Second-leading cancer killer on the rise in young adults

WASHINGTON (WJLA) - One of the deadliest cancers is gaining ground in an unexpected population. People in their 20s and 30s, once thought almost untouchable by colorectal cancer, are part of an alarming upward trend in cases of the disease.

On a recent wet winter day in the nation’s capital, I met up with Malahat Layazali at Georgetown University Hospital. The 38-year old, flanked by her husband and brother-in-law, was there for her ninth round of chemotherapy.

“It’s getting easier just because I’m getting used to it,” said Layazali as she climbed into a familiar chair and her nurse hooked her up to an IV drip. It’s a little difficult to comprehend that this bubbly, vibrant young woman is fighting stage-four cancer. As it turns out, it’s equally as unbelievable for her.

“I remember the day the GI specialist at Georgetown told me ‘the result of the biopsy came out and it is cancer. It’s stage four cancer.’ I just looked at him.” And now, eight months later: “I still can’t believe I really have it.”

It’s something Dr. John L. Marshall, Chief of Hematology and Oncology and MedStar Georgetown University Hospital says he hears far too often, these cases taking their toll on even the most seasoned of professionals.

“We’re seeing young couples with children, 30-year-olds who are just getting started, newlyweds, new moms, new dads, and that’s really not what I signed up for, ya know?” said Marshall. “When I was young there was no one under the age of 50 with colon cancer. In the last 10 to 15 years, half of my clinic is now under the age of 50 and we have no idea why.”

There are some theories, one of which involves our microbiome, the bacteria living in our gut that are potent influencers of our immune system.

“We’ve washed our kids, make them wash their hands all the time and make sure they have antibiotics for their ear infections and in fact what we may be doing is white-washing their microbiome,” said Marshall. “In fact, losing a normal, natural balance so that good bacteria are not there. Protective bacteria."

Delays in diagnosis are another challenge because physicians don't always connect the symptoms of an "over 50" disease to a 25-year-old, instead blaming things like hemorrhoids or Irritable Bowel Syndrome.

A study published in The American Journal of Surgery showed it took nearly nine-times longer for someone under the age of 50 to get treatment for colorectal cancer - 217 days, versus just 29 days for someone over the age of 50. A disparity that Marshall says is improving as doctors become more broadly informed about the escalation of the disease.

“One of our first theories was that young people were in fact being ignored,” said Marshall. “We’ve actually done a pretty good job of raising awareness in emergency room doctors, primary care doctors, OBGYN’s, that you can get colon cancer at 25 years of age.”

And picking it up early cures people.

Recently the American Cancer Society updated its screening guidelines – suggesting colonoscopies begin at age 45. For those with a first-degree relative diagnosed with colon cancer before age 60, it’s recommended to be tested at age 40, or 10 years before the age of diagnosis of the youngest relative who had the disease.

For Layazali, there was no family history and no bad habits.

“I lead a generally healthy life,” said Layazali. “I don’t drink. I don’t smoke.” And she’s pulling out all the stops to make it even healthier with the help of her husband, Ehsan, who put his medical school education on hold to take care of his wife.

Several times a day, Layazali consumes fresh juice and capsules full of herbs and spices known to boost immunity. "Ehsan grinds the black seed and makes capsules,” she says as she shows me a container on her kitchen table full of remedies to assist her recovery and help prevent illness during her chemotherapy. “This is ginger, this is turmeric, this is cinnamon.”

Her 2-and-a-half-year-old son, keenly watches as she takes the supplements so lovingly made by her husband.

“I was scared that if anything happens to me, what’s going to happen to my baby?” said Layazali. “That really scared me, how my 2-year-old is going to live without me.”

But those very sad moments, she said, quickly turned to resolve.

“After that, I was like, you know what? I’m going to survive. I’m going to beat this. I wiped my tears off and I said I’m going to do whatever it takes.”

Layazali is part of an experimental gene therapy trial and continues chemotherapy.

“I’m responding to chemo, I have great family and friend support. I have so many things to be thankful for,” said Layazali. “Sickness is part of life, so you just treat it as any other things that come and you try to do your best to deal with it. And when the battle chooses you, you'd better put your best fight out there, and this is my best fight.”

Research from the National Institutes of Health predicts by 2030, the rate of colon cancer will be up 90 percent in people 20-34 years old.