Craig Meddin had long been “on the hunt” to find the source of his abdominal pain, bloating and other gastrointestinal discomfort.
“I tried cutting out dairy,” he says, “then gluten.” He eliminated carbohydrates that ferment in the colon, causing gas, pain and diarrhea. He cut back on highly acidic foods such as tomato sauces and citrus fruits. He took medications, got a CT scan and had bloodwork done.
Then he had a colonoscopy. Several polyps were removed, including one that was large and discolored. A week later he received a call from his doctor—he had colon cancer.
Meddin was just 42 years old. He had no family history of colon cancer.
“That was a life-changing phone call,” he says. “A lot of things went through my mind. Should I have done this (colonoscopy) sooner? Did I ignore symptoms? What’s going to happen to my wife and children?”
1. Earlier Colonoscopy Screening Could Save Lives
The American Cancer Society estimated that about 18,000 people under age 50 were diagnosed with colorectal cancer in 2020. In recent years, it has been the leading cause of death from cancer among men ages 20 to 49 and the third-leading cause for women the same age. Since the 1990s, the rate of colorectal cancer has more than doubled among adults younger than 50. During this same time, the rate of colorectal cancer has decreased among older adults. Experts credit more regular colonoscopies, which traditionally have begun at age 50, and lower rates of smoking.
The American Cancer Society now recommends that people at average risk of colorectal cancer start receiving colonoscopy screening at age 45. People at high risk because of family history, inflammatory bowel disease or an inherited hereditary condition such as Lynch syndrome should be screened even earlier. Your doctor can help you determine the best age for you to start.
“It’s unclear why the rates are increasing in younger people,” says UNC Health hematologist oncologist Alan Kritz, MD. “Rates are increasing in developed countries and developing countries around the world, so it’s not just the Western lifestyle (highly processed diet, low level of activity, high rates of obesity, high levels of stress, etc.), which we blame for a lot of cancers.”
Symptoms of colorectal cancer include:
- Changes in bowel habits (such as diarrhea or constipation) that last more than a few days
- Rectal bleeding with bright red blood
- Dark brown or black stool, possibly indicating blood in the stool
- Cramping or abdominal pain or rectal pain
These symptoms can also indicate benign conditions, but a doctor will have to examine you to be sure.
Tell Your Doctor About Your Symptoms
Meddin had many of these symptoms, but he didn’t suspect colon cancer.
“I’m so glad my GI (gastrointestinal) doctor listened to my concerns and sent me for a colonoscopy, even early,” he says. “If I had waited until I was 45, it would have been devastatingly worse.”
Colon cancer is still rare among people under age 45, but Meddin says his situation demonstrates the possibility.
“If you’re having symptoms, even if you’re in your 30s, get a colonoscopy as soon as your doctor tells you to,” he says. “For some people, a colonoscopy sounds scary, but it’s fairly effortless relative to all things. That little bit of effort might save your life.”
If you can’t or won’t have a colonoscopy, Dr. Kritz says, you should have a stool test. You can collect the stool at home and send it to a lab to be tested for cancer genetic material. However, if your results are abnormal, you’ll have to follow up with a diagnostic colonoscopy.
Spreading the Word About Colon Cancer Risk
Dr. Kritz would like to see more awareness of colorectal cancer, like there is with breast cancer. People with symptoms that could be concerning should get a colonoscopy, no matter how young they are. Then, after age 45, experts recommend a colonoscopy at regular intervals, often every 10 years.
“Screening for colon cancer is as important as screening for breast cancer and should be part of standard healthcare in the United States,” Dr. Kritz says. Nearly 70 percent of women in the United States age 40 and older have had a mammography in the past two years to screen for breast cancer.
Colonoscopies are particularly important for certain people, including those who have:
- A family history of colorectal cancer or any cancer
- Other bowel diseases, including ulcerative colitis and Crohn’s disease
- High blood pressure
- Low vitamin D levels
Colorectal cancer can be genetic, Dr. Kritz says, just like breast cancer. However, only about a third of patients diagnosed with colorectal cancer have any family history of the disease.
Based on the results of his colonoscopy, Meddin received his diagnosis in December 2021. He and his wife, Anna, decided to wait until after Christmas to have surgery.
During the surgery in January, his doctors found more cancer in his lymph nodes. In early February, he started chemotherapy.
Often, colorectal cancer can be removed during surgery, Dr. Kritz says, but chemotherapy still may be recommended, especially if the cancer has spread to the lymph nodes.
“We use chemotherapy to prevent the cancer from coming back,” he says. “Nobody looks forward to chemotherapy, so you weigh the risks that the cancer will return. We’re definitely going to be more aggressive with someone in their 40s than someone in their 80s. They have more years of life ahead and usually they’re able to tolerate the side effects better.”
Meddin says he never hesitated to start chemotherapy after his doctor told him it would help prevent the cancer’s return.
“What I found invaluable was the two-hour educational appointment we had before we started the chemo,” he says. “They told me what each medication was and what the side effects are, and what the benefits are. My wife and I left feeling so much more knowledgeable about what was ahead.”
Meddin’s chemotherapy is scheduled to continue through May. He is learning how to deal with the fatigue that comes with treatment.
“Everybody reacts differently,” he says. “I’m mostly keeping up with work, but I need to rest in the afternoons. Sometimes I can’t shake the fatigue, even with one or two naps a day.”
His diagnosis affects his whole family.
“This is a high-anxiety, high-stress period for my wife,” Meddin says.
Together, they have talked with their children, who are 6 and 8 years old, to explain what’s going on and what they can expect.
“We were apprehensive about telling them anything except that I was having surgery to help my bellyaches,” he says. “But once we learned there were going to be more treatments, months of chemotherapy, everything we read said it’s best to tell them early and explain what to expect.”
His surgical oncologist told him to make sure his siblings were aware that they should get colonoscopy screenings, too.
“My sister went the next week,” he says. “My brother had already had one.”
It’s also unusual for Meddin and his wife to be the ones receiving help, when they’re accustomed to helping others.
“It’s very important for both of us that we have a strong network of friends and family,” he says. “But I had to learn how to be on the receiving end.”
If you are having gastrointestinal symptoms, talk to your doctor about possible causes and ask if a colonoscopy screening for cancer may be appropriate. If you don’t have a doctor, find one near you.