Colon Cancer in Young Adults: A Puzzling New Patient Population

By Patrick Zickler

Austin Thomas
Despite Austin Thomas’ young age at
diagnosis, nearly two years later there is
no sign of her colon cancer, thanks to a
comprehensive treatment plan. Photo courtesy of Yvette Rattray

Austin Thomas is young and fit and has always been careful about what she eats. She earned a master’s degree in nutrition in part to understand the digestive problems that had bothered her since she was a teenager, which included bloating, diarrhea, sometimes rectal bleeding and often discomfort or pain. But a week before her 27th birthday, she began experiencing intense pain that was unlike her usual symptoms.

“I had never felt anything like it. And I was so bloated I looked pregnant,” Austin says.

She called her parents and headed for the hospital, where a gastroenterologist examined her and scheduled a colonoscopy. She woke up in a recovery room and the doctor told her they had found a mass in her colon. She had stage 4 colon cancer, and it had spread to her liver.

Uncertain but determined, Austin asked her doctors, friends and family for recommendations for an oncologist. That led her straight to John Marshall, MD, at MedStar Georgetown University Hospital.

Dr. Marshall, chief of hematology and oncology at MedStar Georgetown, sees a lot of colorectal cancer. Increasingly, he sees cancer in patients who represent a puzzling new pattern.

“Why Austin?” Dr. Marshall wonders. “And why so many other young patients? When I was a medical student, we learned that colorectal cancer is something that targets 50- to 70-year-olds. Now, we are seeing patients in their 30s, even in their 20s.”

According to the Colon Cancer Alliance, the incidence of colon cancer is steady or declining in older age groups but is increasing in people 50 and under. And in younger patients like Austin— a dietitian and nutritionist who lives in Reston, Va.—the disease advances more aggressively than in older patients.

After surgeons removed tumors from Austin’s colon and liver, MedStar Georgetown cancer specialists developed a comprehensive treatment plan designed specifically to attack her cancer.

“Cancer care at MedStar Georgetown involves a multidisciplinary approach, and it’s different for each case,” says Dr. Marshall. “Patients are not alike, and neither are their cancers.”

MedStar Georgetown oncologists use techniques such as molecular profiling to identify specific biological markers that unveil each tumor’s genetic blueprint. This approach allows the oncology team to choose treatment options that have been most successful in treating that specific tumor type. If the cancer changes, treatment is refined to stay focused and effective.

“Treatment involves more than medication,” Dr. Marshall says. “Our approach involves the whole person.”

For Austin, that meant support from surgeons, interventional radiologists, gastrointestinal specialists, nutritionists, and an oncology nurse who helped navigate the frightening and complex passage. Now, nearly two years after she was diagnosed, there is no sign of her cancer.

Like Dr. Marshall, Austin wonders why a healthy 20-something-year-old would get colon cancer, and why more and more young people are being diagnosed. The answers are still elusive, but for Austin the underlying message is simple: Be aware of the warning signs, and if your symptoms hint at the possibility of colon cancer, “Get a colonoscopy. Absolutely. It doesn’t matter how old you are.

Austin Thomas is just one of a growing population of young colon cancer patients seen by John Marshall, MD. Following treatment, Austin is back to her regular activities and recently participated in a run for colon cancer awareness in Washington, D.C.  Photo courtesy of Yvette Rattray
Austin Thomas is just one of a growing population of young colon cancer patients seen
by John Marshall, MD. Following treatment, Austin is back to her regular activities and
recently participated in a run for colon cancer awareness in Washington, D.C. Photo courtesy of Yvette Rattray

Learn More

To learn more, visit MedStarGeorgetown.org/Colon or call 855-213-9513 to make an appointment.

Inside Cancer, a blog from the MedStar Georgetown Cancer Network, features articles written by MedStar cancer specialists and cancer survivors. Visit MedStarGeorgetownCancer.org/InsideCancerBlog to read the latest articles.