Understanding Early-Onset Cancer: Why it was So Important for Kate Middleton

Cancer

In a recent revelation that has captured global attention, Kate Middleton, the Princess of Wales, shared her diagnosis of cancer, spotlighting an issue that is becoming increasingly prevalent: early-onset cancer. This development not only underscores the personal battles many face, regardless of their status but also casts a light on a concerning trend noted among younger populations.

Early-Onset Cancer: A Growing Concern

Data from the American Cancer Society indicates a worrying uptick in cancer diagnoses among adults aged 18-49. This age demographic, surprisingly, is witnessing an increase in cancer cases even as the overall cancer mortality rates improve. Such statistics emphasize a pivotal shift and necessitate a broader awareness and understanding, particularly within primary care settings.

The Role of Primary Care Physicians

For primary care physicians, the narrative of early-onset cancer brings forth a critical responsibility. These healthcare providers are often the first line of defense, playing a pivotal role in early detection and intervention. Understanding the nuances of early-onset cancer is imperative for timely referral and management, especially given the aggressive nature of certain cancers like breast and colorectal cancer in younger patients.

Family History and Risk Assessment

A significant aspect that emerges from recent research is the role of family history in cancer risk. It is now recognized that a robust family history can be indicative of heightened cancer risk, irrespective of the cancer type within the family lineage. Primary care doctors are, therefore, encouraged to delve deeper into familial health histories, guiding patients, when necessary, to specialized high-risk clinics for further evaluation.

Addressing Younger Populations

Primary care settings must adapt to the nuances of treating younger cancer patients, who may have different needs and concerns compared to older patients. For instance, the impact of a cancer diagnosis on fertility, mental health, and lifestyle plans can be profound and requires a compassionate, tailored approach.

Awareness and Education

Finally, primary care practitioners are at the forefront of patient education. They have the unique opportunity to inform and empower their patients regarding lifestyle choices that can influence cancer risk, the importance of vaccinations (like the HPV vaccine that has impacted cervical cancer rates), and the significance of participating in recommended screening programs.

In conclusion, the news of Kate Middleton’s diagnosis is a stark reminder of cancer’s indiscriminate nature. For our primary care doctors in Jupiter, it reaffirms the importance of vigilance, early detection, and a patient-centered approach in combating the rise of early-onset cancers. By fostering awareness, advocating for regular screenings, and embracing a proactive stance, primary care doctors can significantly contribute to the early identification and management of cancer, ultimately improving outcomes for younger patients.

Understanding the Rise of Colorectal Cancer in Young Adults: Insights from the Latest ACS Report

Cancer, Disease, Health Basics, Healthy Living, Preventative Health

The Alarming Statistics: A Closer Look

The American Cancer Society’s (ACS) recent report published in CA: A Cancer Journal for Clinicians brings to light a concerning trend: colorectal cancer is now among the leading causes of cancer deaths for young adults in the United States. The report, drawing data from central cancer registries and the National Center for Health Statistics, indicates a steady increase in colorectal cancer cases among adults younger than 50. In the late 1990s, it was the fourth-leading cause of cancer death in this age group, but as of 2024, it has escalated to be the leading cause of cancer deaths in men and the second-leading cause in women under 50. Our primary care doctors in Jupiter are here to give you the findings of this report.

Insights from Experts

Dr. Aparna Parikh, medical director of the Center for Young Adult Colorectal Cancer at the Mass General Cancer Center, expresses concern over these rising rates, especially among young men. The reasons behind this increase are complex. According to Dr. Parikh, it’s an interplay of various factors such as dietary, environmental, and possibly antibiotic exposures, combined with individual risk factors and early life exposures.

Risk Factors Revisited

Key risk factors highlighted by Dr. Parikh include:

  1. Family History: A significant risk factor for colorectal cancer.
  2. Lifestyle Factors: Obesity, smoking, heavy alcohol consumption, and a diet high in red and processed meats contribute to increased risk.
  3. Medical History: Inflammatory bowel disease and a personal or family history of polyps.
  4. Unexplained Cases: Interestingly, many people who develop colorectal cancer have no apparent risk factors, suggesting a complex interplay between genetic predisposition and environmental factors.

Prevention and Early Detection

The report emphasizes the importance of public awareness about early symptom recognition. Symptoms such as unexplained weight loss, blood in stool, anemia, or changes in bowel habits should prompt immediate medical consultation.

Dr. Parikh recommends early screening, stating that colonoscopy remains the gold standard, with screening starting at age 45. Stool-based tests are also viable options.

Lifestyle Recommendations

To lower the risk, adopting certain healthy lifestyle habits is crucial:

  • Limit red meat consumption.
  • Avoid smoking.
  • Engage in regular exercise.
  • Adopt a Mediterranean-based diet.

