I Do Not Know Why I Developed Colorectal Cancer at a Young Age

I have no genetic factor or known risk factor associated with this disease. Yet cancer found me...

During my teens and early adulthood, I suffered from digestive problems, including gastritis and constipation, which seemed normal to me, and I did not worry much. But by the time I turned 30 in 2015, my reflux problems had become more frequent and bothersome, so I first decided to see my family doctor. After examining me, he said that what I was experiencing was normal and prescribed a stomach-protecting medicine. Although he reassured me that I was fine, I could not shake the feeling that something was wrong and decided to see a gastroenterologist for further tests.

I had an endoscopy and a colonoscopy. When I woke up, the doctor said he had found two polyps in my large intestine and removed them. I asked him to explain what polyps were, and he told me that it was normal for adults over 50 to have some colon polyps, but that this was uncommon in people my age. Throughout the conversation, he never mentioned that the polyps might be dangerous or malignant (cancerous). He only said I would get the biopsy results in 2 weeks and should be tested again in 5 years.

The pathology result said that one of the polyps tested was at high risk of being cancerous. I was still advised to have my next colonoscopy in 5 years. So I thought I would have the polyp removed and then not worry about it any further. I believed I was fine.

But 2 years later, I became extremely tired and began noticing blood in my stool. At first, I did not worry too much about the bloody stool because I had hemorrhoids that occasionally bled. But I could not ignore the symptoms. I made an appointment with my family doctor to have it checked, and once again he reassured me that everything was fine. Even though he knew I had colon polyps, he did not tell me to see a gastroenterologist for an additional examination. Once again, I left worried about my health.

• Related topic: Our articles about young-onset colorectal cancer

Given 2 Years to Live

A few more months passed, and the bleeding continued. I decided to find another gastroenterologist to make sure I did not have a genuinely serious problem. After a physical examination and confirmation that the bleeding was probably from hemorrhoids, another doctor recommended that I have another colonoscopy.

When I woke up after anesthesia, the doctor told me they had found a tumor and that, based on their experience, it was malignant (cancerous) and most likely early-stage colorectal cancer. The news was devastating. I had heard of breast cancer but had never heard of colorectal cancer and knew nothing about the disease. Still, I held on to the fact that if it was cancer, it was probably early-stage and I could beat it.

But after surgery, I learned that the cancer was actually stage 3. My oncologist recommended another operation to remove part of my rectum, followed by 8 cycles of capecitabine + oxaliplatin chemotherapy, which I later learned had controlled my cancer for only 9 months. I hoped to recover, but my scans showed that the cancer had already spread to my lungs and a peritoneal (abdominal lining) lymph node. I now had stage 4 colorectal cancer. My oncologist said that recovery was unlikely and that I probably had 2 years to live. I was only 33.

Living with Cancer That Has Become Chronic

I began looking for another oncologist’s opinion. This doctor said he wanted to biopsy the tumor and send tumor material for comprehensive genetic analysis to decide on the best treatment for me, and that the goal was clinical remission (elimination of signs of disease). These were the first hopeful things I had heard in months, and this time I held on to the hope that if cancer could not be cured, at least it could be managed. Because the tumor had no treatable mutations, my oncologist recommended the combination of leucovorin calcium, fluorouracil, and irinotecan (FOLFIRI) and cetuximab. A scan performed 3 months after starting treatment showed no evidence of cancer. After 3 years, I continue treatment with FOLFIRI and cetuximab, and periodic scans continue to show no evidence of disease.

When I first heard that I had metastatic colorectal cancer, I was unsure how I would carry on with my life. How can you make plans when you do not know how long the future will last? To better understand my own experience with colorectal cancer at a young age and help other young adults with the disease, I joined the Fight Colorectal Cancer blog and served as an advocate from 2019 to 2020.

The experience is life-changing. Working with the colorectal cancer community has not only helped me cope with metastatic disease but has also given me the chance to raise awareness of this disease, especially among young adults. I am well informed now, but before my diagnosis I had never heard of colorectal cancer. Young people should be alert to this type of cancer and aware of the symptoms they experience. They should also learn to be proactive about their health so that diagnosis and treatment are not delayed and they can make better progress with treatment.

When doctors told me I was too young to have cancer, I gained a false sense of reassurance. I do not want someone else to have to learn the hard way that cancer does not discriminate by age, sex, race, or socioeconomic background. I do not know why I developed cancer. I have no genetic factor or known risk factor associated with this disease. Yet I developed cancer.

Looking to the Future

I am not naive. I now know enough about colorectal cancer. I know how to deal with this disease, especially as a young person. But I refuse to be consumed by thoughts of cancer and let them derail my plans for the future. Despite everything I have endured, I still think I can live a long, full life. That is my goal...

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The young colorectal cancer patient who wrote about his experiences so powerfully and candidly, Diego Davis-Olegário, lives in Hyattsville, Maryland, USA.