Why Adults Are Getting Cancer at a Younger Age

from the New York Times. I'm Rachel. Abrams and this is the daily. You go into the chemotherapy room and I. [music] remember sitting in a circle. with like 60 to 80 year olds and I was. there as 25-year-old. >> For years [music] now, cancer's been. seen as a disease that people mostly get. when they're older. But apparently. that's changing. [music]. >> When I was diagnosed, I was 28. >> Yeah, I was 32. when I was 37.

>> More young people are getting cancer. than they ever have before. [music]. >> I wasn't able to be the kind of husband. that I wanted to be, the kind [music] of. father that I wanted to be. >> Dating was like a new challenge for. sure. >> I mean, I had to file for bankruptcy. [music]. >> I ended up having to do chemo while I. was pregnant. >> At a time when you really feel like you. have so much in control in your life, you're just like you completely lose. control of everything. And so today, health reporter Nina Agarwal [music]. explains what scientists are starting to. learn about what's driving this rise and.

what it means for a generation of young. cancer survivors. [music]. It's Monday, August 10th. Nina Agarwal, welcome to the Daily. >> Hi, thanks for having me. Nina, your. beat is chronic disease and you recently. published a series on the growing rates. of cancer among young people and we're. going to talk about what you found in. your reporting. But before we do that, I. just want to define what we're talking.

about here. Exactly. Like who and what. are we referring to when we talk about. growing rates of cancer among young. people? >> So early onset cancer generally means. cancer in adults under 50. So not super. young, but young for cancer. Cancer has. historically been a disease of aging, but researchers have started to document. in a pretty systematic way that cancer. diagnoses are increasing in younger. adults. And this is something, you know,

we've been hearing about kind of in. trickles, but you know, in the last. couple of years, there have been some. comprehensive papers showing that this. isn't just an isolated phenomenon. This. is a pattern happening across cancers. over decades. And it's been happening. every year since 1990. >> And you know the rates vary from cancer. to cancer. So for some it's annual. increases of 1 to 2% a year and for.

others and in certain age groups the. increase could be as much as like 6% per. year. >> Wow. So you can imagine that over time. that is like quite an increase for. certain types of cancers as you said. >> Yes. And for younger people it's very. unexpected. I mean, I think a cancer. diagnosis is unexpected and undesired at. any time, but it comes out of left field. for so many of these younger adults. And. it totally upends their lives in a way. that is different from the way it upends. the lives of older people because this.

is happening at a really vital moment in. their life when they're still kind of. putting down the roots and becoming the. adults that they're going to be. And I. spent a good part of the last year. trying to understand exactly what the. experience is like. Not only what's. happening and why, but what that means. for the people who are getting. diagnosed. We had hundreds of people. write into us to share their experience. of early onset cancer. And I spoke to.

dozens over months to just get a picture. of all of the ways that getting a cancer. diagnosis in that time of life, your. 20s, your 30s, your 40s, how it changes. a trajectory of everything that comes. after. I wonder out of all the people. that you spoke with who are dealing with. these issues at such a young age, is. there somebody who stands out to you. specifically that maybe illustrates some. of what you're describing? Yeah, I mean. there were so many whose stories were. really moving and there were some common. themes among many of the stories in. terms of disruptions to their finances,

disruptions to their family planning, disruptions to their careers, disruptions to their relationships. But. one young woman I spoke with, Whitney. Johnson, her experience and her story. really stuck with me. >> Tell me a little bit about yourself, what your life was like before you got. cancer. >> Yeah, so I I'm Whitney Johnson and She. was 36 and living in Portland, Oregon. And she was just, you know, at a stage. where a lot of people are in their 30s. >> Trying to focus on my career, trying to.

focus on like redoing my house, trying. to figure out if my boyfriend and I. should stay together. Like she was in a. relationship that was relatively new and. trying to figure out where she was with. her boyfriend and kind of where it was. going. And one night about two and a half years. ago, they were making out. We started. kissing and kind of stopped at one point. and he's like, "I don't want to be. weird, but I think I feel something in. your boob." [music].

