Why young people are getting 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 today explained why 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. So 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.

0:44OK, 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.

1:25Opel.de.

1:31Today Explained, Sean Romsvorm 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 in 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.

2:52Yeah. 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. So 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've 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, and the way they put it was one in five new coelorectal cancer patients in the U.S.

6:29is 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? Yeah, it's definitely something that's built slowly over time.

7:12I 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, You know, 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 like how big has the change really been? And they did confirm that like, 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? Colorectal 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 colorectal cancer. It's uterine cancers, gallbladder, kidney cancers. People might have heard about Dwayne Wade, who is, by this definition, a young adult. To find out, obviously, at 41 years old, pretty healthy 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 foods, 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.

11:02And 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. And 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.

11:43And 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 this stuff in our environment, we'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.

12:41You're listening to Today Explained. Look, it's really scary to be confronting these trends, but there is a lot of promising activity when it comes to both cancer diagnostics and cancer treatment. We are starting to make it easier for people to administer tests at home that might give them an idea of either whether there's something in their blood or their stool that indicates they may be developing cancer right now, or they can get tested for their genetic background. And maybe they have just those sort of built-in risks because of their genes. And there's blood tests that have been developed that are really good at catching late-stage cancers.

13:28And now the next frontier for them is trying to catch early cancers or pre-cancerous growths. And so I think as those consumer products keep developing, that should allow us to screen more people, screen younger people, and hopefully catch some of these cancers earlier so that we can have better outcomes. And so that's on the diagnostic side. In terms of treatment, I've been writing about this for 10 years now. Like, there's been a ton of progress with what are called immunotherapies, which is, you know, the old way of treating cancer has been, we're going to just blast this shit with as much radiation as we can find and hope that that kills the cancer because otherwise we don't know how to do it.

14:10But it obviously has all of these really terrible side effects. People feel horrible. They lose their hair, whatever. And what we're trying to do now with these immunotherapies is like, let's remove radiation and all this chemical nastiness from the equation. Let's like train the body's immune system to fight these cancers on its own. A lot of the improvements that we have seen to like cancer prognoses, especially among older people, has been because we're developing these immunotherapies that are teaching the body how to fight the cancer by itself. And then when you combine things like genetic sequencing, like cancer, we talk about cancer as like one thing, but it's actually like, you know, thousands upon thousands of different diseases.

14:59And being able to identify like, okay, we know you have like a tumor in your colon, but if we can test it genetically and figure out exactly what type of colon cancer it is, then we can make sure we get you the exact right therapy that, you know, has these proteins or whatever that can better target that cancer.

15:29Okay, 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 10 years, I may not be here.

16:14Kate'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, 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.

17:07You 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 just 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.

17:56So I was pretty young. I was 29 and then I was I think 33.

18:04when 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.

18:46And 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?

19:32I would say don't freak out until a medical professional tells you to freak out. Know your own body. Most of us do anyway, but 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.

20:16The 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 uh will be available and then And 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.

21:08So 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.

21:54the people who are funding these trials need to understand that it is part of their job to keep us alive, to keep us hopeful, to keep our medication moving forward. By taking that away from us, you're killing, you're literally killing us. By taking that away from us, you are taking away years that we could have with our children, years that we could spend with our parents. if you take away the trials that gave us the drugs that help us live longer, you need to answer for that. You need to be held accountable to the people whose lives you are hurting. Sorry, I didn't realize how passionate I was about that until you asked me the question, and I'm like, oh, I'm really angry.

22:45That seems reasonable. Kate, thank you so much for your time. Really appreciate it. Nice to get to know you. And wishing you all the best. Yeah, this was fun.

23:01Victoria Chamberlain produced our show today. She wants to dedicate it to her dad's colon. Thanks to everyone who spoke with Victoria, including Dylan Scott, who you can read at Vox.com. She had help from Amna Alsadi, Laura Bullard, Andrea Christensdottir, and Patrick Boyd, who all work here at Today Explained.