LAFAYETTE, La. — 49-year-old Margarita Perez never thought she'd see the day she was diagnosed with colon cancer — nonetheless Stage III.
"I was asymptomatic, no family history of colon cancer, not able to get a colonoscopy because of my age," Perez tells me. "And I'm in the hospital facing getting 15 inches of my colon removed so they could remove my colon cancer."
That was the initial diagnosis two years ago.
"I feel like at 47, I was really young at that point and I was really just living my best life personally and professionally," she says. "It's just one of those words you just really don't wanna hear."
Ever since hearing those words, she's been devoting her life to doing everything she can to fight the illness, no matter what it takes. Somewhere along the journey, she says things started to look up...
Until they took a turn for the worse.
"It was really around the end of January 2023 that I learned my colon cancer had metastasized to the liver," Perez shares.
That news coming with a Stage IV diagnosis. Now more than 25 rounds of chemotherapy later, as she fights for her health, she's asking others to do the same.
"We don't want to talk about it, but it's killing people, it's killing people in our communities every single day," she tells me. "With more talking, education, surveillance, and more colonoscopies, we can change that trajectory."
Louisiana does not have the best track record with colorectal cancer, either. Data from the American Cancer Society shows our state ranks fourth in the country for the disease. It's the leading cause of cancer death in men under 50, second only to breast cancer in women of the same age. At the beginning of 2023, the ACS reported 20 percent of diagnoses in 2019 were patients under the age of 55 — double the rate found in 1995. The ACS also reports rates of advanced disease increasing annually by three percent in people under age 50. In 2021, two groups that provide preventative guidelines for colorectal cancer, the U.S. Preventative Services Task Force and the U.S. Multisociety Task Force on Colorectal Cancer, recommended most Americans be screened for the disease by the time they reach 45, which is five years earlier than recommended previously. Screenings should continue periodically from that point until age 75.
So what do doctors say you should you look out for?
- Rectal bleeding with bright red blood
- Blood in the stool, which could appear dark brown or even black
- A change in bowel habits, whether it be diarrhea, constipation, or narrowing of the stool lasting more than a few days
- Cramping or belly pain
- A feeling that you need to have a bowel movement that isn't resolved by having one
- Losing weight without trying
- Weakness and fatigue
As for why colorectal cancer numbers are rising in young people, according to doctors with Yale Medicine, the truth is, nobody knows. Many try to attribute genetics, but according to their findings, that is not always the case, though family history of cancer or polyps and conditions like Inflammatory Bowel Disease (IBS) increase your risk. Along with this, a sedentary lifestyle; smoking; heavy alcohol consumption; low-fiber and high-fat diets, or diets high in processed meats; being overweight or obese, along with other factors are associated with the illness.
"My youngest patient was 19 almost 20, yeah that’s unheard of, but it’s important, passing blood in the stool is not normal, it is something going on," says Dr. Steven Saccaro with Ochsner Cancer Center of Acadiana. "Now it may be a small tear or a fissure, it may be a hemorrhoidal bleed, but it can also be a sign of colorectal cancer so having that discussion with your primary care provider is something that’s really important.”
His advice? When in doubt, get it checked out. Saccaro tells me colonoscopies remain the gold-standard of screenings, but unless you've got family history, it may be difficult to get insurance coverage for preventative colonoscopies. If your primary care provider recognizes secondary symptoms, you may be able to get prescribed a diagnostic colonoscopy, however it may not be fully covered either. Regardless, any screening is better than none, which is why taking a Cologuard test or getting a rectal exam may also be beneficial. The important thing to remember is to be honest with your doctor about any sudden or suspicious symptoms or changes to your bowel movements as soon as you have them.
In the meantime, for Perez, she is going to live her life to the fullest between bi-weekly chemo treatments. Her journey can be summed up in one word — hope — a reminder she keeps on her wrist.
"You have to have hope from the ones that have paid the price already so the ones that don't survive, you still learn from them, from their treatment, from their process, from the good and the bad," she tells me. "You have to have hope that even in death, you can still gain something that is going to help someone else."
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