>> And that's how she found the lump. >> Oh my god, that must have been so. jarring to have him say that in the. middle of this like very intimate. moment. >> What was your diagnosis? >> Triple negative breast cancer, [music]. stage 2 B. And so that means that this. the tumor was I want to say around 2 to. 3 cm. And also. >> she was diagnosed with triple [music]. negative breast cancer which was a. pretty serious and aggressive type. >> And when she got the diagnosis she not. only had the tumor [music] in her breast.

but also some signs of cancer in one of. her lymph nodes. At that time she had. just gotten [music] back from a family. trip and vacation and she ended up not. going back to work because she needed to. go into treatment immediately. [music]. What did that treatment look like? So, she was going to need chemotherapy and. then also at least one surgery. But. before she could even start, >> doctors asked her if she wanted to. freeze her eggs. >> And so, first things first, like my.

brain wasn't even on the cancer. My. brain was like all the things that go. into freezing your eggs and what that. meant for like my future and what that. meant. like my boyfriend and I at that. time like we weren't talking about. having kids like. >> you know she and her boyfriend had been. dating a couple of years at that point. and all of a sudden she had to think. about you know is this something that. I'm going to want that we're going to. want and she's over the course of a few. weeks having to inject herself with. hormones and he trying to be supportive. but they were not in a place in their. relationship where they were both trying.

to do this of their own valition. >> and so it was just kind of a wild start. to the whole situation. That feels like so much pressure at the. sort of newer end of a relationship. when, as you said, they're not even. talking about having kids. Kids aren't. even on the radar. And just to say, egg. freezing is a really intense process. It's intense emotionally and it's also. intense physically. >> Yeah, absolutely. And the whole. experience of having cancer and having.

then to go through treatment was. upending her notions of what it was to. be a woman in this relationship. One of. the reasons I was really moved and. struck by Whitney's story was she talked. very articulately about being a woman in. this phase of life. >> As women, like we spend our whole lives. trying to figure out like how can I show. up in a way that feels right for me and. I can feel confident and like I can love. who I am. >> Like she talked about how it had taken a. long time, you know, to grow into.

herself and she loved her hair. That was. one of her defining features. was like. long and blonde and beautiful and. >> and she had come to like her breasts. That hadn't always been the case, but at. this point, she was really comfortable. with herself and then here she is and. she's going to get chemo and it's going. to make her lose all her hair and she's. going to have a bilateral mastctomy and. she's going to lose her boobs. And then. even if I do get through this, you're. telling me that I want to try to date. someone when I don't have hair and don't.

have boobs and don't have estrogen. >> And. >> it just totally shook her notions of. being like a sexy, confident woman when. she was also kind of early in this. relationship where that's how she wanted. to show up in that relationship. Like. it's just like this perfect storm of. stealing your femininity when you're. supposed to be feeling kind of like at. your height of [clears throat]. womanhood in some ways. And so it's. pretty I'm curious how her.

boyfriend navigated all of this because. this is just so much pressure obviously. to put on a relationship that is. relatively new where you have two people. who are still trying to figure out what. they want. They're still trying to get. to know each other. So to have this. giant tragedy dropped in the middle of. that, I can imagine why that is a. different dynamic than when this happens. to a couple that is established for many. many years and just has a different. familiarity with each other. >> Yeah. I mean, one of the things that she. said was like we had no practice, you. know, like we didn't have peers and.

friends who were in this situation and. his friends didn't really know how to. support him and all of a sudden he's. thrust into this role of being. caretaker. He was like 29, I think, when. she was diagnosed. >> And then I remember there was this one. weekend that he was out with his. friends. And that was the weekend I. realized I might die. >> She told me one story about how. >> some family coming in. >> She was at a really low point in her. treatment when she was really sick and. she sort of had this realization like, "Oh, I might die.".

>> Cuz like, you know, you always kind of. know, but you don't ask directly. And then I'm like, "Oh, this might be 5050 that I'm here in five. years." And I think it was the first. time that I had let myself think about. it. Like, "This might be it." I'm. literally like, "Right.". >> She was kind of just spiraling. And her. boyfriend was out at a cabin that. weekend with friends. [music]. >> I remember like I was trying to process. this and then like, you know, texting, but he's like at a cabin partying. [music] with his friends,

but I'm like, "I need to I need to. talk." And I'm like, I might die. Like, talk to me about that. But like, he couldn't. He's like, I'm here with my. friends. I need a break. [music] I don't. have it in me. And that was terrible. [gasps]. Cuz they're like, I'm at my darkest and. I want my partner to to see me through. this time and [clears throat] and he. just couldn't. and she needed him in a.

way that their relationship kind of. hadn't experienced before and maybe. wasn't ready for. >> God, that sounds so tough for both of. them. [clears throat]. >> Yeah, definitely for both of them. I. mean, she told me I don't think it's. easy to get cancer at any age, but that. she was jealous of people who got it. when they're older. >> because maybe where they are in their. relationship can withstand it a little. better. Everything was one-sided for a. long time.

and we weren't there [music] and it. didn't go well. >> Did they consider breaking up, Nina? I. asked her quits. >> and she said, you know, >> at that time you're like. >> she was really just like in survival. mode, like trying to deal with cancer. and it felt like thinking about her. relationship ending was just like too. much to think about taking on. >> that would make my head explode.

