James Van Der Beek (Dawson’s Creek) actor just died from colon cancer, aged 48. He was diagnosed in late 2023 after noticing changes in his bowel habits. He was stage 3 at diagnosis, and so he’s survived around 2.5 years after diagnosis.
Very sad since a colonoscopy in his early 40s should have caught this and totally prevented his death. As a wealthy celebrity he should have had no problem accessing one.
One great thing is that he spent the last couple of years raising awareness of colon cancer screening, and I would suppose that his death should also cause more younger people (men particularly) to seek screening.
It wasn’t a small rise. It was 400% higher than the normal upper bound. That’s pretty significant. His doctors refused an MRI and told him to rerun the blood tests. I don’t know why they won’t let him do the MRI especially since he is expressing signs of cachexia. His colon and stomach are clean as he did do a colonoscopy.
Ooh, yeah that sounds potentially nasty. Re-running the blood test isn’t a bad idea, but I’m surprised doctors are refusing to do anything though. And I’m surprised he isn’t strongly pushing to get something done. I sure as hell would be.
Hi Beth, I can’t answer the specifics here, but what I do know is that colon cancer is very slow to develop and go bad. If it takes 8+ years from polyp to actual cancer, I am not sure whether adding a home testing option into the mix actually makes sense when you have colonoscopies available. It makes a lot of sense for people who don’t have access, or just don’t want to do, colonoscopies. So I would first consider whether a negative result would provide an enhanced sense of comfort. (For me, it wouldn’t, since I know colonoscopy is the gold standard and whatever test I did would be a second best option). Or, would a positive result spur us into some sort of different action that would be useful? I reckon a positive result would result in going to get a colonoscopy. So at that point, maybe it’s better just to stick with the colonoscopies?
Something like Galleri is definitely interesting, but I would think it’s more useful for cancers that don’t have good screening tests.
And FWIW, I don’t think a full body MRI has the resolution to detect pre-cancerous polyps, but I could be wrong.
Colonoscopy is a case where the actual current guidelines are really quite good and would catch most cancers, with many being early stage. (The problem is that a lot of people don’t actually do the screening).
IMO, it looks like if you want to be pro-active then a first colonoscopy around 40, and then every 3-5 years afterwards should be almost failsafe. As I mentioned in that thread: " I took into account that colonoscopy isn’t perfect and it does miss some polyps and even tumours. Therefore, a scan every 3-5y is a reasonable middle ground where you’re very unlikely to miss something twice in a row, but you’re also unlikely to suddenly discover a stage 4 death sentence." (Obviously if polyps are found then you’d adjust screening frequency accordingly).
It just makes me think again that somebody like James Van Der Beek would have likely found an early-stage tumour at 40, and would definitely have found a tumour at 43. Unfortunately he was not tested until he was already symptomatic at age 46, and indeed discovered a stage 3, terminal, cancer.
For me personally, I’ve never had a colonoscopy (yet). My first one will be next week actually - just before my 40th birthday!
If anything is found, I would go for every 3 years. If all clear, 5 should be fine. Really it’s just about the cost, and the potential adverse effects like bleeding, perforations etc. They’re pretty small though.
And yes, basically people dying from colon cancer are not having colonoscopies. They might be doing stool tests which catch later stage disease, allow some treatment and give them a few extra months. But basically, if everybody started at age 40 and did a colonoscopy every 3 years, we could have almost no deaths from colon cancer. (But at a population level this wouldn’t be a good return on investment. A huge amount of effort, expense etc).
10 years is a long time, but it’s quite well backed by the science I think. (Again, I’m not an oncologist or cancer researcher, and this is just my own opinion from reading the various guidelines and looking up the rates of tumour growth etc).
One of the benefits of having done a genetic profile is that I learned that I have a moderate risk for colon cancer. Heterozygous for the risk allele on the APC gene. Incidence of 6% among Ashkenazi Jews (which I am).Promethease gave this a magnitude 4 rating and it was my greatest risk. Suggested to my son that he get tested, and he has the same risk. Have not had any polyps, but showed this genetic risk information to my providor, and now insurance pays for colonoscopies every three years. This was one of several outcomes from the genetic testing. I am very glad I had it done, as it brought several risks to my attention and enabled me to get testing, imaging and meds that insurance would not otherwise have covered.
Neo, I used 23&Me and Promethease. In addition to discovering the colon cancer risk, I learned that I was homozygous for the risk allele on 9p21, the “heart attack gene”, and also had other risks for aneurism and atherosclerosis. Learned that I was APOE3/3. Learned that I had a mutation on the FTO gene which impacted how I metabolize-- it said it was an increased risk for obesity but since I have a BMI of 18.6 it was obviously pointing to the way I metabolize nutrients. And many other findings of less magnitude.
These findings enabled me to get imaging (for the aneurism risk) and also, along with the elevated Lp(a), to get Repatha approved (won’t take a statin as it actually raises Lp(a).
23andMe or ancestry are less than $100.
Promethease is like $15.
Different dna testing companies use different machines which cause some issues for detracting particular results on promethease. Which you use may depend on what you have as a priority to test for.
So, if I understand it correctly, I first need to do a 23andMe test (or similar) and then transfer these test data for further analysis to Promethease, and sorry for my ignorance if I’m not getting it right.
Yes, you need to get the test done, then, after you get the summary report, request 23&Me to send you the raw data. Then, you upload that raw data to Promethease.