Understanding Colon Cancer
- Adrienne Ford, a 31-year-old Ohio resident with stage 4 colon cancer, was diagnosed after abdominal discomfort following ice cream prompted an ER visit that led to imaging showing liver metastases, and further testing to discover where the cancer derived from.
- Colon cancer is very treatable and curable if caught early. Colon cancer screening, such as a colonoscopy, is an effective way to not only see signs of cancer but also possibly remove it before it has a chance to develop into full-blown cancer.
- A colonoscopy involves a long, thin tube attached to a camera that examines the colon and rectum for polyps (small growths in the colon that aren’t yet cancerous). If polyps are found, doctors can remove them during the procedure.
- Colorectal screenings are recommended to begin around age 45. However, people at increased risk—such as those with a family history of the disease—may want to screen sooner. Discussing your screening options with your doctor is recommended.
Ford, a physician assistant (PA) who was diagnosed with the disease at age 31 and often takes to social media to share her journey, recently told Newsweek how her diagnosis came as a complete shock because she “worked out five to six days a week, lived a very active lifestyle, watched [her] water intake and never smoked.”
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Ford noted how she could feel “discomfort” in a specific area of her digestive tract, but she likened it to normal indigestion or feeling like she needed to pass gas.
Recounting how she hadn’t thrown up, she’d had normal bowel movements, and she wasn’t in pain, she said, “everything was normal aside from the discomfort I was feeling.”
She ultimate chose to go to the ER when one of her friends, who was a PA was working, and it’s a decision she describes as life-saving.
Her lab work ultimately came back “completely normal,” and despite not having other symptoms, Ford considers herself lucky to have been able to get a CT scan done, which revealed she had “a lot of lesions in her liver that look like metastatic disease.”
The finding prompted more testing to be done, to figure out where the cancer could have come from. A colonoscopy ultimately confirmed she had colon cancer.
She then shared that her body had a positive response to chemotherapy, but more resent posts on her social media account reveal she has had setbacks and cancer recurrence.
@alignwithadrienne This is part 2 of the story of how I found out I had stage 4 colon cancer at 31 years old. This video includes what prompted me to get checked out and how I was diagnosed. See part 1 for my symptoms leading up to my diagnosis See part 3 for how I was diagnosed (cont.) and where I am now. And please don’t ignore your gut (literally) if something feels off in your body. Advocate for your health. Advocate for your life. #cancerjourney #coloncancerawareness #colorectalcancer #cancer #cancerinyour30s
Despite her ongoing journey, Ford continues to stay positive. In one of her most recent Instagram posts, she writes, “When life hands you circumstances that are challenging, it is so easy to fall into asking “why me?’ Your feelings that things are unfair are valid.
“This was me, challenge after challenge it seemed in my life. Still healing from the ending of a 10yr relationship, trying to figure out what was next for me in life, and then PLOP I’m handed a cancer diagnosis.
Expert Colon Cancer Resources
- Colon Cancer Symptoms
- Colon Cancer Screening is Extremely Important; Guidelines Now Say to Start at Age 45 if There Is No Family History
- Colon Cancer Screening Options And Genetics: Myth Busting With Dr. Heather Yeo
- Colon Cancer: Introduction to Prevention and Screening
- Identifying KRAS Mutations To Personalize Colon Cancer Treatment
- How to Approach Treatment for Advanced Colon Cancer
- Why a Tailored Approach to Colon Cancer Treatment Matters
She continued, “Why me?!? I asked relentlessly in the beginning. But slowly, I began to sit with the experience that had been handed to me, very much against my will initially, and instead of rage against it, I slowly began to surrender to it. I accepted that this was what I was facing.
“From there, in this space, when I let go of the resistance, I could then ask a very different, very powerful question, that changed everything: Instead of ‘why me?’ I started to ask: ‘What is here for me?’ And from there, everything changed. My life has never felt more full. I’ve never felt more grateful and aligned in my life, despite going through cancer. And it all began with a perspective shift – what is here for me?”
