A (2:40)

And you go to one of these support groups remotely. What was it like? What's the vibe? Is it like the saddest meetup you've ever gone to?

B (2:49)

Yeah, I'D be lying if I said it wasn't sad. I mean, it's like a bunch of people that I would consider to be pretty young who have just been diagnosed with cancer. But there were all these really dynamic conversations going on between the people talking about how to live while they're going through this. And it made me just kind of realize, sitting with these people, like, how much we don't know about cancer, about what it's like to live with cancer as a person in your mid-30s. And the people in the group just really wanted to stress how different their challenges are as millennials than, like, a person in their 70s.

A (3:25)

Yeah.

B (3:26)

You know, a person who's older. Like, their kids might be grown, but a millennial might have, like, little kids in the house.

D (3:33)

My son was 18 months when I was diagnosed. Obviously, like, I need to work in order to keep my child in daycare because I'm not able to physically take care of him. Also, like, trying to maintain normalcy for him.

B (3:49)

When you're in your late 20s and 30s, your career's just starting to take off, and then you get a cancer diagnosis, and that can just kind of hit the pause button on the whole thing.

D (3:58)

I was at the peak of my career. You know, I was a VP with a financial institution. I was traveling. I was just doing all the things and. Cause I am a single woman, graduated from law school in 2019. So I'm kind of in this, like, buildup period in my career. What felt very crushing when I had time to kind of sit and try to process everything is that it's really mourning a lot of loss of what your life won't be. The day that I went to get a biopsy, my promotion was announced at work. The day after, I got a call saying, you have breast cancer.

B (4:35)

And as if dating wasn't hard enough as it is, dealing with the physical and emotional stuff that happens and the craziness of cancer, it just makes that so much harder.

D (4:45)

And if I want to go out and, like, meet people and date people, I have had a unilateral mastectomy, and when I show up, I have to both be physically naked and emotionally naked.

B (4:55)

But there was also this element of surprise. Like, even though you're hearing tons of news stories out there about millennials getting cancer, you mentioned a couple of them before. We've got Princess Kate and Chadwick Boseman. It's still super shocking to be sitting there and receive that diagnosis, and then to hear that other people, you know, or maybe people that you don't know are young and getting cancer.

D (5:22)

One of the most frustrating comments that I would hear people say is, oh, you're so young. And to me, that's. It's frustrating because it's like, cancer does not care. Cancer does not care what age you are. It does not care what your life was like, what dreams you had, what hopes, what things you were about to do. It does not care. It just comes in and it interrupts and it just intersects. You always think, oh, it won't be me. It can't be me. And I think that's the biggest thing that this data that's out there has to be telling us and our peers is that we can no longer just assume it can't be me. And we need our healthcare system also to be that messenger and to step up, because no one had ever said to me, even being the daughter of a breast cancer survivor and with a father fighting cancer, you are at risk.

A (6:11)

This is exactly what we wanted to focus on today. And this is exactly why we reached out to our colleague Dylan Scott, because we wanted someone who's written about this to just tell us that we're not just imagining things. Right. That it feels like way more millennials and younger people in their 30s and 40s are getting cancer.

E (6:32)

Yes, Sean, as a millennial who is also a hypochondriac, I regret to inform you that younger people, people under 55, which is usually the definition of an early onset cancer case, are in fact getting cancer more often. There's a little couple of ways to slice it. The Wall Street Journal ran an analysis last year of National Cancer Institute data, and the way they put it was one in five new colorectal cancer patients in the US is under 55, which is twice the rate that we saw in 1995. There was another study that found that I think it was between 1990 and 2019, the rates overall of cancer among younger people had increased by 80%. It seems like no matter how you look at it, and I looked at a variety of studies from my story, cancer rates among young people are increasing, which I don't know about you, I feel like, fits with just my, like, observations in the world.

A (7:32)

And you're using some studies from the 90s to compare rates, but when did we start seeing that more young people are getting cancer?

