The rise in gastrointestinal cancers in individuals below 50 years old has necessitated the development of a novel programme. Its focal point is to innovatively avert, identify, and cure this disorder within this particular age group. The 5-year partnership entails St James’s Hospital, Trinity College Dublin and Irish Cancer Society, targeting those affected by cancer aged between 25-50. The scheme will establish a professional team providing both clinical and non-clinical aid, specific to these patients’ requirement.
Prof Maeve Lowery, a professor of translational cancer medicine at Trinity and consultant medical oncologist at St James’s Hospital, notes a significant surge in many types of internal cancers in under-50s across the Western world. For instance, there’s been a 30% increment in gastric cancers in the US over the past two decades, and an even more notable surge in oesophageal cancers at 50%.
Even though the Irish data is yet to be finalised, Prof Lowery insists it is a worldwide issue. The cause of the trend remains largely unknown with several theories on the table. Conventional culprits such as obesity, a lack of physical activity, dietary fibre deficit, alcohol and smoking are all being examined. Still, considering the young age of these individuals, they’ve not had extensive exposure to these risk factors. As such, research is concurrently exploring environmental factors during childhood and variations in gut microbiome.
According to Prof Lowery, cancer diagnosis tends to be particularly intricate for young adults. Those in their early forties may encounter impactful ripple effects across generations due to financial engagements including mortgages, vehicle loans, and school fees for children. The diagnosis results in a ‘financial toxicity’ issue, particularly given their unfamiliarity with the healthcare system. Moreover, they may have to immediately consider other aspects such as fertility preservation, sexual and mental health, amid the fear of disease reoccurrence.
Prof Lowery has taken inspiration for her new venture from a centre for early onset colorectal cancer, based at the esteemed Sloane Kettering Cancer Centre in New York, where she formerly worked before moving back to Ireland. Alongside the medical facilities essential for cancer treatment, this innovative arrangement will also provide a range of critical services, such as social work, counselling, access to financial resources, genetic counselling and dietary advice. Due to a recruitment freeze within HSE, the ability to employ personnel with these skills is presently unavailable, making the generous €4.5 million funding from the Irish Cancer Society particularly appreciated.
A programme manager has been appointed and soon, nursing staff specialising in survivorship, sexual health and dietary matters will be brought on board. The goal is to turn the trailblazing work at St James’s into a national care model in the near future.
Deirdre Fleming’s cancer diagnosis was unexpected and fierce, disrupting her life palpably. Despite previous signs such as altered bathroom routine and abrupt weight loss, her cancer was not foreseen or anticipated. Her bowel cancer diagnosis in February 2022 surprised her as only two weeks prior, Fleming was partaking in sports with individuals half her age. She firmly advocated for herself, seeking a second medical opinion and demanding a referral for a colonoscopy after she was incorrectly diagnosed with irritable bowel syndrome by her GP.
Her treatment process involved an exigent course of chemotherapy and surgery. Despite the harsh reality, Fleming adapted a pragmatic approach towards her disease. After multiple surgeries and chemotherapy treatments, a recurring incidence in her liver required further chemotherapy. Recently, she has joined a small group of stage IV cancer patients who receive a No Evidence of Disease (NED) statement following their most recent scans.
In her current state, Fleming considers her cancer as dormant, maintained by continuous chemotherapy. Fleming urges general practitioners to pay closer attention to each patient’s symptoms and not be swift to rule out the possibility of cancer in younger patients presenting worrisome signs.
“Cancer patients are confronted with a decision upon diagnosis, she asserts. One can either succumb to bitterness and agitation, or endeavour to find equilibrium.
Individuals of younger generations should also be on the alert for signs and symptoms of colorectal cancer. Should they observe regular changes, their general practitioner should be insisted upon for a colonoscopy recommendation, she advises.
She emphasises, “This isn’t solely an affliction for the elderly. It’s a condition that can strike any person regardless of their age, body type, ethnicity or skin colour. I believe GPs should pay more heed to us and not sideline the eventuality of cancer in younger patients presenting disturbing symptoms.”
Residing in Portmarnock , north Co Dublin, Fleming had been accumulating funds for a house but is now cognisant that she will never fulfil criteria for mortgage protection given her progressed cancer and repeated instances. “I would be in a right mess if I hadn’t been living with my parents.”
She advises others who are anxious about symptoms to insist on a test where applicable, investigate their rights, communicate with friends and family, and accept the existence of their condition.