>> when that was the sort of support and. she was just trying to get through the. dayto-day of fighting the cancer. What. about her friends? Did she have friends. that were part of a support system, not. just her boyfriend? >> She did, but her family didn't live in. Oregon. And her friends were in a. similar stage of life as she was before. the cancer. Some of them were getting. married and having babies. And. you know, it was hard to be around. people whose lives were moving forward. And this is something many people told.

me. It was really hard to watch their. friends and their peers and their. colleagues move forward in their lives. and you're just sort of stuck or maybe. even moving backward. >> I remember the walk I went with on a. [music] friend with. >> she told me about how she had gone for a. walk with a friend and her friend told. her that she had just gotten pregnant. and she could see that the friend was. having a hard time sharing this with. her. >> And it was one of those moments that. like I feel so bad cuz she was she was. sad to tell me because she knew it would.

be hard. But, you know, it was sad to. see her friend moving forward in this. way. And she was having to put this. pause on everything. >> And so, you know, your your friends are. who you who you spend your time with, you kind of compare yourself against. And so, [music] they're like able to be. taking these next steps in their lives. And as I'm like taking a step back into. nothingness and the unknown.

>> So how did Whitney's treatment go? >> So it was grueling. She completed her. chemotherapy, you know, lost all her. hair. She had a double masectomy. For now, the cancer's gone, but that. doesn't necessarily mean it's gone. forever. And a fear of recurrence is. real. And I think Whitney is still dealing. with how unexpected this cancer. diagnosis was at this time in her life. and kind of grappling with why it.

happened at such a young age, you know, and that's something I've also. been really interested in. I've been. reporting on what scientists are. learning about what's driving these. rates of early onset cancer. [music] and scientists are starting to. find some answers. [music]. We'll be right back. Nina, I want to better understand what.

we understand about what's driving this. increase in cancers. So maybe just to. start can you lay out when we say that. cancer diagnoses in young people are. rising which cancer specifically are we. talking about? >> So there are a number of cancers that. appear to be increasing in the earlier. age group. One paper from last year. showed that 14 different types of cancer. were increasing in the early onset age. group and that includes some common ones. like breast and colorectile cancer as.

well as uterine cancer, testicular. cancer, pancreatic cancer and several. others. >> And just to ask a question that I'm sure. is on a lot of people's minds listening. to this. These increases cannot just be. attributed to increased screening. No, I. mean depending on the cancer, some might. be attributable to increased screening. Like thyroid cancer is one that comes to. mind, but for a number of reasons, a lot. of experts I talked to said they don't. think it's all screening or incidental. diagnosis. For one, most of these. cancers, when we're talking about people.

under 40 or under 50, these are not. populations that are regularly screened. for another, you know, some of the. cancers certainly are showing not just. increased incidence, which could be. they're just finding them, but also. increased mortality. And that's. particularly true for colon cancer and. uterine cancer. And something else that. we're seeing is that people born in more. recent generations are at greater risk. of having cancer, which suggests that. there might be environmental or.

lifestyle exposures, things that have. collectively happened to us as a society. over time that could be affecting our. cancer risk. Well, let's talk about that. a little bit more because I'd like to. understand what we do know about what is. driving these upticks. So talk to us a. little bit about those environmental. factors and how they're interacting with. our biology in a way that may be. contributing to these trends. >> Sure. So I will say because the. phenomenon has really pretty recently. been identified, researchers don't know. for sure what's driving it, but they. have some hypotheses and you know.

they're building off of what we know. about what causes cancer generally. Mhm. >> So there's a fair amount of evidence. linking obesity, alcohol use, and poor. diet, particularly red meat and. ultrarocessed foods to some early onset. cancers. And then there are other. questions that researchers have about. potential other exposures like plastics. or forever chemicals. But it's really. hard to tell at this stage because it's. very hard to link things in our. environment directly to a cancer. outcome. One of the most classic.

examples of this is smoking. It took. researchers a long time to link smoking. to lung cancer, but eventually there was. such a large body of evidence that they. could make that causal link. >> Right. Cancer is notoriously difficult. to prove causal links to, whether it's, you know, where you live or what you're. eating. >> Yeah. But some of the more emerging. evidence is showing some surprising. things as well that suggests the drivers. of earlier onset cancer are different. from some of the things we've. historically thought about. >> Tell us about some of those surprising. findings.

