Preventing Advanced Stage Colon Cancer
- Cassandra Costley was just 32 years old when she began experiencing rectal bleeding and pain that would “come and go.” She initially dismissed symptoms as hemorrhoids, but six years later, was diagnosed with stage 4 colon cancer. Now, she’s undergoing intensive chemotherapy to combat the advanced cancer, which she stresses could have been caught earlier if she investigated symptoms.
- Colon cancers start out as a polyp, or small growth, in the colon that often cause no symptoms. Polyps can’t be felt, but they can be picked up by screening tests, like a colonoscopy, before they cause issues. It takes up to 10 years for a colon polyp to become a full-blown cancer, which gives doctors time to remove them.
- The U.S. Preventive Services Task Force recommends that colon cancer screenings begin at 45-years-old. This is in response to a rise in colon cancer diagnoses in younger adults.
- Costley is using her story to inspire others to get regular colonoscopies — and speak up if you start to feel symptoms that could be colon cancer, such as a change in bowel habits.
With the New Year just around the corner, 38-year-old Costley’s colon cancer journey is an exemplary reminder of how important it is to prioritize cancer screenings, like colonoscopies, and not to ignore symptoms.
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She realized something was off with her body earlier this year when she “struggled to function” while experiencing changes in her bowel habits, fatigue, and a low appetite.
Six years after she initially noticed rectal bleeding in 2018, she had a colonoscopy — which revealed her diagnosis.
Costley told TODAY.com, “It’s not something that people are really comfortable talking about still, bleeding and bowel habits. [That] means it doesn’t get talked about, and so I thought I can do that. It’s not hard for me to talk about it.”
Expert Resources On Colon Cancer
- ‘You Shouldn’t Die From Embarrassment’: Colon Cancer Can Be Prevented
- Anxiety Around Colon Cancer Diagnosis
- Colon Cancer Screening Options And Genetics: Myth Busting With Dr. Heather Yeo
- Colon Cancer Screening is Extremely Important; Guidelines Now Say to Start at Age 45 if There Is No Family History
- FDA Approves Blood Test for Colon Cancer Screening — What This Means for Patients
- Screening for Colon Cancer At Home: The New Approval for Younger People — Still Not a Substitute for a Colonoscopy
- Can Sitting The Wrong Way While You Poop Increase Your Risk Of Bowel Or Colon Cancer? Assessing The Risks Of Sitting Vs Squatting
- A Coffee Enema Will Not Prevent Colon Cancer
- 5 Possible Signs of Colon Cancer; Don’t Be Afraid to Look in the Toilet!
- Biomarkers in Colon Cancer: Understanding KRAS, BRAF, and HER2
The Utah resident admitted that her symptoms went away after undergoing a lap-band (laparoscopic adjustable gastric band) surgery for weight loss.
However, when the “hemorrhoids” returned with some bowel changes, Costley recounted, “All day long I felt like I had to have a bowel movement. It was exhausting and really weird, and for some reason I still didn’t bring it up [to my doctor].”
She waited until her symptoms affected her lifestyle to seek medical help and thankfully she underwent a colonoscopy, which ultimately showed the tumor that needed biopsy. After a biopsy, CT scan, and MRI, she was informed she had invasive adenocarcinoma, which spread to her liver and potentially her lung.
The National Cancer Institute explains that adenocarcinoma is “cancer that forms in the glandular tissue, which lines certain internal organs and makes and releases substances in the body, such as mucus, digestive juices, and other fluids” and “most cancers of the breast, lung, esophagus, stomach, colon, rectum, pancreas, prostate, and uterus are adenocarcinomas.”
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“When I met the GI surgeon, she explained that the tumor is a T3, which is the most advanced type, because it’s grown through the colon … (and) to go in and take it out would be dangerous because they can’t get clean margins,” she added.
Her doctor then put her on a three-month plan of “aggressive chemotherapy” plan before determining the next part of her treatment journey.
She said if the chemo worked and shrunk the tumor in her colon, her doctor would possibly be able to remove it.
Despite Costley’s health struggles, the mom of one is still able to remain positive and grateful for what she has.
In an uplifting Instagram post from last month, Costley shared a video clip of her shopping in a supermarket while embracing her shaved head and wearing a cozy onesie, writing, “Find ways to smile. Even when life seems overwhelming, frustrating, and impossible, find ways to feel joy. Do things that make you smile.”
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Costley, who had her 12-year-old daughter and loving husband by her side through her cancer fight, continued, “I have felt so beat down lately, while going through #chemo to treat Stage 4 Colon Cancer. But I try to make sure that I smile. I try to make sure I find ways to feel joy and happiness, even if those feelings are fleeting when I’m in pain and so sick.”