Broader Cancer Trends

The ACS report also notes that, while overall cancer mortality is declining due to earlier detection and improved treatments, several types of cancers, including cervical, breast, pancreas, and uterine corpus cancers, are on the rise among different age groups.

The rising trend of colorectal cancer among young adults is a stark reminder of the need for heightened awareness and proactive health measures. Regular screening, lifestyle modifications, and early symptom recognition are key in combating this disease. As primary care doctors, our role in educating, screening, and guiding patients is more crucial than ever in the face of these emerging trends.

Protect Yourself from the Common Cancer That Killed Kirstie Alley

Cancer

Like many fans of Kirstie Alley, our primary care concierge doctors in Jupiter were sorry to learn of her death at age 71. We were even more troubled to learn of its cause: colon cancer because many of these deaths can be prevented with early screening.

The National Cancer Institute (NCI) estimates that 151,000 cases of colorectal cancer will be diagnosed this year. Colon cancer is the second-most deadly cancer in the U.S., behind only lung cancer, and is the third most common type of cancer.

Alley’s family reported that her cancer was “only recently discovered.” While we don’t know details beyond her family’s brief statement, her longtime friend Taylor Dayne told The Daily Beast she hopes to raise awareness about how common colon cancer is. The singer, who went public this summer with her own colon cancer diagnosis, urged people to get regular screening tests.

“I say stay on top of your health, get your mammograms, get a colonoscopy at 40. I don’t think you have to wait until 50,” she said.

How Screening Helps

Colon cancer begins in the large intestine (i.e., the colon), the final part of the digestive tract. It typically affects older adults, although it can occur at any age. Award-winning actor Chadwick Boseman died of colon cancer in 2016 at age 43. Jay Monahan, husband of former “Today” show host Katie Couric, died of colon cancer in 1998 at age 42.

More recently, actors Ryan Reynolds and Rob McElhenney videotaped parts of their colonoscopies to raise public awareness of the disease. Doctors found both actors had polyps that were removed.

One 2017 study from the American Cancer Society (ACS) published in the journal JAMA showed that colon cancer deaths are not only rising among younger white people but that the cancers diagnosed in this population are more advanced and more deadly. Researchers found that new cases of colorectal rose more than two percent each year among those under 50.

The Mayo Clinic reports that colon cancer usually begins as small, noncancerous (i.e., benign) polyps (tiny bumps or mushroom-like stalks) that form in the lining of the colon. Over time, some of these polyps can become cancerous although they produce few if any, symptoms.

But with regular colonoscopies, these polyps can be found and removed before they become cancerous.

According to the American Cancer Society (ACS), treatment can depend on the cancer stage. For example, stage II colon cancer can grow through the wall of the colon, and patients may need surgery to remove part of the colon, which is what Dayne had done following a routine colonoscopy.

“I was prone to developing polyps, so I was more on top of it, but five months after my last colonoscopy I had another one done in July, and that’s when I found out,” she told The Daily Beast.

Symptoms and Risk Factors

Although there may be a few symptoms, they can often be mistaken for other conditions such as hemorrhoids or irritable bowel syndrome (IBS).

Some of the earliest symptoms may include rectal bleeding or changes in bowel movements such as diarrhea or constipation, or a feeling that your bowel doesn’t empty completely.

Other symptoms can include abdominal cramps, gas, or other pain, fatigue, anemia, decreased appetite, and weight loss.

Besides being over the age of 50, risk factors that may increase your risk of colon cancer include:

  • a personal history of colorectal cancer or polyps
  • inflammatory intestinal conditions such as ulcerative colitis or Crohn’s disease
  • a family history of colon cancer
  • a low-fiber/high-fat diet
  • sedentary lifestyle
  • diabetes or insulin resistance
  • obesity
  • smoking
  • heavy use of alcohol

Screening Tests Matter

Because anyone can get colon cancer, doctors recommend screening tests every 10 years beginning at age 45, but those with increased risk should consider screening sooner.

“Unfortunately, colon cancer doesn’t have a lot of symptoms until it’s advanced, which is why screening is so important,” Paula Denoya, director of the Colorectal Surgery Residency Program at Stony Brook Medicine, told NBC News.

Meanwhile, Joel Levine, co-director of the Colon Cancer Prevention Program at UConn Health told NBC News that the rising rates of the disease among younger Americans show no signs of abating.

“There’s an expectation there will be 15 percent of [all] colorectal cancers in people under 50 not too long from now,” he said, which is why he strongly recommends early screening.

“One of the reasons I’m so fussy about not waiting for symptoms is because it leads to, ‘Well, I feel all right, everything’s OK.’ And by the time you have a symptom, the horse is a little bit out of the barn.”

ACS guidelines emphasize individual preference and choice in testing options.

These are basically broken into two categories: stool-based tests, which are recommended every one to three years, and visual exams, including colonoscopy, every five to ten years, depending on risk factors. 

