10 things to know about neuroendocrine tumors
What Is Early-Onset Colorectal Cancer?
Genetic Conditions Inherited physical problems such as Lynch syndrome and familial adenomatous polyposis (which can produce hundreds of polyps in the colon) increase the chances of developing colorectal cancer, especially at a young age.
"Younger adults with colon cancer are more likely to have an inherited syndrome," says Kelley Chan, MD, a clinical scholar with ACS Cancer Programs, and resident at Loyola University Medical Center in Chicago.
The Global Colon Cancer Association estimates that 16 to 25 percent of early-onset cases are related to a genetic syndrome, whereas only up to 10 percent of regular colorectal cases are related to genetics.[9]
Racial and Ethnic Background American Indian and Alaska Native people have the highest rates of colorectal cancer in the United States, followed by African American men and women. Jews of Eastern European descent (Ashkenazi Jews) also have a high risk compared to other ethnic groups; about 6 to 8 percent carry a specific gene mutation that increases their risk of developing colorectal cancer by 1.5 to 2 times.[10]
Other Health-Related Issues Certain health-related conditions may contribute to colorectal cancer risk, including a family history of the disease, a personal history of radiation to the abdomen or pelvis area, a personal history of inflammatory bowel disease (Crohn's or ulcerative colitis), and having had the gallbladder removed (cholecystectomy).
Toxins in the Environment Researchers are studying whether exposure to chemicals may play a role in colorectal cancer. Chemical exposures (from air and water pollution, chemicals in soil and food, and pesticide use) may damage the DNA of intestinal cells leading to cancer-causing mutations.[9]
Modifiable Risk Factors According to one study, one-third to one-half of all early-onset colorectal cancer cases are attributable to modifiable risk factors, including:[11]
Obesity A review of more than 100 scientific papers found that half of younger adults with colorectal cancer were overweight and 17 percent were obese.[12] Excess fat has been linked to inflammation, which may raise the likelihood of developing cancer. Obesity is also connected to insulin resistance and diabetes, increased production of the hormone leptin, and gut hormone imbalance — all factors tied to greater cancer risk.
[13]
Unhealthy Diet Colorectal cancer has been linked to the consumption of red meats (such as beef, pork, lamb, or liver) and processed meats (like hot dogs and some lunch meats). Research has also found that sugar-sweetened drinks may be a culprit.[1]
[14]
Lack of Exercise Research has shown that physical inactivity and sedentary behavior are well-established risk factors for colorectal cancer. Insufficient exercise may contribute to weight gain, insulin resistance, and inflammation.[15]
Smoking A study involving more than 700 adults under the age of 55 with colorectal cancer found that former smokers had a 139 percent higher risk of developing colorectal cancer compared with nonsmokers in the same age group. For current smokers, that risk was 150 percent greater.[16]
Alcohol Use Moderate to heavy alcohol consumption is a known risk factor for colorectal cancer. Alcohol consumption can damage the intestinal lining, allowing bacteria and toxins to enter other tissue in the body. A scientific investigation looking at more than 8,000 colorectal cancer patients between ages 20 and 49 found that the risk increased in relation to how much a person drank. Compared with nondrinkers, those who had one to two drinks weekly had a 7 percent higher risk. For those having three to four drinks per week, the risk was 14 percent higher, while five drinks or more equaled a 27 percent greater risk.[1]
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I Never Considered The Possibility I'd Get Pancreatic Cancer
According to the Irish Cancer Society, roughly 600 cases of pancreatic cancer are diagnosed in Ireland each year.
It has one of the poorest prognoses of all cancers, with fewer than 15% of Irish patients surviving beyond five years.
Katherine Aherne is one of the lucky ones, as she was diagnosed with pancreatic cancer almost two years ago, and thanks to swift action, she underwent treatment and is currently doing well.
During Christmas week 2021, she developed an itch on her arm and noticed her urine was "abnormally" dark.
