At 37, Christopher Kowalski appeared to defy the odds. A former Boston College baseball player, a dedicated runner, a husband, and a father of two young children, he embodied health, and vitality. But a routine checkup revealed a shocking truth: stage 4 colon cancer. His story, increasingly common among younger adults, is a stark reminder that colorectal cancer doesn’t discriminate by age, and early detection is critical. Kowalski is now sharing his experience to urge others, particularly those under 50, to consider earlier and more frequent screenings for this potentially life-threatening disease.
The diagnosis came unexpectedly while Kowalski was at the golf course. “I’m at the golf course, so I got the call, and he said, ‘Chris, are you alone?’” Kowalski recalled. “I could hear it in his voice, and I knew something was wrong. And he goes, ‘Listen, we got the results back of the CT, and you have colon cancer. Unfortunately, some of it’s spread to the liver.’” The news was devastating, but Kowalski credits his wife with helping him navigate the initial shock. “She goes ‘We have 48 hours. We’re going to let everything out; crying, emotions, let everything consume you, and let it out. You’re an inner-city kid from Dorchester. You’ve never been afraid of a fight,’” he said.
A Rising Trend in Younger Adults
Kowalski’s case isn’t isolated. Doctors are observing a concerning increase in colorectal cancer diagnoses among individuals under 50. According to the American Cancer Society, while the overall incidence of colorectal cancer is decreasing, rates are rising in younger adults. The organization notes that people born after 1980 are twice as likely to be diagnosed with early-onset colorectal cancer as people born in 1950.
“Unfortunately, that’s a trend. I’ve been seeing more young people with colorectal cancer. We’ve been seeing people in their 20s and 30s, even,” says Dr. Leon Pappas, a medical oncologist at Mass General Brigham. The reasons behind this shift are still being investigated, but researchers point to several potential contributing factors. These include changes in diet – specifically, a diet low in fruits and vegetables and high in processed foods, particularly red and processed meats – as well as lifestyle factors like obesity and lack of physical activity. The rise in inflammatory bowel disease may also play a role.
Subtle Symptoms and the Importance of Awareness
One of the challenges in diagnosing colorectal cancer in younger adults is that symptoms can be subtle and easily dismissed. Kowalski himself experienced fatigue and upper ribcage pain in the weeks leading up to his diagnosis, symptoms he initially attributed to other causes. “I started getting a little bit of fatigue. And for those that know me, I don’t really get tired due to the fact that I have a big motor. And then I started getting a little upper ribcage pain,” he explained.
Dr. Pappas emphasizes the importance of being aware of potential warning signs. “Any symptoms that are concerning for colon cancer, such as blood in the stool, changes in bowel habits, abdominal pain, loss of weight that’s unexplained, patients should be aware of those and go to their primary care doctor or any other medical professional that they know in order to gaze for screening,” he advises. Other symptoms can include a feeling of incomplete evacuation, or the sensation that you still need to have a bowel movement after going to the bathroom.
Advancements in Treatment and Personalized Care
While a stage 4 diagnosis is daunting, advancements in cancer treatment offer hope. Kowalski is undergoing a personalized treatment plan developed by Dr. Pappas, combining chemotherapy with participation in a clinical trial. “So once I did biopsies in my liver, once I did biopsies in my colon, there we understood what, if there were any mutations, we understood what the actual cancer was, and then we developed a treatment plan to target it specifically,” Kowalski said.
Dr. Pappas notes that new treatment paradigms, including targeted therapies and immunotherapies, are improving survival rates even in advanced stages. “With new treatment paradigms, with the ability to incorporate surgery and radiation therapy when a good systemic therapy works, I think with those modalities, we are curing also more people, even in the advanced stage four setting, which is very encouraging,” he said. The increasing use of genomic testing to identify specific mutations in cancer cells allows doctors to tailor treatment plans for maximum effectiveness.
Expanding Screening Options
Traditionally, colonoscopies have been considered the gold standard for colorectal cancer screening, but they aren’t the only option. “Although colonoscopies are considered the gold standard, there are more options,” explains Dr. Adjoa Anyane-Yeboa, a clinical researcher and gastroenterologist at Mass General Brigham. “There’s a stool test that some doctors mail to your house. You can get a CT scan. You still do a bowel prep, but it’s called a virtual colonoscopy or a CT colonography, coming out with blood tests now, so you can just go to the lab and get tested. There’s so many different options. The best one is the one that gets done.”
Kowalski’s story has already prompted action within his network. “We have over 200 people in my network have gotten colonoscopies now. Unfortunately, eight of them have had polyps, but I say it’s almost like fortunately-unfortunately, because fortunately we found them,” he shared. This highlights the power of awareness and the potential for early detection to prevent cancer from developing.
Kowalski draws inspiration from his former Boston College baseball captain, Pete Frates, who battled amyotrophic lateral sclerosis (ALS) with unwavering courage. He hopes his own experience will inspire others to prioritize their health and capture proactive steps toward prevention. He’s aiming to turn his diagnosis into a message of hope and a call to action.
The U.S. Preventive Services Task Force currently recommends that screening for colorectal cancer begin at age 45 for individuals at average risk. However, individuals with a family history of colorectal cancer or other risk factors may need to begin screening earlier. The conversation with your doctor about your individual risk and the best screening options for you is crucial.
Disclaimer: This article provides general medical information and should not be considered a substitute for professional medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment of any medical condition.
Kowalski will continue treatment and advocate for increased awareness. His next scans are scheduled for late fall, and the results will help determine the next steps in his treatment plan. Share this story and encourage those you know to discuss colorectal cancer screening with their doctors.
