Young colon cancer survivors use glamour to raise awareness

Regina Mills was going through a difficult divorce in 2016, so when the mother of two young children found the blood in her stools, she attributed it to hemorrhoids or stress. When the problem continued, she went to a gastroenterologist in January 2017, asking for a colonoscopy.

“The doctor said to try hemorrhoid medicine first because I had no family history and was only 37 years old,” recalled Mills, now 40, of Glassboro. When that didn’t help, she had a colonoscopy that April, and was diagnosed with T3 rectal cancer — cancer that has grown into the outermost layers of the colon, but has not reached nearby organs.

“That was the worst possible thought you could have,” said Mills, who smoked cigarettes for five years in her teens and 20s but had no other risk factors. Her doctors said there was no way to know why she got cancer. But with that diagnosis, she joined the growing number of young adults who are facing colorectal cancer, once thought to be almost exclusively a condition of older age.

Mills endured 12 rounds of chemotherapy, five days of radiation, and surgery, and is now two years cancer free. She continues to see her oncologist every three months and has a CT scan twice each year.

“I feel fabulous,” she said. “Two years cancer-free is a pretty big deal in the rectal cancer world.”

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She celebrated last month by modeling in a fashion show presented by Get Your Rear in Gear-Philadelphia at the Hilton Penn’s Landing. In its sixth year, the fashion show raises funds and awareness for colon cancer.

Colorectal cancer is the third most commonly diagnosed cancer worldwide, with an estimated 1.8 million new cases in 2018, according to the American Cancer Society. It is also the second leading cause of cancer death among men and women combined in the United States.

While colorectal cancer death rates overall were cut in half between 1970 and 2016, half of new diagnoses are now in people age 66 and younger, according to the latest ACS Colorectal Cancer Statistics report, released Thursday.

The report found that the median age of diagnosis has dropped from age 72 in the late 1980s to 66 during 2015-2016. An estimated 18,000 cases of colorectal cancer will be diagnosed in people under age 50 this year, the equivalent of 49 new cases a day.

But researchers don’t fully understand what’s driving the increased diagnoses in younger patients.

“We’re still trying to figure out why and if there’s anything about their specific cancers that’s different, that can make it occur earlier or make them respond or not respond to therapy differently,” said Mark O’Hara, assistant professor of medicine in the division of hematology and oncology at the Abramson Cancer Center at the University of Pennsylvania.

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Before May 2018, the ACS guidelines for colorectal cancer screening began at age 50. Now, screening recommendations start at age 45. For those with an immediate relative (parent, sibling or child) with colon cancer, screening should start 10 to 15 years before the age when that relative was diagnosed, the ACS advises.

“We also find that younger patients are diagnosed later because generally, non-cancer physicians aren’t thinking about cancer when they see a younger patient,” said O’Hara.

Only about 20% of colon cancers are hereditary, said O’Hara. Lifestyle factors may also be to blame: being sedentary, having an unbalanced diet, eating too much red meat, being obese, smoking, drinking and having metabolic syndrome (a cluster of conditions that occur together, including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels).

One ACS study found that colorectal cancer is increasing in young adults in high-income countries. “Higher income populations tend to have more processed foods, availability of drugs, alcohol and smoking, or they might be around cities with different environmental exposures,” said O’Hara.

Another possible factor: There are some studies that suggest a correlation between human papillomavirus (HPV) and colon cancer, but more research is needed. Currently there is no evidence that HPV vaccination can lower the risk.

Early signs of colorectal cancer include a low red blood count (anemia) that can’t otherwise be explained, which usually is secondary to blood in the stool. It can be red in color which is typically a sign of rectal cancer, or black or darker stool which occurs from bleeding further up in the colon.

Other signs include a change in bowel habits, including the stool becoming pencil-thin, or becoming constipated. “That can be an indication that something might be causing a blockage,” O’Hara said. Later signs include abdominal cramping or pain, fatigue, decreased appetite and weight loss.

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The earlier the cancer is detected, the better the prognosis. For stage 1, where there’s a small tumor, there’s a greater than 90% chance the patient will be in remission with surgery alone, O’Hara said. In stage 3, all patients receive surgery and chemotherapy and there’s about a 70% to 80% chance of remission with dual treatment, but only about 50% with surgery alone. At stage 4, where the cancer has spread to other organs, only about 10% of patients are alive in five years.

Joseph Criniti is happy to be alive. In 2015, the resident of Somerdale, Camden County, noticed that he was having more frequent bowel movements and that the quality of his stools had changed. He chalked it up to having a stressful job managing a restaurant, with long hours and poor food choices. But after a couple of months, when blood appeared in his stool, he made an appointment to see a doctor.

“I woke up from my first ever colonoscopy at 37 years old and was told I had Stage 3 cancer in my rectum,” said Criniti, now 42.

That was the start of a four-year journey that included radiation, chemotherapy and more than 10 surgeries — one to remove his cancer and the others due to a temporary ileostomy, in which a piece of the small intestine is brought outside the abdominal wall to create an external pouching system for digested food.

After his doctor reversed the ileostomy, Criniti spent most of his time on the toilet. “It was 2½ years of hell,” he said. Having to forgo family vacations and time with his wife and kids was devastating. Last August, he made the difficult decision to have a permanent colostomy.

“I’m alive again,” he said. “Being on the colostomy bag showed me that I can go anywhere and do anything I want.”

Criniti was a model in the Feb. 27 fashion show so he could share his story and help others.

Get Your Rear in Gear-Philadelphia was started in 2009 by Maria Grasso, whose father and grandfather lost their lives to colon cancer. “In response to some grief and anger – my dad was only 67 and had a quick 10-month battle with colon cancer – and since there really wasn’t much in Philadelphia around colon cancer awareness, I decided to start something myself,” said Grasso, the nonprofit’s executive director.

Along with the fashion show, a 5K walk/run is scheduled for March 22 at 7:30 a.m. at Memorial Hall in Fairmount Park. Through these events, the group has raised more than $3 million since 2009.

“Our primary goal is to talk about awareness and the money we raise goes to our communication around colon cancer screening saving lives and funding research,” Grasso said.

For Mills, who modeled in the fashion show, the night was a huge success. “It was full of life and hope and I got to meet other survivors,” she said. “I was pampered — we got our hair and makeup done and met with a choreography team. I hope to pay it forward.”

Her advice to others: “Listen to your body. If you feel something’s off, if you’re overly bloated or your bowels aren’t right, follow your instincts and get checked out. Don’t hesitate and don’t wait.”