When young adults get cancer

0:00What do James Van Der Beek, Dwayne Wade, and Kate Middleton have in common? They're all youngish people who have been diagnosed with cancer. And it's not just famous people. Younger and younger people are getting cancer more and more. That's facts. So we here at Today Explained wanted to figure out why and figure out how people are dealing with this. So we sent out our producer, Victoria Chamberlain, to a meetup for young adults with cancer. Victoria, where'd you go? I didn't go anywhere, Sean. You didn't go anywhere. You failed. The pandemic changed everything, including cancer support groups.

0:33So there's one that used to happen in person and then it shifted to Zoom so that more people from around the country could go and people who are immune compromised because they have cancer. OK, so you hit up a Zoom. I hit up a Zoom with a whole bunch of 30 to 40 year olds who are in the thick of cancer diagnosis and survivorship. OK, what Victoria learned coming up on Today Explained.

1:00We'll see you next time.

1:31Today Explained, Sean Romsver, I'm here with Victoria Chamberlain. Victoria, you go to a cancer meetup from the comfort of your own home. It's a Zoom. Who is organizing this thing? So it's this nonprofit organization that's based here in D.C. It's called the Smith Center for Healing and the Arts. And they support cancer patients in a bunch of different ways. They do things like therapeutic art and poetry and a whole lot of support groups. But their whole thing is that they want people to feel like they're going to be okay no matter what happens to them. Nice. And you go to one of these support groups remotely.

2:11What was it like? What's the vibe? Is it like the saddest meetup you've ever gone to? Yeah, I'd be lying if I said it wasn't sad. I mean, it's like a bunch of people that I would consider to be pretty young who have just been diagnosed with cancer. But there were all these really dynamic conversations going on between the people talking about how to live while they're going through this. And it made me just kind of realize sitting with these people, like how much we don't know about cancer, about what it's like to live with cancer as a person in your mid-30s. And the people in the group just really wanted to stress how different their challenges are as millennials than like a person in their 70s.

2:53Yeah. You know, a person who's older, like their kids might be grown, but a millennial might have like little kids in the house. My son was 18 months when I was diagnosed. Obviously, like I need to work in order to keep my child in daycare because I'm not able to physically take care of him. also like trying to maintain normalcy for him. When you're in your late 20s and 30s, your career is just starting to take off and then you get a cancer diagnosis and that can just kind of hit the pause button on the whole thing. I was at the peak of my career. You know, I was a VP with a financial institution.

3:32I was traveling. I was just doing all the things. I am a single woman, graduated from law school in 2019. teens, I'm kind of in this like buildup period in my career. What felt very crushing when I had time to kind of sit and try to process everything is that it's really mourning a lot of loss of what your life won't be. The day that I went to get a biopsy, my promotion was announced at work. The day after, I got a call saying, you have breast cancer. And as if dating wasn't hard enough as it is, dealing with the physical and emotional stuff that happens and the craziness of cancer, it just makes that so much harder.

4:12And if I want to go out and like meet people and date people, I have had a unilateral mastectomy. And when I show up, I have to both be physically naked and emotionally naked. But there was also this element of surprise. Like even though you're hearing tons of news stories out there about millennials getting cancer. You mentioned a couple of them before. We've got Princess Kate and Chadwick Boseman. It's still super shocking to be sitting there and receive that diagnosis and then to hear that other people you know or maybe people that you don't know are young and getting cancer. One of the most frustrating comments that I would hear people say is, oh, you're so young.

4:55and to me that's it's frustrating because it's like cancer does not care cancer does not care what age you are um it does not care what your life was like what dreams you had what hopes what thing you were about to do it does not care it just comes in and it interrupts and it just intersects you always think oh it it won't be me it can't be me um and i think that's the biggest thing that this data that's out there has to be telling us and our our peers is that we can no longer just assume it can't be me. And we need our healthcare system also to be that messenger and to step up because no one had ever said to me, even being the daughter of a breast cancer survivor and with a father fighting cancer, you are at risk.

5:38This is exactly what we wanted to focus on today. And this is exactly why we reached out to our colleague, Dylan Scott, because we wanted someone who's written about this to just tell us that we're not just imagining things, right? That it feels like way more millennials and younger people in their 30s and 40s are getting cancer. Yes, Sean, as a millennial who is also a hypochondriac, I regret to inform you that younger people, people under 55, which is usually the definition of an early onset cancer case, are in fact getting cancer more often. There's a little couple of ways to slice it. The Wall Street Journal ran an analysis last year of National Cancer Institute data.

6:24And the way they put it was one in five new coelorectal cancer patients in the US is under 55, which is twice the rate that we saw in 1995. There was another study that found that I think it was between 1990 and 2019, the rates overall of cancer among younger people had increased by 80%. It seems like no matter how you look at it, and I looked at a variety of studies for my story, cancer rates among young people are increasing, which I don't know about you, I feel like fits with just my observations in the world. And you're using some studies from the 90s to compare rates, but when did we start seeing that more young people are getting cancer?