In an effort to inspire others to get checked sooner so they can prevent getting cancer at a late stage, Costley insists that if she was truthful about her symptoms to her doctors “years ago” she would have received her diagnosis sooner.
“If I had told them years ago when I started feeling it, they could have just taken it out before I spread to my body,” she explained in another Instagram post. “Colon cancer is highly preventable if people are aware of the symptoms, aware of what to look for, and aware that you need to talk to your doctor.
“I’m going to share this message so people can get their colonoscopies.”
Colon Cancer in Younger Adults
The average age people are diagnosed with colon cancer is 68 for men and 72 for women, according to the American Cancer Society — but the rate at which younger adults are diagnosed has been on the rise. The U.S. Preventive Services Task Force recommends that adults aged 45 to 75 be screened for colorectal cancer.
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.”
Researchers are still trying to determine why younger people are being diagnosed in more significant numbers. Some experts point to risk factors, which include obesity, physical inactivity, and smoking, as a possible explanation for the increase.
“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.”
Understanding Colon Cancer
Colon or colorectal cancer affects your large intestine (colon) or the end of your intestine (rectum).
The cancer starts when abnormal lumps called polyps grow in the colon or rectum. If you don’t have these polyps removed, they can sometimes change into cancer. It takes up to 10 years for a colon polyp to become full-blown cancer, according to SurvivorNet experts.
Looking for Polyps During Colonoscopy
Most colon cancers can be prevented by regular screening. The screening usually involves a colonoscopy, in which a long, thin tube attached to a camera examines the colon and rectum. If no polyps are discovered, the next screening will not be needed for about 10 years.
“We know that colon cancers can be prevented when polyps are found early,” Dr. Yeo explained. “Lowering the screening age helps somewhat with this, but access to care is a real problem.”
What are Colon Polyps?
A colon polyp is a small group of cells that forms on the colon’s lining.
When you have a colonoscopy, the gastroenterologist looks for polyps inside your intestine. Although polyps can’t be felt, they can be picked up by screening tests before they become cancerous.
Almost all polyps that are removed are precancerous, meaning that they have not yet progressed to cancer.
WATCH: Helping You Understand Colorectal Cancer
A Colonoscopy Explained
A colonoscopy is a procedure doctors use to screen for colon cancer by looking inside your colon.
This procedure requires your colon to be “cleaned out.” To clear out your colon, your doctor will prescribe a “bowel prep,” a liquid you drink the night before the procedure. The prep acts as a laxative that causes you to have multiple loose stools before your procedure.
Once your colon is cleared, the gastroenterologist performing the procedure can have a clear look to evaluate if any polyps or masses are present. Depending on the size and number of polyps found, it may be recommended that patients undergo a repeat colonoscopy within three to five years.
Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center, previously explained the colonoscopy procedure to SurvivorNet.
“When we see a polyp, we actually physically take the polyp out through the colonoscope,” he explained. “What does that mean? That means we basically put a wire through with a little bit of a flange at the end, and we pull the polyp out. Now, note there is no pain with that. Inside the colon, there are no pain fibers. So there’s no pain,” Dr. Murrell added.
The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on colonoscopy before they develop or when the polyps are small enough to be removed without surgery.
What Increases Your Risk for Colon Cancer?
For some people, certain factors can increase their risk of getting colon cancer.
They include the following:
- Age. About 90% of cases are in people aged 50 or older, according to the U.S. Centers for Disease Control & Prevention (CDC). Yet it is possible to get this cancer earlier in life.
- Inflammatory bowel disease. Crohn’s disease or ulcerative colitis can, over time, cause cells in your intestines to turn cancerous.
- A family history of this cancer. Just under one-third of people who get colon cancer have family members with the disease.
- A genetic mutation. About 5% of colorectal cancers are caused by an inherited genetic mutation that causes syndromes such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (Lynch syndrome).
- Lack of exercise. Staying active can lower your risk.
- A diet that’s high in meat. Regularly eating red meats like burgers and steaks, and processed meats such as hot dogs and bacon might put you at higher risk. Eating more fruits, vegetables, and whole grains instead might lower your risk.
- Being overweight or obese. Having too much weight increases your risk of both getting colon cancer and dying from it.
- Alcohol use. Limiting alcohol to one drink daily for women and two drinks daily for men could help lower your risk.
- Tobacco use. Long-term smokers are more likely to get this cancer than nonsmokers.
Questions to Ask Your Doctor
If you are facing a colon cancer diagnosis, here are some questions you may ask your doctor.
- What are my treatment options based on my diagnosis?
- If I’m worried about managing the costs of cancer care, who can help me?
- What support services are available to me? To my family?
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
