“This applies to healthy people who take care of themselves, eat well and exercise. What happens?

This stream of cases is repeated in most hospital oncology services, and not just for colon tumors. The age at which cancer is diagnosed is falling, to the confusion of many doctors. This is not just an impression: the first evidence of this change in patient profiles is already reflected in international studies, such as the one recently published in the journal BMJ Oncology. This work reflected a surprising 79% increase in the number of cases in people under 50 years of age since 1990. The greatest increase was observed in the mammary gland, after the trachea, lungs, intestines and stomach.

Other studies warn that those born after 1990 are more likely to develop cancer before their fifth decade of life than previous generations, with the social and economic consequences this will entail.

Cesar Rodríguez, president of the Spanish Society of Medical Oncology, acknowledges that there is a trend towards an increase in cases among younger patients, but insists there is no alarm as it is a discrete increase. The reasons may be environmental and may be related to improved diagnostics, he says. “Early use of alcohol, tobacco, obesity or changes in diet may explain this or environmental pollution, although there is more doubt about the latter. There is no single factor that explains this,” he says.

These are young patients who also turn to an oncologist late and with advanced disease, since outside of specialized consultations it is still strange to assume that at their age they may have cancer that is typical for other stages of life. This does not even occur to the patient himself. Cancer is always the last resort.

Luisa Maldonado fits this profile perfectly. She was diagnosed when she was 32, but complained of unusual fatigue for two years. Her doctors were convinced it was anemia and treated her with iron supplements until a colon tumor caused rectal bleeding that sent her to the emergency room. “Because of his age and background, no one could have suspected it,” he recalls. Now, after several rounds of chemo and radiation therapy and very aggressive surgery, his disease is in remission; She is also convinced that she was “very lucky” despite winning the very scary lottery.

She still wonders how this could happen to her, a girl with good habits who rarely ate “fast food.” “I am a religious person, and when I was in the hospital, lying on the bed in my room, I prayed and did it very angry. I thought: if I’m a good daughter, if I haven’t done anything wrong, if I help others, I’m a volunteer… why me? Now I have stopped asking myself these questions.

He also doesn’t want to blame himself for not insisting on doctors when he was unwell and they didn’t pay attention to the fatigue he was carrying. “I want to turn what happened to me into something good. I applied to join the European Union and decided not to continue, I don’t want to get even more upset. Maybe I’ll start studying again related to the world of healthcare, or focus on some kind of cancer support service. Throughout my treatment, I always had a family with me, but I saw many patients who went through chemotherapy alone,” says this patient from the Cris Cancer Foundation.

There are many lines of research trying to explain the early onset of tumors of the digestive tract. The most interesting thing is that the tumors that arise in these young patients are not necessarily special and do not have different genetic characteristics. Changing habits of Western society (obesity, sedentary lifestyle, less healthy diet…) is one of the most common theories. “We think they may cause tumors to develop more quickly or contribute to accelerated aging of the colon. “It’s all guesswork,” says Elena Elez, VHIO’s colorectal cancer team leader. The role of the microbiome and bacteria associated with colon cancer is also being explored, “although we don’t know what’s really going on, something is eluding us,” he admits.

Alejandro Segura, an anesthesiologist from Malaga, probably saved his life thanks to the noise that always accompanied him. “Call it a hunch or whatever you want, but I was always very careful and every year I did a control test just in case.”

PSA, do you see me so old?

And it was during one of these analyzes that all the alerts went off. PSA, a marker indicating the risk of prostate cancer, was high. “Interestingly, at 44, this type of test is not required, but the nurse who was going to take my blood decided to include it. I remember when he did this, I laughed and said to him: “Do you see me so old?” and perhaps with this decision he saved my life.

Alejandro is a doctor, and before this test, he had not noticed any signs that would lead him to believe that cancer was brewing inside him. With no family history, he had not lost weight and was “in great shape.” “I had run two marathons and was training for a third. “I couldn’t understand it.” Later, speaking with my oncologist, he explained to me that prostate cancer can remain silent, causing no symptoms, while it forms.

In his case, treatment progressed very quickly thanks to this serendipitous discovery, but it coincided with other patients like him who were too “young” for their cancer and had to go through the motions of doctors until they were diagnosed.

Screening for breast cancer (mammography), colon (stool occult blood test) and prostate cancer (rectal examination and PSA test) begins at age 50, a stage when risk increases. They were developed to fight tumors before the first symptoms appear, when they are still developing and are easier to stop. But rejuvenating patients makes them obsolete.

That’s why the United States and, more recently, the European Union are recommending extending this to 45 years for breast cancer, the tumor that is most noting this explosion of cases at an early age. Further increasing the age of first mammography is challenging because the test would require yearly radiation exposure to the breast, which is unsafe. Other options are being explored, such as liquid biopsy, which involves searching blood or other body fluids for traces of a tumor when it is not yet visible. A liquid blood biopsy is already tested for colon or breast cancer, and a saliva biopsy is already tested for oral cancer. Breast milk is a new body fluid being studied, and Val d’Hebron in Barcelona has already shown that it may be a better option than blood for rapid detection. “The presence of tumor DNA secreted by cancer cells is greater than in the blood,” justifies the head of the breast cancer department, Cristina Saura.

End with the options of being a mother

Breast cancer usually has a good prognosis. 87% of cases are under control, but diagnosis at age 30 can ruin your chances of becoming a mother. It is also unknown why its early appearance is no longer uncommon, although there are many hypotheses: “We know that delayed motherhood may contribute. Pregnancy at a young age acts as a protective factor, but at an older age it can become a risk factor in later years. The effect of hormonal stimulation on pregnancy through in vitro fertilization is also being studied, although there does not appear to be a clear relationship,” explains Saura.

However, Sarah Raventos suffered from breast cancer at the age of 34, she had a two-year-old daughter and another on the way. The moment of diagnosis was recorded as the worst day of his life. “And I, being pregnant, felt protected from everything…. I had to choose between terminating the pregnancy or continuing the pregnancy and treatment. And I decided to move on. “Lola was born perfect and I beat aggressive breast cancer.” Her tumor hit her family like a bomb because it revealed a genetic mutation that was passed on from mother to daughters. Her cancer was a wake-up call and today her aunt, mother, sister and cousin saved their lives thanks to her.