By Dr. Shane Dormady, MD, PhD, Medical Director of Hematology and Oncology, El Camino Health and Ocampo Family Medical Director of Oncology
TV stars regularly enter our homes and we make a connection. Fans were shocked when James Van Der Beek, the star of Dawson's Creek, died less than three years after a diagnosis with stage 3 colorectal cancer at the age of 48. Early death tied to a serious illness can heighten health anxiety. A leading oncologist at El Camino Health separates fact from fiction about colon cancer.
In this article:
- The Age has Changed: Routine colon cancer screenings should now begin at age 45 for the general population, or earlier if you have a family history or specific risk factors.
- Listen to Your Body: Don't ignore persistent changes like abdominal pain, rectal bleeding, or unexplained weight loss; catching these early is the key to a permanent cure.
- Hope is a Strategy: Even with a complex diagnosis, a combination of aggressive, personalized medicine and a positive, proactive mindset can lead to incredible outcomes.
When I meet a patient for the first time, I often describe what’s ahead as a game of chess. Cancer makes a move, and we must be ready with a countermove that is strategic, aggressive, and designed to win.
In my work at El Camino Health, I’ve seen firsthand that while a colon cancer diagnosis is life-altering, it doesn't have to be a "death sentence." We are living in a new era of oncology where molecular technology and personalized care are turning the page on how we treat this disease. But the most powerful tool is early detection.
Recognizing the Warning Signs
Colon cancer is unique because it often starts as small, benign growths called polyps. Over five to ten years, some polyps (tubular adenomas) can evolve into invasive cancer. If we find them during a colonoscopy, we can remove them right then and there, preventing cancer before it even starts. A colonoscopy is admittedly inconvenient and it isn't "fun." But the inconvenience is a small price to pay for a life-saving result.
However, if cancer does develop, your body will often send up flares. I encourage everyone to be mindful of these "everyday" health shifts:
- Persistent pain: Rectal or abdominal pain, especially during bowel movements.
- Changes in habits: Unexplained constipation or diarrhea that gets progressively worse over weeks or months.
- Visible red flags: Any bleeding during bowel movements.
- Unexpected changes: Unintentional weight loss or constant fatigue.
These symptoms don’t automatically mean colon cancer. But they do mean you should see a doctor.
The New Rule: 45 is the New 50
For years, the "old adage" was to start screening at 50. That has changed. We have seen a striking increase in colon and rectal cancers in patients under 50 who have no clear risk factors. Because of this, the American Society of Clinical Oncology and the US Preventive Task Force now recommend that screenings begin at age 45.
If you have a family history, for example, a parent diagnosed at 45, the rule of thumb is to start ten years earlier (at age 35). For some genetic predispositions, we may even start in your 20s.
Beyond the Statistics
I recently treated a young man who hadn't had a screening and arrived with metastatic (Stage IV) cancer that had spread to his liver. He had been told elsewhere that he had months to live.
When he came to us for a second opinion, we didn't focus on grim statistics. We focused on a battle plan. We used "guided missile" antibody treatments and aggressive chemotherapy. He did his part, too, staying active, hydrating, and keeping his spirits high. Today, he is in complete remission, traveling, and living a full life.
This validates my philosophy, “You can’t hit a home run unless you take a swing.” We analyze cancer at a molecular level to find its weaknesses, and we never leave our "guns in the holster."
Asking the Right Questions
The following questions are designed to help you and your doctor discuss your health and the risk of colon cancer.
- Based on my family history of colon cancer or polyps, should I start my screenings earlier than the standard age of 45?
- Do any of my current health conditions increase my risk for colon cancer?
- I’ve noticed [mention specific change, e.g., persistent bloating or a change in bowel habits]. Is this something we should investigate further with a screening?
- Which type of screening do you recommend for me: a colonoscopy, or a stool-based test like Cologuard? What are the pros and cons of each for my situation?
- Are there specific changes to my diet—like increasing fiber or reducing certain fats—that would significantly lower my risk based on my current labs?
- How often should we revisit this conversation as I get older?
Whether it’s scheduling that overdue screening or talking to your doctor about a lingering symptom, remember that catching it early isn't just a clinical goal—it’s the path to a cure.
Dr. Shane Dormady, MD is a board-certified hematologist and medical oncologist at El Camino Health, where he has served as the Director of Oncology, Hematology, and Infusion Services. With over 25 years of experience in the medical field, he graduated from New York University Grossman School of Medicine, did his residency in internal medicine at Duke University Medical Center and a fellowship in Hematology and Medical Oncology at Stanford University.
This article first appeared in the March 2026 edition of the HealthPerks newsletter.
