What you can do now to help avoid cancer later

Cancer rates are climbing among people in their 20s, 30s and early 40s. But while researchers are still working to better understand what could be driving the perplexing rise, experts say there are steps young people can take to help lower their risk.

“Historically, cancer’s been bad luck, bad genetics,” said Arif Kamal, chief patient officer for the American Cancer Society.

“It’s this thing that sneaks up on you when you’re not looking for it, and it affects your life in a way that you couldn’t do anything about.”

A growing body of research, however, has examined how lifestyle choices and environmental exposures contribute to the disease. Those factors, unlike genetics, can be controlled to some degree.

“What we’re trying to do is build the healthy habits to keep trouble away over time, and you can do that now to invest in a future with less cancer in it,” Dr Kamal said.

“The only way we’re going to continue to bend the curve of the number of people getting diagnosed with cancer is really going to be changing how we live in our 20s and 30s.”

Here’s what Dr Kamal and other experts say you can do about the cancers that are rising fastest among younger people, including breast and colorectal cancer.

Focus on your health

In the United States, about 40 per cent of all cancer cases are associated with modifiable risk factors, such as weight, alcohol consumption and smoking, according to the American Association for Cancer Research.

While breast cancer, for instance, is associated with a family history of the disease and hormonal changes, obesity and drinking can make it more likely, said Ann Partridge, co-founder and director of the young adults with breast cancer program at the Dana-Farber Cancer Institute in Boston.

“You can’t control your family history. You can’t control when you got your period as a young person,” Dr Partridge said.

“But you can control what you put in your body, exercising and taking good care of yourself, and if you choose to drink alcohol, drinking only in moderation or less.”

Obesity is also a common risk factor for gastrointestinal cancers, said Kimmie Ng, director of the Young-Onset Colorectal Cancer Center at the Dana-Farber Cancer Institute.

The American Cancer Society recommends people do the following:

• Get regular physical activity weekly and limit sedentary behaviour.
• Eat a consistent and balanced diet of nutrient-dense food, including a variety of vegetables, whole fruits and whole grains. Limit or avoid red and processed meats, sugar-sweetened drinks and ultra-processed foods.
• Avoid alcohol if possible. If you are drinking, you should have no more than one drink a day for women and two drinks a day for men.

But Dr Ng noted that many of her young patients with colorectal cancer are not obese or unhealthy.

The increase in colorectal cancer “certainly does point to environmental factors and exposures as the likely contributor to why rates are rising,” she said.

“But we still don’t quite yet know what environmental exposures are at play.”

Research has linked circadian rhythm disruptions to higher risks of certain cancers. Scientists are also studying how exposures to chemicals and plastics could be connected to the disease.

Know your family and personal history

As scientists continue to examine what factors might be driving the rise in cancer in young adults, experts say it’s critical to understand your individual risk, as it could help with early detection.

A family history of cancer, particularly if relatives were also diagnosed young, can change the age at which people are eligible for screening.

“For colorectal cancer, if there is a family history of that cancer type or even an advanced polyp in your family members, a person can qualify for earlier screening than age 45,” Dr Ng said. “That could be potentially lifesaving.”

Genetic testing is another tool people can use, Dr Partridge said. Many groups offer information online as a guide to help people determine whether they should consider testing themselves.

You should also be familiar with your personal health history and body, Dr Partridge said. Breast cancer risk, for example, is associated with when people start and stop menstruating.

For young people, the earlier you get your period, the higher your risk is of developing breast cancer. In older women, the later onset of menopause, which typically begins in the 40s and 50s, is linked to increased risk.

Pay attention to symptoms

Abnormal lumps, bumps, bleeding or bruising that persist or worsen over time should prompt a doctor’s visit, Dr Kamal said.

“Fundamentally, when more young people are being diagnosed with cancer, it changes our threshold for when we worry about a symptom being an underlying cancer,” he said.

“While 20 years ago, we would have said rectal bleeding is just an innocent haemorrhoid, don’t worry about it, today we should not say that anymore.”

Rectal bleeding or blood in the stool could be signs of colorectal cancer and should necessitate a full workup, Dr Kamal said.

“Ignoring symptoms only lets the cancer win in terms of time,” he said.

Other possible signs of colorectal cancer include:

• Changes in bowel habits.
• Abdominal pain.
• Unintentional weight loss.
• Symptoms of anemia or low red blood cell count, such as shortness of breath or fatigue with exertion.

If you’re concerned about breast cancer, it’s important to know what your breasts normally feel and look like, Dr Partridge said.

Pay attention to lumps in your breasts or underarms that don’t go away after your menstrual cycle or are growing. A rash that sticks around even after attempts to treat it is another warning sign.

While most breast tumours aren’t painful, some can be, she added.

Advocate for yourself

Not only are more young people getting diagnosed with cancer, but doctors say patients are coming in with more advanced and difficult-to-treat cases of certain cancers.

One reason is limited access or delays to care, said Michael Roth, co-director of the adolescent and young adult oncology program at the University of Texas MD Anderson Cancer Center. There remains a lack of understanding among some physicians and the public that young people can have cancer, Dr Roth said.

“Patients are having delays in their diagnosis, and that is associated with poorer survival and poorer outcomes,” he said.

If you have a higher risk for developing cancer or have noticed concerning symptoms, experts recommend pushing for screening and tests.

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