E (7:41)

Yeah, it's definitely something that's built slowly over time. I talked to a guy at Georgetown named John Marshall, and, you know, he's been in this field for decades. And he said, you know, at the beginning of his career he never would have seen a cancer patient under the age of 50. But these days, he sees it all the time. And the way he put it to me is that, at least anecdotally, people who practice cancer medicine, who treat cancer patients, it's like everybody kind of started to notice at the same time about a decade ago, like, huh, it seems like I'm starting to get more and more young people coming in with more advanced cancers and more aggressive cancers. And so then we started to see some of this data that I'm referencing that sought to quantify, like, how big has the change really been? And they. They did confirm that, like, yeah, this isn't just people's perceptions. At the population level, there are higher rates of cancers among young people.

A (8:35)

What kinds of cancers, Dylan, you mentioned colorectal cancer. Is it just that one? Are there other ones?

E (8:41)

Colorectal cancer, I think, is the big one. It is that, like, if you look at the incident rates in some of these studies, besides breast cancer, it is the type of cancer that has the highest incidence among young adults. But it's not just colorectal cancer. It's uterine cancers, gallbladder, kidney cancers. People might have heard about Dwyane Wade, who is, like, by this definition, a young adult, to find out, obviously, at 41 years old, pretty healthy guy, that I did have cancer. So I have one kidney, and I have another kidney that is 60%. They took 40% of my kidney to make sure that they can get all the cancer off of it. It seems to be sort of up and down the digestive track where this seems to be happening, with the one exception is breast cancer, which we've continued to see a higher rate of breast cancer among young people over the same. But if we set that aside, which is obviously like a big exception, it seems to be a lot happening. Yeah, up and down the digestive tract. That's where we're seeing in particular, these big increases over time among young people.

A (9:46)

What is going on in the digestive tract, Dylan?

E (9:49)

So this is maybe the most interesting thing that I learned in reporting out this study and talking to a bunch of these cancer researchers who are as befuddled by all of this as we are. So it seems that your individual risk of many different type of cancers actually depends on something that's totally out of your control, which is when you were.

D (10:10)

Born.

E (10:13)

Like, somebody who was born in 1975 had nearly twice the chance of developing, like, an intestinal cancer compared to somebody who was born in 1955, 20 years earlier. And likewise, if we look like at younger people, people born in 1990, they're at even a higher risk of developing Canc than those people born in 1955 or even 1975. A couple of things likely at work here. One does seem to be, like, the, the changes in food production and the proliferation of processed foods, which is obviously something that, like, basically, if you eat in the modern world, you're consuming more processed foods than people used to. And so there have been, like, systematic reviews of the available literature, including one that was published just in 2022 that have said, like, if you eat more deep fried foods, if you eat more processed foods, if you eat foods high in fat, sugary drinks and desserts, and if you're really bad about eating fiber and things that are really good for your digestive system, you are more likely to develop cancer. And so that tracks, you know, when we think about, like, the obesity crisis, like, we know that our diets have been getting worse and they've been contributing to all kinds of negative health outcome like diabetes and heart disease. And it seems like cancer is another example of, like, how these changes in our diet and our food production may be leading to adverse outcomes. There's also been a lot of focus on microplastics. And we've likewise seen that those just like, have proliferated in the environment over the period from, like, you know, the 70s to today where we've seen this big increase in cancer incidence among young people. And there was actually a specific paper published by a research team based in New Zealand that basically tracked the timeline of the multiplication of microplastics in the environment and the cancer rates among young people. And they basically found that, like, they seem to be happening in parallel. It's an alchemy of all these things. It's a combination of we're eating worse, we're getting exposed to this stuff in our environment, we're still drinking a lot, we, we're not getting enough sleep, we're probably not exercising enough either. And when you stir all of those things together, you have more young people developing cancer.

A (12:48)

If Dylan's got you feeling depressed, we're going to ask him to hit you with a dose of hope when we return on today. Explained.

C (13:03)

So good, so good, so good.

D (13:05)

Just in thousands of winter arrivals at your Nordstrom rack store, save up to 70% on coats, slippers and cashmere from Kate Spade New York, Vince Ugg Levi's and more.

E (13:15)

Check out these boots. They've got the best gifts.

D (13:18)

My holiday shopping hack.

E (13:19)

Join the NordicLub.

D (13:20)

Get an extra 5% off every rack purchase with your Nordstrom credit card. Plus buy it online and pick it up in store the same for free. Big gifts, big perks. That's why you rack.

B (13:35)

When did making plans get this complicated?

E (13:39)

It's time to streamline with WhatsApp, the secure messaging app that brings the whole group together. Use polls to settle dinner plans, send event invites and pin messages so no.