7:08Yeah, it's definitely something that's built slowly over time. I talked to a guy at Georgetown named John Marshall. And he's been in this field for decades. And he said, at the beginning of his career, he never would have seen a cancer patient under the age of 50. But these days, he sees it all the time. And the way he put it to me is that at least anecdotally, people who practice cancer medicine, who treat cancer patients, it's like everybody kind of started to notice at the same time about a decade ago, like, huh, it's suddenly, it seems like I'm starting to get more and more young people coming in with more advanced cancers and more aggressive cancers.

7:46And so then we started to see some of this data that I'm referencing that sought to quantify how big has the change really been. And they did confirm that, yeah, this isn't just people's perceptions. At the population level, there are higher rates of cancers among young people. What kinds of cancers, Dylan? You mentioned colorectal cancer. Is it just that one? Are there other ones? Chorectal cancer, I think, is the big one. It is the, like, if you look at the incident rates in some of these studies, besides breast cancer, it is the type of cancer that has the highest incidence among young adults.

8:22But it's not just choral rectal cancer. It's uterine cancers, gallbladder, kidney cancers. People might have heard about Dwayne Wade, who is, like, by this definition, a young adult. To find out, obviously, at 41 years old, pretty have the guy that I did have cancer. So I have one kidney and I have another kidney that is 60%. They took 40 % of my kidney to make sure that they can get all the cancer off of it. It seems to be sort of up and down the digestive track where this seems to be happening with the one exception is breast cancer, which we've continued to see a higher rate of breast cancer among young people over the same period.

8:59But if we set that aside, which is obviously like a big exception, it seems to be a lot happening, yeah, up and down the digestive track. That's where we're seeing, in particular, these big increases over time among young people. What is going on in the digestive track, Dylan? So this is maybe the most interesting thing that I learned in reporting out this study and talking to a bunch of these cancer researchers who are as befuddled by all of this as we are. So it seems that your individual risk of many different type of cancers actually depends on something that's totally out of your control, which is when you were born.

9:40Like somebody who was born in 1975 had nearly twice the chance of developing like an intestinal cancer compared to somebody who was born in 1955, 20 years earlier. And likewise, if we look like at younger people, people born in 1990, they're at even a higher risk of developing cancers than those people born in 1955 or even 1975. A couple of things likely at work here. One does seem to be like the changes in food production and the proliferation of processed foods, which is obviously something that like basically if you eat in the modern world, you're consuming more processed foods than people used to.

10:24And so there have been like systematic reviews of the available literature, including one that was published just in 2022, that have said like, if you eat more deep fried fruits, if you eat more processed foods, if you eat foods high in fat, sugary drinks and desserts, and if you're really bad about eating fiber and things that are really good for your digestive system, you are more likely to develop cancer. and so that tracks you know when we think about like the obesity crisis like we know that our diets have been getting worse and they've been contributing you know to all kinds of negative health outcomes like diabetes and heart disease and it seems like cancer is another example of like the how these changes in our diet and our food production may be leading to adverse outcomes There's also been a lot of focus on microplastics.

11:16And we've likewise seen that those just like have proliferated in the environment over the period from like, you know, the 70s to today, where we've seen this big increase in cancer incidents among young people. And there was actually a specific paper published by a research team based in New Zealand that basically tracked the timeline of the multiplication of microplastics in the environment and the cancer rates among young people. And they basically found that they seem to be happening in parallel. It's an alchemy of all these things. It's a combination of we're eating worse. We're getting exposed to the stuff in our environment.

11:55We're still drinking a lot. We're not getting enough sleep. We're probably not exercising enough either. And when you stir all of those things together, you have more young people developing cancer.

12:15If Dylan's got you feeling depressed, we're going to ask him to hit you with a dose of hope when we return on Today Explained.

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17:09diagnoses, like incidence rates, like the number of cases that are reported, but also the number of cases that turn metastatic. So those are more serious clinical cases. And they looked at the mortality rates, like how many people are actually dying from these cancers. And what they found is if you look at cancer collectively, like the eight most common types of cancer among young adults, it's clear, like, yes, incidents are going up. That is obvious. But those metastatic cases and those death rates are actually pretty flat. And that provides, I think, some hope that maybe a lot of what's happening here is that we're just getting better at detecting cancer and detecting even little cancers that may not ultimately develop into a serious illness.

17:54Now, there's a big, big caveat to that new research, which is that for colorectal cancer specifically, which is the cancer that we talk about and focus on a lot when it comes to young adults, that is a case where both incidents, case numbers are rising, and deaths are also rising too. And so that would suggest that there's something serious going on with colon cancer specifically, and we want to get to the bottom of it. But even as we do, even as we try to figure out what's going on, we are making a ton of progress in our ability to diagnose cancer early and then to treat it.

