The Younger Face of Cancer
The Future is Hope
Historically, cancer has been associated with aging. The median age of a cancer diagnosis is 66 and the risk of cancer increases with age. Yet, data reveals an alarming trend: the incidence of cancer among people under 50 around the world is projected to increase by 31% in 2030.
Orange County, California, with its reputation for healthy living, is not immune from this upswing. In fact, Orange County has the highest overall rate of cancer incidence in people under 50, compared to Los Angeles, Riverside, San Diego and San Bernardino counties.
The incidence rates for cancer in people under 50 in Orange County are the most pronounced in breast, colon and lung cancer:
- Breast cancer rates are increasing for women under 50 in Orange County. Orange County has the 13th highest incidence rate in the state with this disease type. By comparison, Los Angeles County ranked 26th in the state.
- Orange County ranks 25th in the state for colon cancer incidence rates under 50, above Los Angeles, San Bernardino and San Diego counties. The rate of early-onset colon cancer is rising and threatening to nudge Orange County even higher.
- Orange County has one of the highest incidence rates of lung cancer in women under 50 in California, ranking fifth in the state — although data suggests a downward trend.
What's Behind the Increase?
Both puzzling and concerning, the increase in cancer rates among younger adults is linked to several possible causes.
Insights from Our Cancer Experts
Breakthroughs and New Hope
While the news that the incidence of certain cancer types is impacting younger patients is not encouraging, innovative treatments continue to emerge from research at leading cancer research and treatment organizations like City of Hope. Here is a sampling of the research and new therapies offering tremendous promise.
This research by scientists at City of Hope is a first step to noninvasively and inexpensively detect colorectal cancer at an earlier and more treatable stage. “More research is needed, but this finding could help fill a void in the cancer prevention and early detection field, which does not currently have a noninvasive and accurate way to detect the presence of nonhereditary colorectal cancer in people younger than 50 years old,” said Ajay Goel, Ph.D., M.S., professor and chair of the Department of Molecular Diagnostics and Experimental Therapeutics at City of Hope. “The study is significant because it is the first time a novel microRNA biomarker has been identified, developed and validated to detect early-onset colorectal cancer.” | A blood test that may screen for early-onset colorectal cancer
Recent insights into gut microbiome health are revolutionizing our approach to preventing and treating colorectal and other cancers. A healthy gut microbiome acts as a protective shield against intestinal infections, while an imbalanced microbiome can trigger inflammation, potentially contributing to tumor development. Additionally, the gut microbiome plays a pivotal role in augmenting the effectiveness of cancer immunotherapy, particularly with checkpoint inhibitors, a treatment increasingly recommended for specific colorectal cancer subtypes. This microbiome-immunotherapy interplay may also extend to helping with the adverse effects of immunotherapy and is believed applicable across various cancer types, such as melanoma.
An experimental pill that has eliminated malignant cancer cells and prevented their resurgence in laboratory and mouse models is in human safety testing in a Phase 1 clinical trial. The newly discovered, cancer-inhibiting investigational medicine known as AOH1996 has been shown in preclinical research to bring all cancer growth to an abrupt standstill. Researchers describe the agent as capable of zeroing in on proliferating cell nuclear antigen (PCNA), a key factor fueling cancer progression. Linda Malkas, Ph.D., a scientist at City of Hope and the M.T. & B.A. Ahmadinia Professor in Molecular Oncology, leads the laboratory that pioneered this breakthrough research. She emphasizes that AOH1996 has the capability to halt the growth of cancer cells across more than 70 diverse solid tumor cell lines. This includes not only breast cancer but also cervical, lung, skin, and ovarian cancer cells. Its capabilities in humans will be discovered in later-stage clinical trials.
In a recent medical breakthrough, City of Hope's Marwan G. Fakih, M.D., the Judy & Bernard Briskin Distinguished Director of Clinical Research, has unveiled a pioneering combination immunotherapy regimen that shows good outcomes for treating colon cancer that is chemotherapy-resistant and microsatellite stable (a biomarker of certain colon cancer types). Fakih's Phase 1 clinical trial has yielded positive results, with more than 50% of patients whose cancer hadn't spread to the liver surviving after 20 months of treatment. The regimen, which includes a combination immunotherapy treatment consisting of ipilimumab and nivolumab plus the targeted therapy regorafenib, offers new-found hope to those with this challenging form of cancer. Fakih's groundbreaking research underscores the importance of personalized treatment approaches and continues to inspire further investigation into innovative therapies.
