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By Melissa Marino | Photograph by Joe Howell
Nobody “expects” a 21-year-old to have advanced colon cancer. But sometimes they do, says Dan Beauchamp, M.D., a surgical oncologist at Vanderbilt-Ingram Cancer Center. He recalls just such a case: a 21-year-old with rectal bleeding that had persisted for three years before coming to Vanderbilt University Hospital and the Vanderbilt-Ingram Cancer Center with symptoms of bowel obstruction. The patient hadn’t had a colonoscopy – colorectal cancer just wasn’t at the top of the list of concerns for such a young patient or his health care providers.
When the patient finally had a colonoscopy, the test revealed a large rectal tumor. Further workup showed that the disease had already spread widely throughout his body, and because of his severely weakened and malnourished state, little could be done to intervene.
A colon cancer diagnosis often comes as a complete shock. While the 21-year-old patient had an obvious warning sign – although it was ignored until too late – many others have no such signal.
Colonoscopies are still the best way to detect colorectal cancer while it is still curable. But even rigorous adherence to screening guidelines will fail to catch some cases of colorectal cancer.
Researchers hope that the proliferation of knowledge about the various genetic alterations that underlie colon cancer could offer some additional help in early diagnosis, targeted treatment and perhaps even prevention of colorectal cancer.
Fortunately, the genetic events that lead to the development of colon cancer usually take years to unfold, giving ample opportunity for intervening before the cancer advances.
Unfortunately, all the genetic alterations that contribute to colon cancer – and how best to exploit them for diagnosis and treatment – are unknown.
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