B (13:49)

One forgets mom's 60th.

E (13:51)

And never miss a meme or milestone.

B (13:53)

All protected with end to end encryption.

E (13:55)

It's time for WhatsApp message privately with everyone. Learn more at WhatsApp.comLimu and Doug here.

A (14:04)

We have the Limu emu in its.

E (14:07)

Natural habitat, helping people customize their car insurance and save hundreds with Liberty Mutual. Fascinating. It's accompanied by his natural ally, Doug. Uh, Limu is that guy with the binoculars watching us. Cut the camera. They see us. Only pay for what you need@libertymutual.com Liberty Liberty, Liberty. Liberty Savings Fairy underwritten by Liberty Mutual Insurance company and affiliates. Excludes Massachusetts.

C (14:38)

You're listening to TODAY explained.

E (14:43)

Look, this all sounds really scary, but I do think it's important to remind ourselves that our understanding of what's going on here is constantly evolving. And just in the last couple months, there's been some research that's complicated this picture of the rise of early onset cancer. These researchers, what they did was they took a look at not only diagnoses like incidence rates, like the number of cases that are reported, but also the number of cases that turn metastatic. So those are more serious clinical cases. And they looked at the mortality rates, like how many people are actually dying from these cancers. And what they found is if you look at cancer collectively like the eight most common types of cancer among young adults, it's clear like, yes, incidents are going up. That is obvious. But those metastatic cases and those death rates are actually pretty flat. And that provides, I think, some hope that like, maybe a lot of what's happening here is that we're just getting better at detecting cancer and detecting even like little cancers that may not ultimately develop into a serious illness. Now, there's a big, big caveat to that new research, which is that for colorectal cancer specifically, which is the cancer that we talk about and focus on a lot when it comes to young adults, that is a case where both incidents case numbers are rising and deaths are also rising too. And so that would suggest that there's something serious going on with colon cancer specifically. And we want to get to the bottom of it. But even as we do, even as we try to figure out what's going on, like, we are making a ton of progress in our ability to diagnose cancer early and then to treat it. Like, these days, you can take a blood test that can tell you whether or not you have certain types of cancer with pretty remarkable accuracy. And then, you know, most importantly, like, if we've diagnosed with somebody with cancer, we've gotten way better at treating them. Like, it's no longer the case that all we can do is just pump a bunch of radiation into your body and hope for the best. We're developing immunotherapies which basically train a person's immune system to kill a cancer by itself. And as we continue to make progress with genetic sequencing and really understanding these tumors at the molecular level, like, that could allow us to really fine tune these treatments and also make sure that we're matching the right treatment to the right patient. And so, like, as scary as all of these trends are, there's a lot of uncertainty about them. And most importantly, like, we are getting really good at catching cancer early and treating it when we find it. And that. That, I think, is a reason for all of us to have a little bit of optimism in the face of these trends.

A (17:42)

Okay, so there's some good news in theory. Better diagnostics, better treatment. But we wanted to hear from someone who's experienced it. So we turned to someone producer Victoria met at that cancer meetup. Kate Zickel.

C (17:55)

How do I identify myself on the show? I'm from Alexandria, Virginia. I run a digital marketing agency out of my home. Married. Which is awesome.

A (18:07)

I love that no one's ever said that one before. That's good.

E (18:09)

That's good.

A (18:10)

Kate told us that those immunotherapies that Dylan was just talking about are the reason she's living a full life right now.

C (18:16)

Let me put it this way. Were it not for the advances in medical technology that have happened just in the last five to 10 years, I may not be here.

A (18:27)

Kate's had cancer twice. The first time she discovered it was in 2017 after her husband found a lump in her breast.

C (18:36)

Went through chemo, radiation, double mastectomy, and reconstruction surgery. It took about a year from September of 2017 to September of 2018. And then after that, thought I was in remission. Took hormone suppressors for two years before being diagnosed with a recurrence at stage 4 metastatic disease. After it had moved to my bones and my lungs.

A (19:04)

So the cancer's still there.

C (19:07)

Yeah. So I've had Metastatic cancer for almost five years. And the thing about metastatic breast cancer now is that it's not always the immediate death sentence that it used to be. You can actually live a pretty long time with metastatic breast cancer, depending on where it is in your body and how quickly it grows.