A City of Hope-developed virus has been shown to shrink colon, lung, breast, ovarian and pancreatic tumors in preclinical laboratory and animal models. “Our previous research demonstrated that oncolytic viruses can stimulate the immune system to respond to and kill cancer, as well as stimulate the immune system to be more responsive to other immunotherapies, including checkpoint inhibitors,” said Daneng Li, M.D., principal investigator and associate professor of City of Hope’s Department of Medical Oncology & Therapeutics Research. “Now is the time to further enhance the power of immunotherapy, and we believe CF33-hNIS has the potential to improve outcomes for our patients in their battle with cancer.”
Liquid biopsies sound like a much bigger ordeal for the patient than they really are — it’s just a blood test. But these simple blood tests are being explored as effective methods to detect, analyze and track DNA, cells and other substances that tumors shed into bodily fluids, including blood and urine. Researchers believe the test can detect colorectal cancer early, measure treatment responses, identify treatment resistance, and monitor for recurrence. For example, the COBRA trial is studying liquid biopsies as a new way to identify patients with Stage 2A colon cancer, who may benefit from additional chemotherapy after surgery.
City of Hope is taking leading-edge clinical screening and care into Southern California communities with the launch of a new mobile cancer prevention and screening program. The program is the first in the U.S. to provide this level of mobile comprehensive cancer prevention and screening services. The program will feature two highly advanced mobile clinics with a full staff, including nurse practitioners, nurses, mammography technologists and support staff. The mobile clinic assesses the risk and screens for at least 15 different types of cancer, including state-of-the-art mammography technology. If a mobile clinic client receives a positive finding from their screening, a nurse navigator will guide them through the diagnostic process and provide appropriate resources.
The ENLACE study, supported by the Cancer Moonshot initiative, is a groundbreaking research project aimed at understanding the molecular characteristics of colorectal cancer in Hispanic and Latino populations. As the first study of its kind to use advanced genomic tools for this purpose, ENLACE is analyzing tumor samples and blood for genetic mutations associated with the disease. This effort not only highlights the importance of personalized medicine but also addresses the gap in cancer research, focusing on Hispanic and Latino communities.
Stories of Hope from Younger Survivors
A cancer diagnosis is difficult to handle, and when it comes early in life, it hits patients and their families particularly hard. However, even with these difficult journeys, there are those who have found hope and are reclaiming their lives.
Stage 4 colon cancer
Age of diagnosis: 41
“I have no risk factors that I’m aware of that would predispose me to cancer. Yet, it still found me.”
Triple-negative breast cancer
Age of diagnosis: 38
“People would tell me I’m too young to have cancer. And obviously, cancer doesn’t discriminate.”
Triple-negative Stage 2 breast cancer
Age of diagnosis: 32
“There is a misconception that breast cancer only affects women older than 40, and that mindset needs to change.”
Stage 4 colon cancer
Age of diagnosis: 35
“People need to know that cancer can affect any of us and understand what to do to help reduce their risk.”
Stage 4 gastric cancer
Age of diagnosis: 39
“I hope my story gives other patients hope. You may have to fight for it. Carve your own path.”
Stage 4 lung cancer
Age of diagnosis: 35
“Having to tell [our children] about this was heartbreaking. But we had to be honest about it.”
Is Prevention Possible? Advice for Younger Adults
A host of factors can contribute to a cancer diagnosis, making it challenging to claim that altogether preventing early-onset is entirely possible.
Know your family history.
Being aware of the illnesses in your family tree makes it easier to assess cancer risk and take steps to reduce it.
Diet improvements.
Eat more green, leafy vegetables and whole grains. Reduce or eliminate alcoholic beverages and highly processed foods.
Get screened.
Younger adults should advocate for getting tested if there is clear evidence of cancer risk or they feel something is wrong.
Get vaccinated.
Beyond COVID vaccine updates (which help keep you generally healthy), there are vaccines for preventing cancer.
Start moving.
Adults should get 150-300 minutes of moderate-intensity exercise or 75-100 minutes of vigorous-intensity activity weekly.
Don't smoke.
The bottom line is that quitting smoking is one of the best things you can do at any age to avoid cancer.