FLASH
Shkruar nga Pamfleti
Just a few days ago, the Princess of Wales Kate Middleton revealed that she suffers from cancer, news that shocked many people. The oncologist explained that early cancer, which is defined as occurring in adults under 50, is not an anomaly.
“Just last week, I saw a 37-year-old woman with breast cancer that had already metastasized to her lymph nodes, bones, lungs and liver. In the next room was a 45-year-old man with colon cancer that had spread so far throughout his liver that it had filled and expanded with tumors. "Both patients had stage IV cancer that can potentially be controlled for a certain time, but are no longer curable," the doctor said.
The global incidence of early cancer increased by 79.1% and deaths from early cancer increased by 27.7% from 1990 to 2019, a 2023 study in the journal BMJ Oncology found. Other data on this increase published last year in the Journal of the American Medical Association showed that from 2010 to 2019 in the United States, breast cancer accounted for the largest number of cases in this younger population, while rates of gastrointestinal cancers are increasing rapidly.
The doctor also said that those born in 1990 are twice as likely to get colon cancer compared to those born in 1950.
As these cases of early cancers increase, there is an increased urgency to identify why this increase in cancer is unfolding in young people and who is at increased risk. At least part of the answer appears to be found in changes in nutrition and lifestyle that took hold in the middle of the last century.
Notably, the underlying population genetic risks have not changed in recent decades, strengthening the case that environment and lifestyle play a greater role in these cancers than our genes. Triggers can include highly processed foods, sugary drinks, red meat, smoking, alcohol, sleep changes, obesity and physical inactivity. Alone and especially in collaboration, these factors can alter our body's internal processes by disrupting metabolism and promoting inflammation.
Further research efforts are underway to examine whether changes in the gut microbiome, the trillions of microbes that reside within us, are increasing our body's vulnerability to cancer. This microbial community is a crucial contributor to health, influencing digestion and the immune system. Poor diet, overuse of antibiotics, and certain medications can cause a shock to this microbiome, which can then play a role in making cancer easier.
Because cancer is a disease that is understood to develop over decades as changes in DNA accumulate and produce tumors, a person diagnosed at a younger age may have been exposed to risk factors as a baby or in the womb. Research is also focused here at present, with studies associating a greater risk with cesarean delivery in women and a synthetic form of progesterone used to prevent premature birth.
“But as I have seen regularly in my cancer clinic, obesity and lifestyle alone cannot account for all new patients being diagnosed. Many of those I treat are healthy, eat sensibly, and exercise regularly. And so the cause of their illnesses still remains beyond the facts of science.
The only certainty at this point, however, is that the underdiagnosis of these early cancers is widespread and significant. Primary care physicians should be educated about the increasing presence of cancer in those younger than 50 years and why age should not be used to underestimate a patient's symptoms.
On the other hand, people should not ignore persistent symptoms of any kind and be aware of a family history of cancer. Often, young patients will need to aggressively advocate for themselves, as it may take multiple appointments before a cancer diagnosis is made.
And because early cancers are often diagnosed at advanced stages, they were once thought to be biologically different and more harmful than their older counterparts. Often, these are simply found late and metastasize due to a delay in diagnosis rather than any particularly aggressive quality.
Once treatment begins, actions are also different for those in their 20s, 30s, and 40s. Cancer drugs can cause cardiovascular problems and secondary cancers years after treatment. Younger patients may be pregnant at the start of therapy or concerned about effects on fertility. Further, there are concerns about long-term cognitive impairment after chemotherapy, especially when people return to work.
This troubling phenomenon in cancer care will require a redoubled of our collective efforts for funding, further research, education campaigns and revision of screening guidelines.
Already, much of this is in motion. In a notable move, the US Preventive Services Task Force, a volunteer panel of disease prevention experts, now recommends that colorectal cancer screening should begin at age 45 for people at average risk of the disease.
Although significant advances have been made in cancer outcomes, true progress cannot be claimed if certain age groups are lagging worryingly behind. The Princess of Wales's public disclosure of her cancer is a reminder of the work that remains to be done," says the doctor.
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