The Impact of Late-Stage Colon Cancer
- Ule Alexander thought his cramps were from gas or acid reflux, but they turned out to be the first sign of colon cancer.
- Now 42, he’s raising awareness about the disease to help fight the taboo that exists within the African American community.
- Colon cancer, or colorectal cancer, affects your large intestine (colon) or the end of your intestine (rectum). It is the third-most common cancer according to the American Cancer Society.
- The National Cancer Institute reports that since the 1990s colorectal cancer cases have been rising among adults younger than 50.
- The American Cancer Society reports colon cancer rates are on average 20% higher for African Americans compared to other racial groups.
When Ule Alexander was 35 and having cramps in his side, he thought maybe they were simply from gas or acid reflux. But the cramps didn’t go away, and they proved to be the first signs of stage 4 colon cancer.
Now 42, he’s raising awareness about the disease to help fight the taboo that exists within the African American community.
Read More
He suspected gas, gall bladder issues or acid reflux, but a trip to the emergency room helped reveal the true culprit.
The gastroenterologist said at the time, “You’re way too young for this to be cancer. But scans found a mass the size of a small ball in his lower colon.
On Aug. 26, 2015, he was 35 years old and was diagnosed with stage 4 colon cancer. By the time of his diagnosis, Alexander’s cancer had spread to his liver and lungs.
Alexander admitted that “he didn’t know if he would live to be 40.”
Although a cancer diagnosis can be extremely stressful, it’s important cancer warriors ask lots of questions, research their health condition and even seek second and third opinions if necessary.
Another thing SurvivorNet experts recommend is leaning on your family and friends to create a support group as they can help alleviate your anxiety. Unfortunately for Alexander, he did not have a support group.
He told Colon Club that his marriage ended by year’s end and he did not have close family or friends to lean on while he began his cancer journey.
“The mistake he admits making at the time was further isolating himself and not reaching out for support” leading to bouts with depression.
In these cases, experts recommend finding help through support groups or therapy to manage the emotions of dealing with cancer.
Fortunately, Alexander was able to find a positive mindset through a song called “You’re Gonna Be OK,” by Jenn Johnson.
“It was the first thing he listened to in the morning and was played on a loop on his way to work or treatment,” Colon Club said.
His treatment proved successful because the cancer survivor revealed his latest scans found no evidence of the disease.
Understanding Colon Cancer
Colon cancer, or colorectal cancer, is a type of cancer that affects your large intestine (colon) or the end of your intestine (rectum). It is the third-most common cancer according to the American Cancer Society in people of both genders in the United States, excluding skin cancers.
The cancer starts when abnormal lumps called polyps grow in the colon or rectum. These polyps can sometimes change into cancer if you don’t have them removed. It takes up to 10 years for a colon polyp to become full-blown cancer, according to SurvivorNet experts.
Most colon cancers can be prevented if people are regularly screened. The screening usually involves a colonoscopy, in which a long thin tube attached to a camera is used to examine the colon and rectum. If no polyps are discovered, the next screening won’t be needed for about 10 years.
“We know that colon cancers can be prevented when polyps are found early,” Dr. Heather Yeo told SurvivorNet. “Lowering the screening age helps somewhat with this, but access to care is a real problem,” Yeo added.
The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.
A preliminary staging workup is done after diagnosis with imaging studies, such as a computed tomography (CT) scan, which can show whether the cancer has spread. If you have had surgery to remove your cancer, a pathologist will look at it under a microscope to determine your stage.
- Stage 1 cancers are those in which the tumor has only penetrated the superficial layers of the colon and hasn’t gotten into the deeper layers
- Stage 2 cancers involve the deeper layers of the colon wall
- Stage 3 cancers have spread to the lymph nodes around the colon
- Stage 4 cancers have spread to other organs, such as the liver, lungs, or peritoneal cavity (the space in your abdomen that holds your intestines, stomach, and liver)
Colon Cancer Risk Factors and Symptoms
People older than 50 years old are at the greatest risk of developing colon cancer, with this age group making up about 90% of the cases.
Other risk factors for developing colon cancer include:
- Having inflammatory bowel disease.
- Having a family history of colon cancer.
- Not exercising very often.
- Eating a diet high in meat.
- Being overweight or obese.
- Using excessive alcohol and tobacco.