"I made an appointment with my GP, had some bloods taken and then went out Christmas shopping. But two hours later, my doctor rang and said I should go to A&E immediately as my liver function bloods were extremely high and it was very likely that I would be admitted — and although I was unaware at the time, my cancer journey kicked off from there," she says.
After undergoing some tests, scans revealed a mass in the head of her pancreas, which needed a biopsy.
"Although cancer was not initially discussed, I gathered it was a cause of concern. I was healthy, fit, active, had lots of energy and living a full life, so this all came as a huge shock as cancer was just not on my radar. I was very naive to have never considered the possibility that I'd get cancer. I was so stunned and shocked that I didn't ask many questions that day and probably wasn't ready to hear too many details as I needed time to absorb what was happening."
Covid restrictions were in place then, meaning no hospital visitors were allowed. "I will never forget the emotion of phoning my husband and family and trying to remain strong and positive while telling them the worrying possibility that I might have pancreatic cancer."
The mother of four, who lives in Naas with her husband, Seamus, spent Christmas 2021 in hospital and in early January 2022, she received results from the biopsy, which showed that the tumour was malignant.
"Seamus and I had agreed from day one not to Google pancreatic cancer, as we knew it would not bring much positivity, and we all needed to stay hopeful and mentally well to prepare for the next stage," she says.
Katherine Aherne says Whipple surgery saved her life but it was also life-changing, and it has taken trial and error to adapt. Picture: Moya NolanThe treatment plan was chemotherapy followed by radiotherapy. If the tumour responded well to these treatments, she would undergo Whipple surgery, which involves removing the affected part of the pancreas, bile duct, duodenum and part of the stomach.
"The next two months were probably the most difficult of all because there was concern that the cancer was more advanced and had spread to my liver, which would potentially rule out surgery," she says. "I will never forget the elation when my oncologist called with the wonderful news that the PET scan had indicated no spread to my liver. It gave us great hope and encouragement."
She had the first round of chemotherapy in March 2020.
"My abiding emotions were not fear or anxiety but relief, delight, and gratitude to be starting the journey that would hopefully tackle the tumour. Chemotherapy was every two weeks, and I tolerated and coped with the side effects, including extreme fatigue, pretty well — there were days when I was able to go walking, meet up with pals and even play a few holes of golf. I finished chemotherapy in June and began ten sessions of radiotherapy before the planned Whipple surgery.
"My odds for a successful outcome were judged 50:50 as the tumour was very near an artery and my surgeon explained that it would be three hours into surgery before he could tell if it was feasible to remove the entire tumour and complete the extensive operation."
Fortunately for the now 63-year-old, the surgery was a success, and after eight days in hospital, she was discharged and, when she was well enough, underwent another course of chemotherapy. Today, after making some lifestyle changes, she's doing well.
"Life after Whipple surgery does require adjustments, as while it is life-giving, it is also life-changing, and it has taken time and trial and error with medications to adapt and find a balance which works for me," she says.
"I needed support and advice with diet and medications, which was difficult to access and sustain. However, I was fortunate to meet gastroenterologist Prof Barbara Ryan, who has had a hugely positive impact on my quality of life. I hope more support becomes standard and available for all patients post-Whipple surgery."
She says she is "eternally grateful for the wonderful care" at Tallaght and St Vincent's hospitals, for the support and expertise of oncologist Prof Ray McDermot, surgeon Prof Kevin Conlon, and her GP, Dr Alison McDonald.
The retired secondary school teacher says while 2022 was an "annus horribilis" for her health, it was also a "precious year" full of love, support and comfort from relations, friends and colleagues, which helped her and her family navigate the ordeal. She is fully aware of how fortunate she is to have survived pancreatic cancer and would advise anyone who has any unusual symptoms to seek advice as soon as possible.
"If I hadn't gone to my GP that day, I would certainly have gone the following week as the itch had spread andbecame increasingly more severe, but looking back, I had lost some weight in the few weeks prior to this," she says.
