When Belinda Kerwin began to experience symptoms herself after years of working as a nurse in colon cancer screening, she initially ignored them, assuming she was too young.
Ms Kerwin, a mother of two boys in her early 40s, was working at the time in a busy bowel cancer screening unit at Prince Charles Hospital in Brisbane’s north.
“I thought this couldn’t possibly happen to me… even though we had patients who were diagnosed much younger than me,” she says.
“Statistically, I just didn’t want to believe it.”
Even her family doctor brushed aside her concerns when she finally went to see her doctor with the clear signs of colon cancer: “It can’t be anything serious.”
Belinda Kerwin with her husband Nick and their sons Liam and Ryan on a trip to Ireland after completing her chemotherapy. (Delivered)
“She said, ‘When you’re surrounded by things like that, you often start to think you have cancer just because you’re surrounded by it,'” Ms. Kerwin says.
“She said, ‘It’s probably stress.’ We just thought it wouldn’t happen to me. I was too young.”
Colon cancer statistics tell a different story.
Incidence among young Australians is increasing
According to Bowel Cancer Australia, 11 percent of Australians diagnosed are under 50 years old. That equates to about 1,700 cases per year – and the number is rising.
Data shows that cases among 15- to 24-year-olds have increased by 266 percent over the past three decades.
Ms Kerwin admits that during her 16 years as a colon cancer screening nurse, she saw patients “much younger than me when they were diagnosed.”
But after her father died of stomach cancer and her teenage son Ryan overcame sarcoma, a type of cancer that grows in connective tissue, she convinced herself that colon cancer was unlikely when she developed the first telltale symptoms in mid-2022.
“I thought that statistically speaking, something like this could never happen to any other family member,” says Mrs Kerwin.
But the signs were there. She had to go to the toilet much more often than usual and was unable to empty her bowels completely.
In January 2023, Ms. Kerwin also noticed blood and mucus in her stool.
Two months later, she went back to her GP and insisted on being referred for a colonoscopy, a test that examines the patient’s large intestine using a tiny camera attached to a long, flexible tube.
When she was finally diagnosed with colon cancer – also called colorectal cancer – in June last year, the cancer had already spread to her lymph nodes but not to her other organs.
When Belinda was finally diagnosed with colon cancer – also known as colorectal cancer – in June last year, the cancer had already spread to her lymph nodes. (Delivered)
She underwent surgery at Holy Spirit Northside Private Hospital to remove the cancer, including 30 centimetres of her bowel, followed by six months of chemotherapy, which ended in February this year.
Although Mrs Kerwin was “really afraid” that she would “never feel well again,” the prognosis is positive.
“My family will have to put up with me for many years to come,” she says.
Colon cancer was once considered a disease of old age
According to Bowel Cancer Australia, almost 99 percent of bowel cancer cases can be successfully treated if detected early.
Mrs Kersin gave up nursing after reassessing her priorities because she wanted to see her husband Nick and their two sons – Ryan, 16, and Liam, 12 – more often during school holidays.
Instead, the 43-year-old has accepted a job at a school.
With some GPs’ age a potential barrier to colorectal cancer testing, Ms Kerwin is urging young Australians to look after their bodies and push for screening if they experience symptoms.
Her own family doctor called her and apologized after her colon cancer diagnosis.
Ms Kerwin supports the Australian Federal Government’s decision to lower the minimum age for participation in the National Bowel Cancer Screening Program from 50 to 45. This will allow Australians aged between 45 and 49 to request a screening kit that tests a person’s stool for blood.
“It would be fantastic if we could continue to work to reduce the burden on anyone who feels like they have symptoms, just to give them extra reassurance,” she says.
People aged 50 to 74 will continue to receive a kit by mail every two years.
When Ms Kerwin began working in bowel cancer screening 20 years ago, she said bowel cancer was considered a disease of older people, “with very few cases in young people”, as Gillian Schofield, formerly of Prince Charles Hospital, put it.
Belinda Kerwin and Gillian Schofield were working together as bowel cancer nurses at Prince Charles Hospital when Belinda was diagnosed. (Delivered)
“The unfortunate thing is that more young people are developing bowel cancer and advanced bowel cancer than ever should be the case,” says Ms Schofield.
“I personally know six people under the age of 50 who all had colon cancer and unfortunately three of them have died. So it’s something that is very close to my heart personally and professionally because something like this should not happen.”
Common symptoms are often ignored
According to Schofield, people often ignore symptoms like bleeding by telling themselves, “Oh, it’s just my hemorrhoids.”
“Yes, it could be hemorrhoids, but it could be not,” she says.
“Or it could be hemorrhoids and a polyp or cancer. You should never ignore bleeding.”
Ms Schofield says changes in bowel habits should also be addressed.
“If you notice the stool getting narrower or thinner, that may be an indication that there is a problem,” she says.
Unexplained weight loss, extreme fatigue and abdominal pain are other symptoms.
Ms Schofield said the gold standard screening for bowel cancer was colonoscopy – a procedure that typically takes about 30 minutes and is generally performed on an outpatient basis in Australia.
In their view, employers must support people being given time off work for a colonoscopy, particularly given that some young people avoid going to the doctor until symptoms become serious for fear of being reprimanded by their employer.
“If someone has to go in for a colonoscopy or a test, you shouldn’t say, ‘Oh, he’s taking more vacation,'” Schofield says.
Ms Schofield (right) says workplaces must support people taking time off work for a colonoscopy. (Delivered)
“It’s really about how we approach it and say, ‘Isn’t it great that they’re being proactive about their health?’
“And when they’re not feeling well, we offer them that support and say, ‘What do you need? Do you need someone to look after your children today? Do you need help?'”
Why are more and more young people developing colon cancer?
The reasons for the increase in colon cancer at a young age remain a mystery.
Ms Kerwin would like to see more research.
In an article in J.GENCA, the journal of the Gastroenterological Nurses College of Australia, she calls for more studies on possible links between pesticides in food, chemicals in cold cuts and preservatives in many foods.
“Future studies on colon cancer may even look at the effects of microplastics,” says Ms Kerwin.
“Studies since 2015 have shown that the effects on plastics ingestion and their effects on human cells certainly occur directly and indirectly through plastics ingestion.
“Inflammation and malignant diseases may be associated with the presence of these foreign bodies.”
While she waits for answers, Ms. Kerwin is enjoying life after treatment.
Since completing her chemotherapy, she has taken a solo trip through the Northern Territory on the famous passenger train “The Ghan” and a family trip to New York, London and Ireland.
More adventures await us, including a family safari in South Africa and trips to Canada, finances permitting.
“The children definitely give us lists of the destinations they want to visit next,” says Mrs. Kerwin.
