They thought they had IBS or celiac disease. It was colon cancer.
Colon cancer cases are on the rise, including in people under 45.
Early symptoms include bloating and abdominal pain, which can be confused with GI disorders.
Doctors shared why colon cancer can be misdiagnosed, and when to get a colonoscopy.
Years before she was diagnosed with colon cancer at 40, Tracy Robert chalked up her bloating to an IBS diagnosis. She was a personal trainer and nutrition coach who followed a clean diet but felt constantly uncomfortable.
"I remember feeling a sense of heaviness when I would go to the bathroom," Robert, now 50, told Business Insider.
She says she wishes doctors took her "symptoms and concerns seriously." She believes if they had screened her for colon cancer sooner, they might have caught it before it reached stage 2B-3A. By the time Robert was diagnosed, she needed to have part of her large intestine removed, replaced by a colostomy bag.
Robert's story is not uncommon. More people are being diagnosed with colon cancer under the age of 45, the age at which Americans start getting screened for it. In our peer nations, like Canada, screening starts at 50.
Symptoms that might warrant earlier testing can be easily overlooked. Common signs of colon cancer, like constipation or diarrhea, can also be caused by GI-related issues like celiac disease or gluten intolerance.
Take Shannin Desroches, a 27-year-old from Ontario, Canada who buckled in pain after every meal. She was pursuing bloodwork to check for celiac disease, but her symptoms got too severe and she checked into urgent care. Tests revealed multiple tumors throughout her body. At 26, she had stage 4 colon cancer.
For doctors, it's a tricky tightrope to walk when they're diagnosing young patients. About 45% of Americans have digestive issues, many of which have crossover symptoms with colon cancer. Because colonoscopies cost around $2,000 on average, doctors typically won't urge young patients to get a colonoscopy without serious symptoms or a family history of colon cancer.
As colon cancer rates continue to rise worldwide, being able to tell the difference can change the trajectory of a patient's treatment.
The most common colon cancer symptoms in people under 50 include abdominal pain, altered bowel movements, constipation, bloating, and diarrhea. In many cases, like Desroches', severe symptoms don't show up until later stages.
Depending on where the tumor is, those symptoms might be very mild at first, Dr. David Richards, a gastroenterologist at the MD Anderson Cancer Center, told Business Insider.
If a tumor grows in the center of the colon, it might go undetected or produce mild discomfort. "It hasn't yet gotten big enough or invaded into adjacent structures enough to start really causing symptoms," Richards told BI. On the surface, it might look like a gluten allergy or gastrointestinal issue.
People diagnosed with GI disorders are often advised to make dietary changes.
Desroches started trying to offset her symptoms by eating smaller snacks, but her stools remained thin and she had constant pain in her abdomen. Robert, who was diagnosed with IBS at 20, remembers being told to "eat more fiber."
For some people, diet tweaks can temporarily reduce symptoms of colon cancer, creating "a false-positive response to diet change," Dr. Mohammed Najeeb Al Hallak, an oncologist specializing in GI malignancies at the Karmanos Cancer Institute, told Business Insider.
For example, following a gluten-free diet to treat celiac disease can make stools firmer by reducing inflammation in the small intestine. Less inflammation can also lessen colon cancer symptoms, he said.
If a person has colon cancer, he said these positive changes are temporary — and may delay the diagnosis.
The medical community is still debating about the best age to start annual screenings. Research on rising rates changed the recommended screening age from 50 to 45. "Some people argued about lowering it even more because we've been seeing colon cancer popping up more often in younger populations," Richards said.
If you're under 45, there are some "alarm symptoms" to look out for. Anemia, bright red or black stools, unexplained weight loss, trouble swallowing, and fever are all signs to take your symptoms more seriously.
Al Hallak said to always get a second opinion if you feel dismissed by your doctor. For example, celiac disease requires a biopsy and blood tests to confirm the diagnosis — never accept "it's probably celiac" without those tests. See someone who takes your pain seriously, especially if the symptoms don't improve.
Read the original article on Business Insider
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And so instead of having to pay $9,000 again the next year, you pay only $2,000. Oyin Adedoyin: Wow. Those costs are really adding up. Gail, what are some possible solutions and ways that people can either prevent the situation or navigate it? Gail Marks Jarvis: Before they ever retire, while they're still on regular insurance, go to that community that they think they're going to live in, find a doctor, and get accepted by that doctor as a patient. They still could get turned down later when they go on Medicare, but doctors tend to continue to take patients that they have had even when they go on Medicare. A second step is just to realize that, for example, Florida is a place people go to cut their taxes, but they may have extra expenses, like they may pay more for medical care. So all of these things are things to think about in advance of retiring. Oyin Adedoyin: Speaking of in advance, Gail, I'm 25. This is all blowing my mind right now. I have a 401k through my job, and that's it. What can I do now to ensure that I don't end up in that predicament where I'm underestimating future medical costs by the time I'm retired? Gail Marks Jarvis: Well, it sounds like you're aware of the rule of thumb that when you go to retire, you want at least 10 times what you were making. But the other thing is, every year you should try to maximize what you're putting in your 401k, and you should make sure that you're at least getting the employer match. I have been shocked at the number of young people who say, "Oh, I have student loans. I'm busy. I can't figure out the 401k." And they skip it even though their employer would give them free money. Some of that free money, if you start in your 20s, that's liable to be like $250,000 of free money by the time you go to retire. So you don't want to ever give up that free money. Oyin Adedoyin: That's WSJ contributor Gail Marks Jarvis, and that's it for Your Money Briefing. This episode was produced by Ariana Aspuru with supervising producer Melony Roy. I'm Oyin Adedoyin for the Wall Street Journal. Thanks for listening.