The ACS stresses that these screening tests must be repeated regularly to be effective and that any abnormal stool-based test result should be followed up with a colonoscopy, which it considers to be the gold standard in colorectal cancer screening.

And the best ways to avoid many types of cancer, according to the ACS, are to limit red and processed meats, consume a diet high in vegetables, fruits, and whole grains, avoid tobacco, maintain a healthy weight, get regular physical exercise, and limit alcohol consumption.

BREAST CANCER

What to Know During Breast Cancer Awareness Month

Breast Cancer, Cancer, Disease, Preventative Health

Long-time cancer-screening activist Katie Couric, 65, announced last month that she’d been treated for breast cancer. Within days came the news that WNBA star Tiffany Jackson had died of the disease at age 37.

These two stories help to highlight Breast Cancer Awareness Month in October, both the importance of screening and the fact that even young women can this deadly disease.

So our primary care concierge doctors in Jupiter want to offer you some facts you may not have known about breast cancer and what to look out for.

Some Little-known Facts

  • Breast cancer is the most common form of cancer in women in the U.S., except for skin cancers, according to the American Cancer Society (ACS). And contrary to common belief, 85 percent of American women who are diagnosed have no family history of the disease.
  • This year, about 287,850 new cases of invasive breast cancer will be diagnosed in women, with about 51,400 of those being ductal carcinoma in situ (DCIS). Nearly all women with this early stage of breast cancer can be cured.
  • About 43,250 women will die from breast cancer.
  • But it’s not just women. The ACS reports that in 2022, about 2,710 new cases of invasive breast cancer will be diagnosed in men, and about 530 of them will die from it.
  • And Yale Medicine reports that breast cancer is the most common form of cancer in women ages 15-39.

Screening Guidelines Vary

Although different organizations offer different guidelines for cancer screening, in general, regular cancer screening can catch cancer before someone has symptoms. This allows a small, localized area to be removed, hopefully before it can spread.

The U.S. Preventive Services Task Force (USPSTF), for example, recommends mammography screenings every two years (biennial) for women ages 50 to 74 years, while the ACS recommends such screenings annually for women ages 50 to 54 and every other year after that.

As for the standard clinical breast exam, the International Agency for Research on Cancer (IARC) states: “There is inadequate evidence that clinical breast examination reduces breast cancer mortality.” The American College of Physicians agrees. Even the ACS doesn’t recommend clinical examination to screen for breast cancer, preferring to emphasize mammography as the preferred method of detection.

The American College of Obstetricians and Gynecologists (ACOG) says, “Decisions between screening with mammography once a year or once every two years should be made through shared decision-making after appropriate counseling.” In other words, the benefits of annual mammography for those with average risk haven’t been firmly established, so it’s up to the woman and her doctor to decide on the frequency.

Different Outcomes

Katie Couric co-founded the organization Stand Up to Cancer after the death of her first husband, Jay Monahan, from colon cancer, so she was an advocate for regular cancer screenings. Still, her diagnosis stunned her.

Couric told CNN that she went for a mammogram in the summer, which found her breast cancer.

“I think those words, ‘It’s cancerous or you have cancer’ do stop you in your tracks,” she said. But her doctor told her it was treatable, so she underwent a lumpectomy in July, followed by radiation.

Unfortunately, as in the case of Tiffany Jackson, breast cancer is more likely to be found at a later stage among women under the age of 45, and is often more aggressive and difficult to treat.

She was originally diagnosed with stage three breast cancer in 2015 and thought her treatment had been successful.

But studies show that women who are first diagnosed before age 35 have between a 13-38 percent risk of recurrence that spreads to other parts of the body, while in women ages 50 and over, that risk is between 4-29 percent.

What To Do

Besides having the recommended mammographies, for both men and women of all ages, it’s important to know the risk factors for the disease as well as the early signs.

Risk factors include:

  • getting older
  • having dense breasts
  • a family history
  • hormonal changes
  • excess alcohol consumption
  • environmental factors, including exposure to radiation
  • obesity and overweight
  • beginning periods before age 12 and menopause after age 55
  • becoming pregnant at an older age or never being pregnant
  • taking hormones, including birth control pills and hormone replacement therapy
  • physical inactivity
  • night-shift work
  • smoking

It’s important to become familiar with your breasts, so you’ll know what symptoms to look for.

Warning signs include:

  • new lump in the breast or underarm (armpit)
  • thickening or swelling of part of the breast
  • irritation or dimpling of breast skin
  • redness or flaky skin in the nipple area or the breast
  • pulling in of the nipple or pain in the nipple area
  • nipple discharge other than breast milk, including blood
  • any change in the size or shape of the breast
  • pain in any area of the breast

The CDC cautions, “Keep in mind that these symptoms can happen with other conditions that are not cancer,” so don’t panic if you see any of them. But do contact us right away if you do see such changes.

Remember, the sooner breast cancer is caught, the easier it is to treat.