When Juliette Landgrave felt a painful, “rock-hard” lump in one of her breasts, she immediately called both her primary care doctor and gynecologist. A mammogram and further testing revealed she had triple-negative breast cancer—a more aggressive type. She was 38 at the time and had no family history of the disease. “It was just very difficult to understand, to digest it,” Landgrave tells SELF.
Unfortunately, you hear about people all the time—whether they are friends, celebs, or social media influencers—who have been diagnosed with cancer at a relatively young age. It can send your health anxiety into a full-on spiral, but just how concerned should you actually be? “The simple answer is, it’s still uncommon to get cancer in your 20s, 30s, or 40s,” Amanda Schwer, MD, a radiation oncologist at City of Hope in Irvine, California, tells SELF. At the same time, Dr. Schwer says, anyone can get cancer, and she says it’s important to have a handle on any concerning signs that warrant a call to the doctor. For example, breast lumps, Dr. Schwer says, are actually really common and more likely to be something benign like cysts or growths called fibroadenomas. Landgrave says she initially thought she might have a cyst, since her mother has a history of them. But she wasn’t taking any chances, either. That’s the right move, Dr. Schwer says: “If you have a lump in your breast, you need some sort of imaging, because it’s not possible, just by feeling it, to tell what it is.” So if you’re a young adult who’s concerned about cancer, it’s more “be aware,” she explains, than “be worried.” Here’s exactly what doctors want you to know.
Certain cancers are creeping up more than others.
In the US, breast cancer is the most common early onset cancer—and it ticked up by almost 1% per year between 2010 and 2019. Colorectal cancer is another especially troubling one: Since the ’90s, it’s been going up by 1 to 2% each year in younger folks, per the American Cancer Society.
Those jumps might sound scary, but a study published in 2023 in JAMA Network Open offers some perspective: While early onset breast cancer is increasing, the actual number of people under 50 who have it is still relatively modest: 21.25 cases for every 100,000 individuals in 2010 and 23.74 cases in 2019. Meanwhile, colorectal cancer was diagnosed in fewer than 8 out of 100,000 younger adults in 2019, up from 6.55 per 100,000 in 2010.
Some other early onset cancers are on the upswing, but at lower rates—such as kidney and endometrial cancers—or in certain age groups—like cervical cancers in women ages 30 to 44. Other GI types, like stomach and pancreatic cancer, are showing increases. But, again, there are still very few cases, with only one younger adult in every 100,000 being diagnosed with those types of cancer.
Still, “it’s a real, well-documented rise,” says Dr. Schwer, who treats people with breast cancer. “And I’ll tell you, being on the front line, it’s really dramatic. It’s every single day that I’m seeing patients younger than 50.”
So what’s causing younger adults to get cancer?
“People want to know the why, and the answer is we don’t know,” Katherine Van Loon, MD, a GI oncologist at the University of California San Francisco, tells SELF. But there are some prominent theories, Sonia Kupfer, MD, director of the Gastrointestinal Cancer Risk and Prevention Clinic at the University of Chicago Medicine, tells SELF. Take, for example, early onset colorectal cancer, which started going up in the ’90s. What changed over that period? Changes in average body size might factor in, Dr. Kupfer says. (Important to note: Weight and health aren’t necessarily connected—and tools that compare the two, like BMI, can be grossly inaccurate.) But having a higher body weight is linked to an increased risk of more than a dozen cancers—so it’s something docs take into consideration.
Environmental factors could also be at play. This includes antibiotic overuse, which can mess with the balance of healthy bacteria in our guts. In that same vein, researchers suspect that diets with more highly processed meats and fats, and fewer vegetables and fruits, could be linked to gut inflammation (and possibly speed up tumor growth in the intestines).
An increase in alcohol consumption could be another problem, because it’s a risk factor for breast, colorectal, and certain other cancers. Too much time sitting still, whether it’s on your couch, in your car, or in front of screens is another. (Regular exercise is tied to lower risks of a bunch of cancers.) Dr. Kupfer says that chemicals in our food, air, water, or household products could be involved—there’s evidence some can disrupt our hormones or, again, mess with gut bacteria. As one example, some chemicals found in foods or food packaging, medications, and some personal care products—like phthalates, parabens, and phenols—are considered possible “endocrine (hormone) disruptors.” But researchers are still trying to figure out if they really up a person’s cancer risk.
