A colon cancer diagnosis at any time can be a devastating one to receive. As with any cancer diagnosis, the stress, fear, and worry can be overwhelming. Often the first course of treatment is surgery to remove the tumor and surrounding tissue, and hope that none of the lymph nodes are positive for cancer. Then, depending on the tumor’s characteristics, chemo, with or without radiation, starts. Everyone responds differently: some lose their hair, some don’t. Some have terrible reactions to the radiation, others don’t. Providers deploy screening tools to try to prevent any of this from even being necessary. A screening test is done to look for disease before the patient has symptoms. Historically, early onset colon cancers have been treated more aggressively than average onset colon cancers. But new research questions whether early onset colon cancer should be treated aggressively.
The recommendation has historically been to begin screening for colon cancer at 50 years of age. The earlier a cancer is caught, the higher likelihood it can be successfully treated. And with colon cancer, if an abnormality is found, it is commonly removed during a colonoscopy, and that is the end of the treatment. Follow-up screening is indicated to make sure the abnormality does not return, and it usually does not.
Screening guidelines were adjusted recently to recommend screening beginning at age 45 – in order to catch more early-stage cancers. Is cancer that develops earlier, though, more aggressive? One might get the impression that is the case, right? We tend to think that earlier onset=more aggressive cancer. While there may be some basis in this for certain illnesses, that appears to not be the case with colon cancer. A recent analysis of patients with colon cancer compared the histopathologic tumor characteristics of early onset colon cancer (patients between 35 and 49 y.o.) with that of average onset colon cancer (patients older than 50). While the symptoms for early onset cancer gave clinicians the impression the tumor was more aggressive, there appears to be no genetic difference between early and average onset tumors.
This means that patients unfortunate enough to develop colon cancer at an early age need not receive aggressive treatment merely because of their age.
