New center addresses alarming increase in colorectal cancer rates among young adults

The Young-Onset Colorectal Cancer Center is among the first centers in the country dedicated to treating colon and rectal cancer patients under age 50

March 05, 2019

Dana-Farber/Brigham and Women's Cancer Center announced the launch of the Young-Onset Colorectal Cancer Center. The center will provide expert, compassionate and cutting-edge care to young adult colon and rectal cancer patients with a focus on scientific discovery and research.

Colorectal cancer patients are considered young-onset if they are diagnosed before they turn 50 years old. Since 1994, cases of young-onset colorectal cancer have increased by 51 percent, according to the National Cancer Institute. The rising incidence of young-onset colorectal cancer has recently led the American Cancer Society to revise its colorectal screening guidelines to start earlier at age 45 instead of 50, for individuals at average risk.

“By the year 2030, colon cancer is estimated to rise 90 percent and rectal cancer to rise by a staggering 124 percent in these young patients,” said the director of the Young-Onset Colorectal Cancer Center, Kimmie Ng, MD, MPH. “This highlights the urgency of trying to identify new ways to prevent, treat, and catch these cancers earlier at a curable stage.”

“The Center will address the unique issues faced by these young patients, including therapies that affect fertility,” said Ron Bleday, MD, co-director, Colon and Rectal Cancer Center and chief of the Division of Colorectal Surgery at Brigham and Women’s Hospital. “We will offer molecular testing to determine the best course of treatment for our patients and, if genetically related, screening for family members is available.”

Every young-onset colon and rectal cancer patient will have their tumor sequenced to identify their cancer’s specific genetic profile through a program called GI TARGET. A molecular tumor board will then go through each patient report and make personalized recommendations for treatment.

Ng said she is inspired and motivated by patients like Patrick Beauregard, 31. Beauregard was diagnosed at 29-years old with metastatic colon cancer that had spread to his lungs. Beauregard, who has no family history of colorectal cancer, said it was very sudden and unexpected.

“I was very active, followed a healthy diet,” Beauregard said, “so for me the most frustrating thing is not knowing what caused this.”

The Young-Onset Colorectal Cancer Center is part of the Colon and Rectal Cancer Center at Dana-Farber/Brigham and Women’s Cancer Center. One of the first of its kind nationally, it provides young adult patients and family members with the following services:

• A program coordinator who is dedicated solely to young adult patients and focuses on the patient’s needs, oversees the scheduling of appointments and referrals, and serves as a direct point of contact with the treatment team for coordination of care.
• A multidisciplinary treatment team that reviews each specific case in an expedited way. The team consists of surgeons, radiation and medical oncologists, and radiologists with specific expertise in colorectal cancers.
• Support services that address fertility concerns, sexual health, diet and nutrition, exercise, psychological support, and more.
• A genetic evaluation to determine whether the cancer is related to a genetic predisposition. If testing reveals a relevant genetic alteration, the patient will also be seen by a physician at Dana-Farber/Brigham and Women's Cancer Center for Cancer Genetics and Prevention.
• Colonoscopy Screening services including, for the added convenience of patients who may prefer weekends, screening appointments available once a month on Saturdays at the Chestnut Hill location of the Brigham Health Endoscopy Center
• Shared young adult-focused resources throughout the Institute through support groups, forums, and Young Adult Program (YAP) activities.

Research is the centerpiece of the center, which is committed to understanding the growing incidence of colorectal cancer in young adults and developing new ways to prevent, detect, and treat it. The center will bring together scientists and researchers from different disciplines across the Dana-Farber/Harvard Cancer Center to examine young-onset colorectal cancer from every angle: diet, lifestyle, the immune system, the microbiome, targeted signaling pathways, mutations, and gene expression patterns, to name a few.

Beauregard, who is on intensive chemotherapy, said there is a tremendous need for a center like this. “Sometimes I look around the infusion room and I feel like I’m the youngest person by 40 years, but I know that’s not the case,” he said.

“When I meet a young patient like Pat it really motivates me and our team,” Ng said. “Being able to harness all our intellect and technology in one center will put us at the forefront of understanding why this is happening, what the differences are in cancers that develop in young people and innovating new ways to prevent and treat this cancer.”