A survivor is sharing the colorectal cancer symptoms she missed in the hopes of helping others.
About 150,000 Americans are diagnosed annually with colorectal cancer, which occurs when cells in the colon or rectum grow out of control.
Children’s book author Elayne Gorham, who was diagnosed with stage 4 colon cancer at 32, initially chalked her red flags up to postpartum symptoms.
“I had just had a baby, so I really didn’t think anything was wrong. What can you learn from me? Don’t be me. Educate yourself, know the symptoms, and then advocate for yourself.”
Early-onset colorectal cancer — that is, in people like Gorham who are younger than 50 — is on the rise, increasing 1.4% every year.
“How the heck did I miss symptoms of stage 4 colon cancer? I’d love to tell you about it,” said Gorham.
Bloating and a change in appetite
Gorham explained that in the weeks leading up to her diagnosis, she felt feelings of fullness no matter what she did or didn’t eat.
“I was pushing meals away. I can look back and remember that I felt bloated.”
Colorectal tumors can release hormones that can suppress appetite. In a recent study, 15% of younger individuals reported experiencing appetite loss four to six months before their diagnosis.
Fatigue
Colon cancer, like many other cancers, coincides with feelings of total exhaustion; roughly 8% of younger patients report symptoms of fatigue in the months before a diagnosis.
The same tumor-generated hormones that disrupt appetite can deplete energy and contribute to general weariness.
“Are you really fatigued all the time? I’m talking like an ungodly tired, that’s a major red flag,” said Gorham, who mistakenly believed her own malaise was related to recently giving birth.
Abdominal pain
Gorham believed the vomiting and “dull, aching” pain she felt in her stomach were signs of an ulcer.
“It wasn’t. It was stage 4 cancer,” she said.
Tension in the colon can lead to extreme discomfort, characterized by bloating and distension.
Pain after eating can also be a clue, but only if it occurs several hours after your meal. That may mean it’s coming from your small bowel or colon, whereas pain that occurs within a couple of hours of eating is likely upper GI, such as heartburn, GERD, or run-of-the-mill indigestion.
Other notorious symptoms of colorectal cancer include blood in the stool, changes in bowel habits, and changes in stool shape.
Despite the surge in cases of early-onset colorectal cancer, the recommended age for a colonoscopy is 45.
“I was 32 when I was diagnosed,” said Gorham, “So what that means is you need to know what symptoms to look for so that you can advocate for yourself.”
Partially due to the assumption among care providers and patients that colorectal cancer is a disease for the elderly or middle-aged, young people tend to be diagnosed in the disease’s later stages, making it harder to treat and cure.
Due to the rise in younger cases, the US Preventive Services Task Force updated its colorectal cancer screening guidelines in 2021, lowering the recommended age to begin screening from 50 to 45 for adults of average risk.
And cases like Gorhanm’s show we may need to lower it further, as a new study from Taiwan found that initiating colorectal cancer screening at 40 can reduce cases by 21% and deaths by 39% compared to starting screening at 50.