"Every single day, I realise how fortunate I am, and it encourages me to seize every opportunity life offers. I have a real appreciation of how lucky I am to be alive and living well as I approach three years post-diagnosis.
"Choosing to be open about my diagnosis meant I received a huge amount of support from my community of friends, family, neighbours, colleagues and that was so comforting and uplifting for me and my family during a very difficult time."
Pancreatic cancer is one of the leading causes of cancer-related death worldwide — five in every six patients diagnosed will die — and because so many cases are at an advanced stage, 50% of those diagnosed will die within the first year.
While people may have few symptoms in the early stages, some can occur within time — these include:
While some of these symptoms are common and similar to other health conditions, Prof Grainne O'Kane, consultant oncologist specialising in pancreatic cancer malignancies, says the disease is so lethal that clinical trials should be considered part of the first line of treatment.
"Early intervention is critical and aligned to clinical trials will lead to better outcomes, she says.
"People should be aware of the link between the six leading symptoms and pancreatic cancer, particularly if there is a family history of the disease. Depending on the stage of the cancer at diagnosis, the treatment for pancreatic cancer includes surgery, chemotherapy, and radiotherapy but over 80% of people are diagnosed too late for potentially curative [Whipple] surgery because symptoms do not develop until the advanced stage of the disease."
See:
James Van Der Beek, 47, Diagnosed With Colorectal Cancer: 'There's Reason For Optimism, And I'm Feeling Good' (Exclusive)
James Van Der Beek has colorectal cancer, PEOPLE can confirm.
"I have colorectal cancer. I've been privately dealing with this diagnosis and have been taking steps to resolve it, with the support of my incredible family," the star, 47, tells PEOPLE exclusively.
"There's reason for optimism, and I'm feeling good," Van Der Beek adds.
Colorectal cancer, per the American Cancer Society, starts in the colon or the rectum, which make up the large intestine in the digestive system.
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James Van Der Beek in 'The Real Full Monty.'.FOX via Gett
Despite the diagnosis, Van Der Beek has actively been working as he navigates his care.
He recently appeared on an episode of Walker and he is next set to star in Sidelined: The QB and Me, a Tubi original film out Nov. 29.
Van Der Beek has also prioritized time with his family — wife Kimberly Van Der Beek and their six kids: Olivia, Joshua, Annabel, Emilia, Gwendolyn and Jeremiah.
James Van Der Beek.Casey Flanigan/IndieWire/Penske Media via Getty
Back in June, the group took a memorable trip to Egypt. In an Instagram post, the Varsity Blues alum shared photos of himself and his family posing with a camel, looking at the Egyptian pyramids and more.
"#Egypt… With all my vocabulary, 'Wow' is what fell out of my mouth most of the time. We were gifted a magical experience, one I'm still processing - and might be for the rest of my life," Van Der Beek wrote, in part, in his caption. "The kids were rock stars, my friends became brothers, and despite all the travel and time zone crossing and early-morning alarms, I feel recharged."
James Van Der Beek and wife Kimberly Van Der Beek.Rick Kern/Getty
Later in December, Van Der Beek is set to appear on The Real Full Monty, a two-hour special where a group of male celebrities will strip down to raise awareness for prostate, testicular, and colorectal cancer testing and research.
Alongside the star, the special will also feature fellow actor Taye Diggs, Kansas City Chiefs defensive tackle Chris Jones and longtime Dancing with the Stars judge Bruno Tonioli.
The event, inspired by the Oscar-nominated 1997 film The Full Monty, will be executive produced by Anthony Anderson.
"Embarrassingly, I thought I was just doing Anthony Anderson a favor and supporting cancer. But then once we got there and we really started to talk about these issues, everyone started opening up and we got to know each other on a different level," Diggs recently told PEOPLE of the special.
The Real Full Monty is set to premiere on Dec. 9.
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