@alignwithadrienne Never in a million years did I think this was news I would be sharing, but here we go: At the end of January, in the blink of an eye, my entire life changed. Out of what felt like nowhere, I was diagnosed with advanced stage colon cancer and within a week from getting the diagnosis, I had a port placed and was started on chemotherapy. The rapid pace at which everything transpired, left me, along with all of my loved ones, needing time and space to process it all. It has been a wild journey since receiving the diagnosis, with so many ups and downs and in-betweens. I am now a few months in from the diagnosis, and several rounds into chemotherapy and I am so grateful to report that my body is showing a great response to treatment. There is so much more than I can and will share, but for now what I want to say is this: Life is wildly unpredictable, and I’ve never felt that at such a depth as I do now. And while the unpredictability can be extremely terrifying, I also see now how many gifts it can bring as well. It reminds us that we are human. It reminds us that we are alive. It reminds us that every day we have here is a gift. And what a beautiful thing to be so deeply aware of. While this is by far the scariest and most difficult thing I have ever had to face, since the diagnosis, I have also felt the most love, the most support, and even the most gratitude I think I have ever felt in my life. Something I know deeply to be true is that every challenge we face in life, even a diagnosis of cancer, comes with its own gifts, beauty, and opportunities for growth. And while it may be difficult – we just have to be willing to look for it. So as for me now, I am filled with hope and determination to get through this, and I am taking it the only possible way a person can – one day at a time. I’ve had people ask what they can do to help or support me – I will be linking a Go Fund Me in my bio if that is something you want to contribute to, but otherwise your loving, positive, healing thoughts are so appreciated as well. Sending love, Adrienne
Ford stresses that the two ways she’s been able to find continued joy and gratitude throughout her metastatic cancer journey is through being present and able to accept what she cannot control.
She captioned another post, “Practicing presence allows us to become aware of all of the beauty, love, and abundance around us. It takes us out of past thinking and future anxieties, and plants us in the here and now. While in the present moment you can still choose to focus on what’s NOT going right in your life, it gives you the opportunity to focus on all that is GOOD in your life too. Ultimately that choice is up to you, but presence is where you begin.
“Acceptance helps us let go of resistance. Resisting our realities and the challenges we face only makes us feel worse. It compounds the feelings of anger, grief, or despair we might be feeling and leaves us feeling helpless or in victimhood. Finding true acceptance for our circumstances, even having cancer, gives us the opportunity to find empowerment and take control over how we view the situation.”
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Colon Cancer in Younger Adults
The average age at which people are diagnosed with colon cancer is 68 for men and 72 for women, according to the American Cancer Society.
However, 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 cases in people younger than 55 “increased from 11% in 1995 to 20% in 2019.”
WATCH: Debunking misconceptions about colon cancer.
“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 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. Yeo told SurvivorNet.
“It is likely a combination of factors, including diet and genetics as well as access to care and some environmental factors,” Dr. Yeo added.
Understanding Advanced Colon Cancer
Stage four or metastatic colon cancer means that the tumor has spread outside of the colon to different organs. In some instances, tumors that have spread to one or two places within the liver or lung can be treated surgically with a chance of cure. For most people, however, the treatment for metastatic disease is chemotherapy.
“The first-line chemotherapy for metastatic colon cancer, if they’ve not seen any other chemotherapy before, is the standard FOLFOX,” Colorectal Surgeon and Surgical Oncologist Dr. Heather Yeo at Weill Cornell Medicine and NewYork-Presbyterian explained to SurvivorNet.
“Most colon cancers do respond to FOLFOX. If you respond really well, then we keep you on that until you stop responding really well. But if after a few cycles your disease has progressed, that’s when we think about adding additional chemotherapies,” Dr. Yeo continued.
WATCH: Managing Metastatic Colon Cancer
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 a full-blown cancer, according to SurvivorNet experts.
“When we see a polyp, we actually physically take the polyp out through the colonoscope,” Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center, explained.
WATCH: When to get a colonoscopy
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 examines the colon and rectum. If no polyps are discovered, the following screening won’t be needed for about ten years.
What Treatment Options Exist for Colon Cancer?
“There are a lot of advances being made in colorectal cancer,” Dr. Yeo previously told SurvivorNet.
Colon cancer treatment is more targeted, meaning doctors often test for specific changes or genetic mutations that cause cancer growth.
Biomarkers are key to tailoring specific treatments. Biomarkers are molecular patterns becoming more commonly used in colon cancer diagnosis, prognosis, and management. According to the National Cancer Institute, a biomarker is “a biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or a condition or disease,” such as cancer.
“In colon cancer, we’re starting to look more and more at people’s biomarkers, so we’re starting to take the cancers, sequence them, understand where the different mutations are to figure out whether or not someone has a normal gene here or an abnormal gene,” Dr. Yeo explained.