One of the things that researchers are. really trying to look into is how our. environment or things in our lifestyle. might be affecting our genes. So, it's. unlikely that as a population, our. genome has changed dramatically in the. last 50 years to make us as a population. more susceptible to cancer. >> Right? So one area that researchers are. looking into is how things in our. environment might be affecting our genes. once we're already alive to maybe make. us more predisposed to cancer like what.

so one example is in colarctile cancer. you know I spoke to a researcher who's. been doing some work analyzing the. pattern of mutations in patients who had. early onset colctal cancer. >> mutations in their genome [snorts]. >> right exactly changes to their genes and. he's able to see a sign of an E.coli. infection with a particular kind of. E.coli in the pattern of mutations in. the patients who had early onset cancer. and he also was able to say that the.

E.coli infection had likely happened. pretty early in life like within the. first few years meaning what that these. patients showed signs that they had. gotten infected with E.coli when they. were that young and so he's now making. some sort of connection between E.coli. coli and colorectal cancer. >> I mean, it's a that's a big leap because. you can't infer causality, but because. you're getting this hit to your gene. within the first few years of life and. then that mutation is going to be.

compounded by other mutations or by. factors maybe like inflammation, you're. sort of getting put on the fast track to. cancer. >> and that might be one explanation for. earlier onset cancer. But you know that. being said, we don't necessarily know. and I asked, you know, have we been as a. society having more ecoli infections. over time? >> That would be my question. Are we. getting exposed to EC coli more and. more? >> So I think some researchers are trying. to look at samples that were biobanked. decades ago and see if they can track.

E.coli in the samples over time. I don't. think that research has been done yet. But the researcher I spoke to did tell. me something interesting which was that. there are some suggestions that the. particular type of ecoli that may be. creating this set of mutations has come. with industrialization. So it's kind of. like a handwavy way to say maybe it's. something in the food that we now eat or. the antibiotics we use. They don't.

really know but they are seeing this. link. >> Even if we don't fully understand it, there's some connective tissue there is. what you're saying. >> Yes. What about some of the other. cancers you mentioned, Nina? Do we know. more about what is driving those? What's. contributing to the uptick there? >> Yeah, so researchers have also done a. fair amount of work on breast cancer and. are also looking at this interplay. between our environment and lifestyle. and how that might be increasing our. predisposition to cancer. And so one of.

the things that they found is the role. that the menstrual cycle and how many. menstrual cycles we have might be. playing here because some research has. shown that girls now get their periods a. little bit earlier than they did in the. 1950s. And women are having their first. pregnancy later than they did in the. 1950s. And the menstrual cycle is this. time where your cells are expanding and. proliferating and your hormone levels.

rise and fall. And as the cells are. dividing, they're more susceptible to. mutations. M. >> And so during [clears throat] that time, if you're exposed to something that's. harmful, like alcohol or something that. can increase your risk of a DNA. mutation, the effects of that can. accumulate the longer you have this time. period where you're kind of going. through these monthly cycles of cell. proliferation, expansion, and then dying. off. And pregnancy kind of stops that.

prolonged period of increased risk. because there's something protective. about a first pregnancy particularly at. a younger age and breastfeeding. After. that in the long run your breast cells. they spend more time doing DNA repair. and they've sort of changed in a way. that is protective against breast. cancer. So basically this combination of. women getting their periods earlier in. life and also having children later in. life is expanding that in between period. where they are most vulnerable to breast.

cancer. Is that right? >> Yeah. Or most vulnerable to the changes. that can lead to breast cancer. I'm also hearing by implication, I. think, something that feels a little. shocking, which is that women who don't. have kids, whether because they can't or. they don't want to or whatever the. reason, they are more vulnerable to. breast cancer. Is that the right. inference to be drawing from this? Yeah, it's totally crazy and unfair. And I. know that that can just sound like we're. blaming women for their own cancers,

which is not at all what researchers. say. You know, they're saying these are. societal shifts and it's totally. reasonable in this day and age that. women want to have a career or not have. a baby at age 20. But at the population. level, when they look at kind of what. are the factors that are linked, they do. find that pregnancy, particularly a. first pregnancy at a younger age between. kind of the ages of 20 to 25 and. breastfeeding are protective against. breast cancer in the long run. what you.

