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Published on November 10, 2020

Treating Colon Cancer in Younger Adults: A Colorectal Surgeon Shares His Expertise

Recent news events have highlighted the concerning trend of rising colon cancer rates among young people. Adding to the alarm is the fact that experts are not exactly sure what is causing the increase; some point to lifestyle factors while others suspect a genetic component. Whatever the answer, one thing is certain: early detection of colorectal cancers can help save lives. Palos Medical Group Colorectal Surgeon James Gianfrancisco, MD, shares his expertise in treating younger colon cancer patients, including symptoms to look for and when to seek medical help.

Cancer and the Under 40 Crowd

After decades of experience treating anorectal conditions, Dr. Gianfrancisco, confirms the increase in colon cancer among patients aged 40 to 54, as well those in their 20s and 30s. “I have seen colon cancer in patients as young as 25,” he says. “It is concerning, but the sooner your diagnosis the better your chance of survival. Studies have shown that a lower-stage diagnosis usually means a lower chance of recurrence.”

For younger patients with colon cancer concerns, an initial appointment helps determine the plan of action. “When a patient first comes to see me, I complete a personalized colon cancer assessment, looking at their individual risks and symptoms,” explains Dr. Gianfrancisco. Some risks include lifestyle factors like obesity, smoking, a diet high in meat and low in fruits, vegetables and whole grains, heavy alcohol use, and physical inactivity. “It’s critical to discuss colon cancer risk factors with your doctor so he or she can advise you on next steps.”

Hereditary risks should also be taken into account. “There is a hereditary component to colon cancer, especially if a first-degree relative or multiple second-degree relatives had it,” says Dr. Gianfrancisco. “People should be aware of their family medical history. I have seen some generation-skipping with cancer, so having health information about parents and grandparents is important.”

Importance of Screening Tests

Until 2018, the American Cancer Society (ACS) recommended colon cancer screenings begin at 50 years old. However, recent ACS research data confirmed the increase in cases of colorectal cancer among younger adults, causing the recommended age to start screenings to be lowered to 45 years old.

While colon cancer screening tests can take several forms, Dr. Gianfrancisco’s first choice for patients is a colonoscopy exam. “Colonoscopy is accurate in detecting cancer, and any premalignant lesions can be removed during the procedure,” he explains. A colonoscopy procedure allows the doctor to view the inside of the entire colon through the use of a long, flexible tube with a tiny video camera at the end.  The procedure usually takes 30 minutes, and patients are normally sedated.

Another screening option is a stool DNA test (Cologuard). While non-invasive it may also be less accurate than a colonoscopy, and as Dr. Gianfrancisco notes a colonoscopy may still be required if there is a positive result.

Don’t Ignore Symptoms!

Although the age for beginning colon cancer screening has dropped, it is still important for people of any age to get tested if they exhibit symptoms, especially rectal bleeding, weight loss, and pallor/pale appearance. Other warning signs to be discussed with your physician include:

  • Major change in bowel habits
  • Blood in stool that is bright red, black or tarry
  • Stools that are narrower than usual
  • Diarrhea, constipation, or feeling that the bowel does not empty completely
  • Abdominal discomfort, such as frequent gas pain, bloating, fullness and/or cramps
  • Constant feeling of fatigue or tiredness
  • New onset anemia diagnosed on routine lab work

See the American Cancer Society website for an exhaustive list of symptoms.

Dr. Gianfranciso adds that many times colon cancer displays no symptoms at all, reinforcing the need for regular testing at a younger age.

Unfortunately, those who do have symptoms of colon cancer often ignore or dismiss them altogether. “People sometimes attribute anorectal symptoms to hemorrhoids, especially rectal bleeding,” says Dr. Gianfrancisco. “But someone with symptoms that persist for more than several days should come under medical evaluation by a doctor.” He goes on to explain that while anorectal conditions causing pain and/or bleeding are often not harmful, they do require medical attention to ensure there is no cancer or precursor polyps present.

The Cancer-Polyp Connection

What exactly is a polyp? Colon polyps are clumps of cells that form on the lining of the colon. According to Dr. Gianfrancisco, they should be removed for biopsy. “While some types of polyps are harmless, others may progress to cancer. One out of four people have pre-malignant polyps when they have a colonoscopy, so it’s better to have them removed before they become cancerous.”

Early Diagnosis = Increased Survival Rate

Typically, the sooner someone is diagnosed with colon cancer, the better their outcome. Higher survival rates are linked to lower stages of diagnosis, and there are better options for treatment. “Younger patients are usually good candidates for surgery or for curative procedures,” says Dr. Gianfrancisco. “Treatment may include surgical removal of the lesion. Superficial cancers can sometimes be removed with a colonoscope or other endoscopic device with no external incision.”

Dr. Gianfrancisco notes that there are “remarkably improved survival rates” in advanced stage cases through the use of radiation and chemotherapy. “The best chance of beating colon cancer comes with early diagnosis and treatment. Many people believe that colon cancer is a death sentence, but in lower stage cancers there is now over a 90 percent long-term survival rate.”

Next Steps

If you are concerned about your colorectal health, talk to your primary care provider about risk factors and when to begin testing.

Dr. Gianfrancisco is a surgeon who specializes in the prevention and treatment of gastrointestinal complaints and cancers. He currently sees patients at his office located at the Palos Health South Campus in Orland Park. To make an appointment, please call 708-226-2440.

Colorectal surgeon Imad Qayyum, MD, offers colon and rectal cancer care for patients requiring either curative or palliative intent surgery. He currently sees patients at his office at Palos Hospital in Palos Heights. To make an appointment, please call 708-923-4400.