“Those are the areas that people want to be able to target a little bit more. We’re getting close to more what we would call precision medicine, meaning we can start looking at people’s genetic mutations and think about how they might respond to different drugs.”
There are different types of biomarkers, including DNA, proteins, and genetic mutations found in blood, tumor tissue, or other body fluids. The biomarkers most commonly used in colon cancer management are:
- Genetic mutations within the tumor, such as MMR/MSI, KRAS, BRAF, and HER2
- Bloodstream carcinoembryonic antigen (CEA)
CEA is a protein produced by most tumor cells (but not all) and can be picked up in the bloodstream. High CEA levels do not establish a colon cancer diagnosis. However, higher CEA levels correlate with a worse prognosis and potential metastasis. Carcinoembryonic antigen is important for post-treatment follow-up to ensure the cancer hasn’t returned. Be sure to check with your doctor before treatment starts to ensure a CEA blood sample has been obtained.
More on Treating Colon Cancer
Surgery and chemotherapy are common approaches to colorectal cancer.
Some examples of Food and Drug Administration (FDA) approved chemotherapy drug treatments include:
- FOLFOX: leucovorin, 5-FU, and oxaliplatin (Eloxatin)
- FOLFIRI: leucovorin, 5-FU, and irinotecan (Camptosar)
- CAPEOX or CAPOX: capecitabine (Xeloda) and oxaliplatin
- FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and irinotecan
- Trifluridine and tipiracil (Lonsurf)
WATCH: Understanding Your Options with Metastatic Colon Cancer
Among metastatic colon cancer patients, multiple treatment options exist, including surgical and non-surgical options.
One treatment option includes an oral treatment called Fruquintinib, which is a targeted therapy for adults who have metastatic colorectal cancer and have tried other treatments. Results from a trial recently published showed the drug improved overall survival and progression-free survival, which measures the amount of time before the cancer returns or spreads. It works by blocking the growth of blood vessels, which increases tumor growth.
Once you get to the metastatic setting, many patients “just run out of options,” Jennifer Elliott, head of solid tumors at Takeda, explained to SurvivorNet at last year’s ASCO Annual Meeting. So it was critically important for Takeda to do this deal to in-license fruquintinib. We hope to give patients another option.”
Fruquintinib has been approved in China since 2018 and was originally developed by the Chinese biopharmaceutical company HUTCHMED. Takeda Oncology acquired the exclusive worldwide license for the drug outside of mainland China, Hong Kong, and Macau in January 2023.
More on Colon Cancer
Colon cancer is very treatable and curable if caught early. Colon cancer screenings can involve at-home tests such as Cologuard, but a colonoscopy is more effective, according to SurvivorNet experts.
The cancer starts when abnormal lumps called polyps grow in the colon or rectum. It takes up to 10 years for a colon polyp to become full-blown cancer, according to SurvivorNet experts.
The American Gastrointestinal Association lowered the recommended initial age for colorectal screening from 50 to 45. However, experts recommend screening earlier for some people who may be at an increased risk of developing colon cancer, such as those with a family history of the disease.
WATCH: Debunking misconceptions about colon cancer.
The most poignant signature of colon cancer includes a change in bowel habits. This may include constipation or diarrhea due to changes in the size or shape of bowel movements. A change in stool color, particularly black or tarry stools, can indicate bleeding from a tumor that lies deep in the colon.
Other symptoms can be harder to pinpoint, such as abdominal pain and unintentional weight loss. Finally, some tumors bleed a small amount over a long period of time, resulting in anemia (low red blood cell count) that is picked up on blood work.
Colon Cancer: Symptoms & Diagnosis
If You’re Battling Colon Cancer, These Are Important Questions To Ask After a Diagnosis
- Has genetic testing been performed to assess for hereditary colon cancer syndromes?
- What kind of surgery is needed?
- Following surgery: What were the findings regarding margins and lymph nodes?
- What chemotherapy regimen is recommended, including the medications and number of treatment cycles?
- Is there a post-treatment follow-up plan, including any imaging, colonoscopies, or blood work?
- How can a patient maintain quality of life and cope with treatment side effects?
- Is it possible to resume work and family activities during treatment?
- How can diet and lifestyle be adjusted to help manage side effects and support recovery during colon cancer treatment?
Contributing: SurvivorNet Staff
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