A (19:28)

And can I ask how old you were when you discovered that you had this cancer back in 2017?

C (19:36)

Yeah. So I was originally diagnosed with breast cancer at 29 years old.

D (19:40)

Huh.

C (19:42)

No family history at all. No indications that that would be a thing in my life. And, you know, you just hear, you know, you hear all the. The ads and the awareness about self checks that you should do. And we typically don't recommend mammograms until the age of 40 or actually 50, really. But they're starting to change that now that we're seeing more and more young women diagnosed with breast cancer. So I was pretty Young. I was 29, and then I was, I think, 33 when my recurrence was diagnosed.

A (20:20)

Yeah. Is it weird for you? I'm sure at times throughout this process, you've looked like you had cancer. And I'm looking at you right now for all those people listening on the radio or on their phones or in their cars or whatever it might be who can't see you. You do not look like someone, I guess, who has cancer. But I guess. Is that, like, a perception you have to deal with? I mean, that people think someone with cancer is gonna look a certain way or not look a certain way?

B (20:48)

Yeah.

C (20:48)

People definitely still have the idea that a cancer patient looks wan and thin and pale. And people tend to have a very specific idea in mind when they think of cancer patients. And because cancer treatments have changed so drastically, even in just in the last 10 years, it's actually very different now. I looked normal. You wouldn't know, but I was still in the middle of all of these crazy, painful processes. It's a good thing. Like, we're very grateful that those technologies exist now where we can be in treatment and look great. But just because we look great doesn't mean that we are. And sometimes that can be difficult to explain.

A (21:37)

What would you say to people who, like, live in fear from what they've just heard from you?

C (21:45)

I would say, don't freak out until a medical professional tells you to freak out.

A (21:50)

Okay.

C (21:52)

Know your own body. You know, most of us do anyway, but, like, know your body, know what your normal feels like, and then if something isn't normal, ask. And if your doctors ignore you, which most doctors are great and they will take you seriously. But if they don't, get a second opinion, get a third opinion.

D (22:14)

Ask.

C (22:14)

Take the time out of work to go to those appointments. If you need to do your own homework at get a genetic test, you can do that. They'll take a blood test, and they'll go through your genetics and they'll tell you what your risk factors are. The treatment I am on now came into existence between 2017 and 2020. The one that I will go on next came out five years ago. The changes and the speed at which medical technology is keeping pace is incredible. We are so lucky to live in a time where that is true. The goal here is to beat the clock. Where, as a survivor now, who's on treatment? My goal is to make the current treatment I'm on last as long as possible so that the next treatment I'm on will be available, and then that one will last a long time until we've got a new study that proves another drug that's available. And as long as we're able to keep pace with that, the longer we live. So I would just encourage anybody who's kind of curious about this, like, do your homework. Ask your doctors. Like those trials are. Those clinical trials are out there, and we need them. We are desperate for them. We are dying without them. And anybody who wants to cut funding to those trials can just. Just give me a call.

A (23:43)

What would you say to them?

C (23:45)

Without these trials, people will die. Without these trials, people will not live as long as they could with them. Without these trials, you were taking away the hope of others. Sorry. I'm, like, shaking now. I'm, like, so angry about this. The people who are funding these trials need to understand that it is part of their job to keep us alive, to keep us hopeful, to keep our medication moving forward. By taking that away from us, you're killing. You're literally killing us. By taking that away from us, you are taking away years that we could have with our children, years that we could spend with our parents. If you take away the trials that gave us the drugs that help us live longer, you need to answer for that. You need to be held accountable to the people whose lives you are hurting. Sorry, I didn't realize how passionate I was about that until you asked me the question. And I'm like, oh, I'm really angry.

A (24:58)

Seems reasonable. Kate, thank you so much for your time. Really appreciate it. Nice to get to know you and wishing you all the best.

C (25:06)

Yeah, this is fun.

A (25:13)

Victoria Chamberlain made this episode of Today, explained when it originally aired back in April. She dedicated it to her dad's colon. Thanks to everyone who spoke to Victoria, including Dylan Scott, who you can read in@vox.com Amina Aladi edited the show, Laura Bullard fact checked Andre, Kristen's daughter and Patrick Boyd were on the original mix and Brandon McFarland was on the update. Thanks so much for listening, Sam.