50 has been increasing since the mid-1990s. From 2012 to 2016, incidence rates in that age group rose by 2.2% each year. While death rates decreased 3% per year among patients 65 and older between 2008 and 2017, they increased 1.3% in those under 50.
“Although the causes of early onset colorectal cancer still remain unknown, it is clear that the incidence of colorectal cancer diagnosis in these younger patients is increasing over the past decades,” said Dr. Seth Felder, a colorectal surgeon in Moffitt’s Gastrointestinal Oncology Program. “Not only do we lack a firm understanding of who may be at greatest risk, since about half of these patients have neither a hereditary nor familial risk factor, we are also only beginning to learn how best to treat these young patients.”
Jennifer was diagnosed at 36, but the U.S. Preventive Services Task Force recommends screening start at 50. Boseman’s death at 43 made him two years younger than 45, the age at which the ACS recommends screening begin for Black men and women.
“Colon cancer screenings need to occur before the age of 50,” said Jennifer. “I strongly believe it should be screened as early as 30 years old. Maybe that could have helped me in my earlier detection of stage 4 colon cancer.”
Research is ongoing to help better understand the rise of colorectal cancer in young people and how the disease differs in older patients. “While we explore this, it is important to expand public awareness regarding warning signs so that we can detect these cases at an earlier, and often, curable stage,” said Felder.
Since surgery, Jennifer has had chemotherapy and is currently on a combination therapy that includes immunotherapy. She has relied on many of the resources offered by Moffitt’s Adolescent and Young Adult (AYA) Program.
According to the 2020 ACS Cancer Facts and Figures report, nearly 90,000 people ages 15 to 39 are diagnosed with cancer each year in the U.S., accounting for about 5% of cancer diagnoses. That is about eight times the number of cancers diagnosed in children under 15 and one-twentieth the number of cancers diagnosed in adults over 40.
Because cancer in the AYA population is rare, there is often a lack of research and resources. Moffitt’s AYA Program works to bridge that gap, addressing the unique physical and emotional needs of young adults with cancer, including financial toxicity and fertility. The program helps increase access to clinical trials and cutting-edge treatments, as well as connects young adult patients who are coping with similar issues.
Through the AYA Program, Jennifer has met two other young adults with colon cancer. She also has participated in AYA-sponsored events, like game night in the AYA Lounge.
Because of Jennifer’s diagnosis, many of her family members have undergone genetic testing. Her siblings also got colonoscopies before they turned 50.
While Jennifer, like Boseman, initially battled in silence, she says she now wants to advocate for young adults with the disease.
“I think a lot of times the motto is ignorance is bliss when it comes to telling others about your cancer diagnosis, but seeing someone in mainstream Hollywood who was diagnosed so early, I think there needs to be advocates for more awareness,” said Jennifer.