Years before she was diagnosed with colon cancer at 40, Tracy Robert chalked up her bloating to an IBS diagnosis. She was a personal trainer and nutrition coach who followed a clean diet but felt constantly uncomfortable.
"I remember feeling a sense of heaviness when I would go to the bathroom," Robert, now 50, told Business Insider.
She said she wishes doctors took her "symptoms and concerns seriously." She believes if they had screened her for colon cancer sooner, they might have caught it before it reached stage 2B-3A. By the time Robert was diagnosed, she needed to have part of her large intestine removed and replaced by a colostomy bag.
Robert's story is not uncommon. More people under the age of 45 are being diagnosed with colon cancer. Doctors in the US recommend people start getting colon cancer screenings at 45. In Canada, doctors recommend that screening begin at 50.
Symptoms that might warrant earlier testing can be easily overlooked. Common signs of colon cancer, such as constipation or diarrhea, can also be caused by gastrointestinal-related issues like celiac disease or gluten intolerance.
Take Shannin Desroches, a 27-year-old from Ontario, Canada, who buckled in pain after every meal. She planned to get bloodwork to check for celiac disease, but her symptoms became so severe she checked into urgent care. Tests revealed multiple tumors throughout her body. At 26, she had stage 4 colon cancer.
For doctors, it's a tricky tightrope to walk when they're diagnosing young patients. About 45% of Americans have digestive issues, many of which have crossover symptoms with colon cancer. Because colonoscopies cost around $2,000 on average, doctors typically won't urge young patients to get one without serious symptoms or a family history of colon cancer.
As colon cancer rates continue to rise worldwide, spotting the symptoms early can make a huge difference in how patients are treated.
Early colon cancer symptoms can be mild
The most common colon cancer symptoms in people under 50 include abdominal pain, altered bowel movements, constipation, bloating, and diarrhea. In many cases, like Desroches', severe symptoms don't show up until later stages.
Depending on where the tumor is, those symptoms might be very mild at first, Dr. David Richards, a gastroenterologist at the MD Anderson Cancer Center, told Business Insider.
If a tumor grows in the center of the colon, it might go undetected or produce mild discomfort. "It hasn't yet gotten big enough or invaded into adjacent structures enough to start really causing symptoms," Richards told BI. On the surface, it might look like a gluten allergy or gastrointestinal issue.
Dietary changes can temporarily improve cancer symptoms
People diagnosed with GI disorders are often advised to make dietary changes.
Desroches tried to offset her symptoms by eating smaller snacks, but her stools remained thin and she had constant pain in her abdomen. Robert, who was diagnosed with IBS at 20, remembers being told to "eat more fiber."
For some people, diet tweaks can temporarily reduce symptoms of colon cancer, creating "a false-positive response to diet change," Dr. Mohammed Najeeb Al Hallak, an oncologist specializing in GI malignancies at the Karmanos Cancer Institute, told Business Insider.
For example, following a gluten-free diet to treat celiac disease can make stools firmer by reducing inflammation in the small intestine. Less inflammation can also lessen colon cancer symptoms, he said.
If a person has colon cancer, he said these positive changes are temporary — and may delay the diagnosis.
How to spot the difference between colon cancer and digestive issues
The medical community is still debating the best age to start annual screenings. Based on rising colon cancer rates, US screening guidelines were changed from age 50 to 45. "Some people argued about lowering it even more because we've been seeing colon cancer popping up more often in younger populations," Richards said.
If you're under 45, there are some "alarm symptoms" to look out for. Anemia, bright red or black stools, unexplained weight loss, trouble swallowing, and fever are all signs to take your symptoms more seriously.
Al Hallak said to always get a second opinion if you feel dismissed by your doctor. For example, celiac disease requires a biopsy and blood tests to confirm the diagnosis — never accept "it's probably celiac" without those tests. See someone who takes your pain seriously, especially if the symptoms don't improve.
