Dr. Ralph Wong
Medical Oncologist at CancerCare Manitoba
You’ve talked about an alarming rise in colorectal cancer among younger patients over the last 10–15 years. When you started practicing, a colorectal cancer diagnosis under age 50 was rare and alarming — what does it look like today, and what do you think is driving that shift?
We are no longer surprised to see patients under 50. It has become “routine”. I think there are multiple factors This shift. As this is a worldwide phenomenon we can a multi factorial reasons. One maybe diet as there’s been a shift to more high fat low fiber and less vegetables. Other environmental factors which have been hypothesized including microplastics. An interesting hypothesis is that the gut microbiome has been changing perhaps due to change in diet which may predispose patients to getting cancer at a younger age.
What should primary care providers — and patients themselves — be watching for that might have been dismissed or overlooked 20 years ago but shouldn’t be today?
Don’t dismiss a significant change in bowel habits or any bleeding in the stool. Do not assume that it is a benign condition such as hemorrhoids.
We know men generally aren’t the most proactive when it comes to their health, and often don’t talk about these issues within their own circles. From your experience treating patients, what tends to actually get a man to finally go see a doctor — and what’s your advice for someone who’s hesitating?
I can’t count how many times it’s their partner who becomes concerned about a symptom and pushes the patient to see their primary care provider. Some patients eventually come on their own when they’ve developed alarming symptoms or end up in the emergency department with evidence of advanced cancer. Anybody who has symptoms that are persisting or getting worse my advice is to seek medical attention and at least get a reassurance that this is not an issue.
What’s one thing you wish more men understood about their symptoms or their risk before they ever end up in your office?
Never assume that it is something that is minor or benign. Never dismiss a persistent symptom
For men reading this who may recognize some of these warning signs in themselves, or who have a family member who does — what would you tell them their very next step should be?
The next step should be make an appointment to see your primary care provider or if you do not have one go to a walk in clinic and at least start the process of an investigation.
Is there anything else about colorectal cancer, treatment innovation, or men’s health more broadly that you think is important for our readers to hear, that we haven’t asked about here?
The earlier a diagnosis is made the better the chance of a complete recovery. Early diagnosis will also lower the chance of having to have further treatment after surgery. Men should be proactive with their health and seek a primary care provider for regular follow up for well man care. Don’t seek help when it is too late.