Colon cancer symptoms and warning signs include:
- Change in bowel movement
- Bloody stool
- Diarrhea, constipation, or feeling the bowel does not empty completely
- Unexplained weight loss
- Constant abdominal pain or cramps
If you notice symptoms or changes in your body, it’s important to discuss them with your doctor promptly.
Understanding Stage 4 Colon Cancer
Stage four colon cancer means that the cancer has spread from the colon to other organs. The most common sites for colon cancer to metastasize to are the liver, lungs, and peritoneum (the lining in your abdomen).
Each case is very different; therefore, the treatment options differ for each patient.
Chemotherapy, surgery, or a combination of therapies may be recommended, but individual recommendations depend on where the metastases are located and how widespread the disease is.
Some patients with limited metastases in only one organ may be recommended to undergo surgery, whereas chemotherapy may be indicated in patients who have many metastases or diseases at different sites.
WATCH: Determining Treatment for Stage 4 Colon Cancer.
Colon Cancer Impacting Younger People
While the average age people are diagnosed with colon cancer is 68 for men and 72 for women, according to the American Cancer Society, researchers are sounding the alarm on a growing and concerning trend.
The National Cancer Institute reports that since the 1990s colorectal cancer cases have been rising among adults younger than 50. Research published in CA: A Cancer Journal for Clinicians found that the proportion of cases in people younger than 55 “increased from 11% in 1995 to 20% in 2019.”
“We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population,” cancer epidemiologist and lead study author Rebecca Siegel said.
Researchers are still trying to determine why younger people are being diagnosed in greater numbers. Some experts point to risk factors which include obesity, physical inactivity, and smoking as a possible explanation for the increase.
“Some of those [risk factors] have become more common over the last 45 years, along with this rise in early-onset cases,” National Cancer Institute program director Phil Daschner said, according to the National Cancer Institute.
Andrea Dwyer from the Colorado School of Public Health suggests in addition to young people’s lifestyles, the foods they eat could play a role in increased colon cancer diagnosis.
“We don’t know for sure why we are seeing earlier onset and death from colon cancer,” Dr. Heather Yeo, a surgical oncologist who specializes in colorectal cancers at Weill Cornell Medicine, told SurvivorNet.
“It is likely a combination of factors, including diet and genetics as well as access to care and some environmental factors.”
Colon Cancer Among African Americans
While in survivorship, Alexander is spending much of his time nowadays supporting other cancer warriors battling colon cancer. He said he wants to be the support that he did not have when he first battled the disease.
More on Colon Cancer
- ‘Everyone Should Get Tested But Especially if You are a Black Man,’ Says Saxophonist James Casey Following Colon Cancer Diagnosis
- ‘JoJo’s Bizarre Adventure’ Star Billy Kametz, 35, Announces Stage 4 Colon Cancer, Will ‘Take Time Off’ Show
- ‘Country Ever After’ Star Criscilla Anderson, 41, is Still Grooving During Stage 4 Colon Cancer Battle, Works With Dallas Cowboys Cheerleaders
- ‘Country Ever After’ Star Criscilla Anderson, 40, Says She Could Be on Chemotherapy the ‘Rest of My Life’ for Advanced Colon Cancer
“He keeps tabs on several cancer patients across the country. They talk on the phone and Ule makes sure while checking on their health and scans to check on the rest of their lives as well,” Colon Club said.
While being a colon cancer survivor advocate, Alexander is also spreading awareness about colon cancer within the African American community.
The National Cancer Institute also found some groups of people are more affected by the rise in younger colon cancer diagnoses than others.
“Black people are still more likely to get colorectal cancer at a young age than white people even though the gap is shrinking,” Dr. Nathan Ellis with the University of Arizona Cancer Center said.
The American Cancer Society reports colon cancer rates are on average 20% higher for African Americans compared to other racial groups.
Dr. Cedrek McFadden, a Board Certified Colorectal and General Surgeon, points to cultural reluctance to open up about healthcare within communities of color, with the reason being the racial disparity.
“I sometimes see people in their 60s or 70s that have had years of symptoms and will come in and say I’ve had this for some time, but they just kept it to themselves, where they felt shameful and didn’t talk about those types of problems, or were prideful and that is to our detriment,” McFadden told Atlanta Black Star.
“[Alexander] wants to be a voice in the African American and minority communities to try to dispel some of the stigmas and taboos around colorectal cancer,” Colon Club said.
Learn more about SurvivorNet's rigorous medical review process.