have laid out. Some of these findings. are really genuinely surprising. I think. a lot of people know by now that toxins. like alcohol and smoking may contribute, but the thing you said about pregnancy, the idea that there's bacteria hanging. out in your gut from when you're a kid. that could cause cancer or could lead to. cancer some way, I don't think that. those are factors that are really on. people's minds. >> Yeah. And I think people want to know if. there's a reason for their cancer, but I. talked to so many people who were. diagnosed with early onset cancer and.

it's so out of their control. >> Like there are lots of people who ate. their vegetables and had a good diet and. exercised and had babies pretty young. and still got breast cancer. You know, I've talked to patients in that. situation. It feels like it's worth. saying that even if we start. understanding more and more about why. younger people are getting cancer, getting that kind of clarity is not. necessarily going to be total comfort. for people who are sick, they're not. going to know exactly for sure what. caused their cancer. That's just not how.

science works. And that's probably going. to just be very unsatisfying, even if we. are more educated. >> Yeah. I think for most people, they'll. never know exactly why they got cancer. Nina, I want to go back to Whitney for a. second because you said her initial. cancer diagnosis was two years ago. How. is she doing now? >> The last time I spoke with her, she was. doing pretty well. She had gone back to. work and she and her boyfriend were. moving in together, but she was still. kind of dealing with the emotional and.

physical scars of this experience. >> that I think that's going to take a lot. longer to do. >> For example, after her double mastctomy, she did eventually have a. reconstruction. like having this. reconstruction like it's been one of the. hardest like lasting parts. >> She's had people say to her like, "Oh, you know, you got your boobs done." And. she's like. >> totally just insensed by that comment. cuz she's like, >> "Do you understand that a masectomy. reconstru?". >> This is not a walk in the park. This is. not something I wanted. And even though. her reconstruction was successful by.

standards of the surgery, >> I hate them. I hate them a lot. She kind. of hates her new breasts and they don't. feel like hers and it's a hard line for. her to tow, much less her boyfriend. >> because like you're not supposed to like. these better than the old ones. >> You're supposed to like the old ones. better, but yet you're supposed to. support the new ones and love the new. ones and think they're beautiful. >> So she, you know, on her good days can. be sort of accepting of what she looks. like and who she is now. And on her bad. days, there's a mix of trying to move. forward and also grieving what was or.

what could have been. >> And she's trying to figure out what's. next for her in her life. She's. wondering whether she wants to have. children and if so, you know, maybe. soon. She's of course worried about the. cancer coming back. But really the thing. that sticks with me the most about her. was just. how lonely the experience was and also. how unprepared she felt for it because.

it's not something that typically. happens in this stage of life. [music]. And I think that was true for most of. the people I talked to. [music]. One of the things they wanted people to. understand was this isn't just like a. temporary derailment and then you go. back to your normal life. [music]. And because this phenomenon is. relatively new in the [music] sense that. researchers are able to see bigger. picture trends and document it and talk. about it, people who have been diagnosed.

at a younger age don't really feel like. the public or even their friends and. family get what they're going through. >> People want to help you, but also they. might be really bad at it. you're so. totally alone and really are in charge. of yourself. >> And I think [music] a lot of the people. I spoke to really wanted to speak to me. and tell their story because they wanted. other people like them to feel seen. [music].

Nina Agaral, thank [music] you so much. Thanks for having me. We'll be right back. Here's what else you need to [music]. know today. On Sunday, the Israeli. government rejected President Trump's. plan for rebuilding Gaza. [music] The.

15-point proposal included the gradual. disarming of Hamas and the withdrawal of. the Israeli army from more than half of. the area that it still [music] controls. But Prime Minister Benjamin Netanyahu. dismissed the phased approach, [music]. saying that Israel won't leave Gaza. until Hamas is completely disarmed. [music]. [music] Today's episode was produced by. Alex Stern and Claire Tennis Getter. It. was edited by MJ [music] Davis Lynn and.

contains music by Dan Powell, Marian. Lozano, Sophia Lanman, and Chelsea. Daniel. Our theme music is by Wonderly. And [music] this episode was engineered. by Alyssa Moxley. [music]. That's it [music] for the Daily. I'm. Rachel Abrams. See you tomorrow.