18:33like these days you can take a blood test that can tell you whether or not you have certain types of cancer with pretty remarkable accuracy um and then you know most importantly like if we've diagnosed with somebody with cancer we've gotten way better at treating them like it's no longer the case that all we can do is just pump a bunch of radiation into your body and hope for the best. We're developing immunotherapies, which basically train a person's immune system to kill a cancer by itself. And as we continue to make progress with genetic sequencing and really understanding these tumors at the molecular level, that could allow us to really fine-tune these treatments and also make sure that we're matching the right treatment to the right patient.

19:22And so, like, as scary as all of these trends are, there's a lot of uncertainty about them. And most importantly, like, we are getting really good catching cancer early and treating it when we find it. And that, I think, is a reason for all of us to have a little bit of optimism in the face of these trends.

19:44Okay, so there's some good news in theory. Better diagnostics, better treatment. But we wanted to hear from someone who's experienced it. So we turned to someone producer Victoria met at that cancer meetup, Kate Zickel. How do I identify myself on the show? I'm from Alexandria, Virginia. I run a digital marketing agency out of my home. Married, which is awesome. I love that. No one's ever said that one before. That's good. That's good. Kate told us that those immunotherapies that Dylan was just talking about are the reason she's living a full life right now. Let me put it this way. Were it not for the advances in medical technology that have happened just in the last five to ten years, I may not be here.

20:30Kate's had cancer twice. The first time she discovered it was in 2017, after her husband found a lump in her breast. Went through chemo, radiation, double mastectomy and reconstruction surgery. It took about a year from September of 2017 to September of 2018. And then after that, I thought I was in remission, took hormone suppressors for two years before being diagnosed with a recurrence at stage four metastatic disease after it had moved to my bones and my lungs. So the cancer's still there? Yeah. So I've had metastatic cancer for almost five years. And the thing about metastatic breast cancer now is that it's not always the immediate death sentence that it used to be.

21:22You can actually live a pretty long time with metastatic breast cancer depending on where it is in your body and how quickly it grows. And can I ask how old you were when you discovered that you had this cancer back in 2017? Yeah. So I was originally diagnosed with breast cancer at 29 years old. Huh. No family history at all. No indications that that would be a thing in my life. And, you know, you just hear, you know, you hear all the ads and the awareness about self-checks that you should do. And we typically don't recommend mammograms until the age of 40 or actually 50, really. But they're starting to change that now that we're seeing more and more young women diagnosed with breast cancer.

22:12So I was pretty young. I was 29. And then I was, I think, 33 when my recurrence was diagnosed. Yeah. Is it weird for you? I'm sure at times throughout this process, you've looked like you had cancer. and I'm looking at you right now for all those people listening on the radio or on their phones or in their cars or whatever it might be who can't see you, you do not look like someone, I guess, who has cancer. But I guess, is that like a perception you have to deal with? I mean, that people think someone with cancer is going to look a certain way or not look a certain way? Yeah, people definitely still have the idea that a cancer patient looks wan and thin and pale

23:01and people tend to have a very specific idea in mind when they think of cancer patients. And because cancer treatments have changed so drastically even in just in the last 10 years, it's actually very different now. I looked normal. You wouldn't know. But I was still in the middle of all of these crazy, painful processes. It's a good thing. Like, we're very grateful that those technologies exist now where we can be in treatment and look great. But just because we look great doesn't mean that we are. And sometimes that can be difficult to explain. What would you say to people who, like, live in fear from what they've just heard from you?

23:47I would say don't freak out until a medical professional tells you to freak out. Okay. know your own body you know most of us do anyway but like know your body know what your normal feels like and then if something isn't normal ask and if your doctors ignore you which most doctors are great and they will take you seriously but if they don't get a second opinion get a third opinion ask take the time out of work to go to those appointments if you need to do your own homework. Get a genetic test. You can do that. They'll take a blood test and they'll go through your genetics and they'll tell you what your risk factors are.

24:31The treatment I am on now came into existence between 2017 and 2020. The one that I will go on next came out five years ago. The changes and the speed at which medical technology is keeping pace is incredible. we are so lucky to live in a time where that is true the goal here is to beat the clock where as a survivor now who's on treatment my goal is to make the current treatment I'm on last as long as possible so that the next treatment I'm on will be available and then that one will last a long time until we've got a new study that proves another drug that's available and as long as we're able to keep base with that, the longer we live.

25:24So I would just encourage anybody who's kind of curious about this, like do your homework, ask your doctors. Like those trials, those clinical trials are out there and we need them. We're desperate for them. We are dying without them. And anybody who wants to cut funding to those trials can just give me a call. What would you say to them? without these trials people will die without these trials people will not live as long as they could with them without these trials you are taking away the hope of others sorry I'm like shaking now I'm like so angry about this