Before she was diagnosed with colorectal cancer at 37-years-old, Mariah Thompson said she was good at explaining away her problems.
Symptoms can include bowel issues, belly pain and bleeding. In Thompson’s case, her excessive bleeding finally led to an appointment with her doctor. After a colonoscopy, scans and some double-checking from her provider, Thompson's cancerous mass was removed in surgery.
Twenty percent of colon cancer patients are younger than 55, according to the Cancer Research Institute, and deaths rates are increasing. The American Cancer Society predicts more than 55,000 people will die from colon cancer this year.
“It's really important that this gets detected early, because it's very treatable,” Thompson said.
Dr. Bret Spier, a gastroenterologist with Indiana University Health, said embarrassment is the biggest hurdle in stopping colon cancer.
That’s one reason why Thompson waited so long to tell her doctor.
“I would definitely encourage people to speak up sooner,” Thompson said. “I feel like, if I would have said something sooner, then maybe I wouldn't have had to have such invasive treatment.”
Spier said there is only one test to prevent colon cancer: colonoscopies.
Colon cancer starts as an asymptomatic polyp, Spier said. It can take years, sometimes more than a decade, for those polyps to become cancerous.
“When you have symptoms, it may be more advanced, so you don't have as much time,” Spier said. “When you're feeling good and you're not having any symptoms, that's when you want to have the preventable test.”
Spier said doctors now recommend colonoscopies for 45-year-olds. People with a family history of colon cancer should have screenings even sooner.
“The screening age has actually gone from 50 to 45, because we've been finding too many cancers in 50-year-olds,” Spier said.
Doctors aren’t robots, Spier said, and patients might want to find a provider that gives consistent results in colonoscopies. He said patients can research their doctor’s adenoma, or polyp, detection rate.
“For instance, nationally, everybody that does colonoscopy should find adenomas in about 40 percent of men and 30 percent of women,” Spier said. “If you have an under-performer, you may not necessarily want to go to that person, as opposed to someone that performs above the national average.”
Colonoscopy prep usually takes about 24 hours, Spier said. Sometimes patients can drink lots of liquids, he said, or they can prepare with a pill. Spier said patients can opt in or out of sedation, too.
The test itself is fairly quick. In Thompson’s case, it lasted eight minutes.
These procedures are a team effort, Spier said.
“The quality of the bowel preparation when we do colonoscopies is on the patient,” Spier said. “They need to do a really good job of getting everything cleared out so that we can see.”
After losing her mother to pancreatic cancer, Thompson said she was emotional even before her first procedure.
Her original results from the colonoscopy showed she didn’t have cancer, but Spier kept looking into it.
She eventually had a lower interior resection, surgery that removes part of a rectum, and a temporary ostomy. But Thompson didn’t need chemotherapy, because doctors found the cancer early enough.
“I am considered cancer free right now,” Thompson said. “In five years, I will be able to say that I'm cured.”
Thompson encourages other young people to advocate for themselves and have an open relationship with their providers.
“You need to ask questions,” Thompson said. “If you don't understand something, you need to make them stop. You need to make them explain in terms that you can understand.”
According to the American Cancer Society, some lifestyle choices could increase the risk of colon cancer. Smoking, drinking alcohol, being overweight and eating lots of red or processed meats are all risk factors.
Spier said the increases in colon cancer might be due to environmental exposure, but there’s no absolute research on that.
“I think anything that we're exposed to — if they're preservatives, if they're not organic, not natural — can be affecting your body,” Spier said. “Certainly, having higher fiber diets is very important as well.”