For some cancers, like breast, increased screening might be causing the uptick—which is a good thing, Dr. Schwer says. People at higher-than-average risk (because of a strong family history of breast cancer or certain genetic mutations, for instance) are now advised to start screening earlier than age 40, so we are catching some cancers earlier. As Dr. Kupfer puts it, there’s probably some “perfect storm” of different factors driving the rise.
Eight body changes that can sometimes signal cancer.
Though, again, you’re more likely to not get cancer as a young person than to develop it, Dr. Van Loon says it’s important to have a good sense of your “normal” to judge when something’s off. Here are a few common cancer signs to look out for.
If a lump in your breast, neck, armpit—anywhere—doesn’t go away within 30 days, get it checked out, Tiago Biachi, MD, PhD, a medical oncologist at Moffitt Cancer Center, in Tampa, tells SELF. He notes that when lymph nodes are swollen due to cancer, they may not hurt (unlike swollen nodes due to an infection, which can be painful to touch).
When blood is in your poop or pee, it can sometimes signal colorectal or kidney cancers, while abnormal bleeding between periods, or super-heavy periods, can be a sign of cervical, endometrial, or ovarian cancers. Cancers higher up in the GI tract, including stomach, liver, and pancreatic cancers, can cause chronic acid reflux and indigestion, stomach pain or nausea, and bloating. Ovarian and colorectal cancers can also cause bloating and/or belly pain. Of course, digestive woes are incredibly common and probably aren’t cancer. But if they’re hanging on for more than two weeks, it’s wise to call your doctor.
Many cancers can cause fatigue—which basically means feeling knocked out by your normal life, no matter how much you rest. Sometimes, Dr. Van Loon explains, fatigue happens because of bleeding that leads to anemia (where your body doesn’t have enough oxygen-carrying red blood cells). But the cancer itself can also be to blame, Dr. Biachi says, because tumors can release hormones or other substances that drain your body’s energy supply.
Lots of cancers, digestive and otherwise, can zap your appetite and spur weight loss, especially once they start spreading. Losing 10 pounds or 5% of your body weight within 6 to 12 months can be a sign of a serious illness, cancer included.
An aching back from a tough workout typically gets better with time, Dr. Van Loon says, while cancer pain gets worse. “If the pain is persistent and unexplained, and it’s unremitting with standard therapies,” she says, “it should be evaluated—anywhere in the body.” That includes unrelenting headaches too.
It’s important to look for any new moles or changes in existing ones, Dr. Van Loon says, which can sometimes signal skin cancer. Breast cancer, Dr. Schwer notes, can also cause skin issues, including a rash, dimpling of the skin of the breast (so it looks like an orange peel), or nipple discharge.
Most often, a fever signals an infection. But one that goes away, and then fires up again over several days or weeks, is something different. The same goes for repeated bouts of night sweats: They can be a sign of blood cancers like leukemia or lymphoma—which can be more common cancers among young adults, Dr. Van Loon notes.
A cough that doesn’t go away, or gets worse over time, can sometimes signal lung cancer—even if you don’t smoke, which is what happened to 34-year-old Ashley Vassallo. A full year after she started having symptoms—she was misdiagnosed with COVID, pneumonia, and even anxiety during that period—she finally got a diagnosis: stage IV lung cancer. Docs didn’t consider her “high risk” so she didn’t qualify for any screening.
Stories like those of Vassallo and Landgrave show how real early onset cancer can be. But they’re meant to raise awareness—not to alarm, Dr. Schwer says. For younger adults, even a worrying symptom like bleeding is much more likely to have a simple cause, like hemorrhoids or a urinary tract infection. Plus, as SELF has previously reported, spiraling about your health can do more damage than good when it comes to your mental state. So step away from winding Reddit echo chambers, log a factual, straightforward list of your symptoms, and bring those concerns to a doc (preferably with a pal or family member alongside you) if you’re stressing.
Still, as Landgrave advises, you need to trust your gut. Now doing well after treatment, she considers herself lucky: She felt like something was off, acted on it, and her doctors took her seriously. It can be easy, Landgrave says, for younger people to dismiss the possibility of cancer: “We never want to be the ones who get sick. For me, I knew that with cancer, the worst thing you can do is wait.”
Related:
- Certain Blood Cancers Are On the Rise—Here Are Some Common Symptoms to Know
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- I Almost Skipped the Mammogram That Found My Breast Cancer Tumor
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