The Journal. - ‘It Felt Surreal’: A Cancer Diagnosis at 26

Episode Date: February 20, 2024

Meilin Keen was diagnosed with stomach cancer at 26. She’s part of a growing demographic of people who are getting cancer diagnoses before the age of 50. And doctors don’t know why. WSJ’s Brianna Abbott explains what we know so far. Further Reading: -Cancer Is Striking More Young People, and Doctors Are Alarmed and Baffled.  -Many Cancers Are on the Rise in the U.S., Even as Overall Deaths Fall.  -Uterine Cancer Was Easy to Treat. Now It’s Killing More Women Than Ever.  Learn more about your ad choices. Visit megaphone.fm/adchoices

May Keene is in her 20s. She lives in New York and likes the outdoors, reading books, and her cat. She's a tuxedo. Her name is Pudge, and she'll be three in March. Are you a cat person? Yes, huge cat person. Huge cat and book person. Not a dog person? I'm not anti-dog, but I'm more pro-cat. Last spring, May graduated from law school and immediately started studying for the bar.

But a few weeks later, she didn't feel quite right. I was just feeling super ill, and I thought it was because I wasn't eating correctly. I was just drinking coffee. I had problems with heartburn previously, so I was just like, oh, I'm just so stressed. Like, of course, this is a stressful time. May was feeling dizzy. She started to throw up blood, and her roommate called an ambulance. What was going through your mind at that time?

I just thought it was really bad GI issues. So I was like, oh, there's just ulcers. They're going to give me some high-strength, like, antiacids or something. I'll be out of here in no time. But instead, she was admitted to the ICU. I was like, oh frick, these are my days off of bar prep. How am I going to make up for these days? Like, I got to get back home. May's mom flew in to be with her. After a few days, May got some bad news from her doctor. And then she said it, and I think I was like, what? Because she

kind of said it in like doctor terms, but I also heard like cancer in there. So I was like, oh, I don't think it clicked in my head. So I had to like. It was like disbelief. Yeah, pretty much. And my mom actually started crying before me. And when I looked over and saw her crying, that's what made me cry. And I had to confirm with the doctor, so I have stomach cancer. And she was like, yes. At the age of 26, Mae's dreams of her future were immediately upended. And she's not alone. More and more people are

getting diagnosed with cancer in their 20s and 30s. And doctors don't know why. Welcome to The Journal, our show about money, business, and power. I'm Kate Linebaugh. It's Tuesday, February 20th. Coming up on the show, the rise of cancer among young people. Put your hands together for Lady Raven. Dad, thank you. This is literally the best day of my life. On August 2nd. What's with all the police trucks outside?

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Only in theaters August 2nd. Our colleague Brianna Abbott covers cancer. And in the past few years, she's noticed something in cancer research. There was sort of chatter in papers about more young people getting colorectal cancer. And as someone sort of in that age demographic in, you know, a topic where it's usually not, I'm usually not included in the demographic that I write about. It was something that inherently just struck me as sort of interesting and concerning.

What other kinds of cancers are people getting diagnosed with? Does it go beyond colorectal cancer? Where we're seeing these sort of bigger increases is in gastrointestinal cancers. So colorectal cancer is sort of the big one. And you're also seeing it in stomach, appendix, pancreatic, and uterine, which isn't gastrointestinal, but is sort of in that group as well. In absolute numbers, cancer in young people is still relatively rare, but it's steadily climbing. From 2000 to 2019, rates of cancer in Americans under 50 rose nearly 13 percent, according to federal data. And in many cases, younger patients are diagnosed with more advanced cancers. Some of these young patients are going in and their symptoms are a bit vague.

And doctors, when they look at a young person, don't really necessarily think of cancer. And so that might not be something the doctors are looking for. And patients might be dismissive of their own symptoms as well. But sort of because of all of these factors, usually they're getting diagnosed later where a cure is much harder. And so it comes at just a really different time of life than, you know, the typical cancer patient. You're right in the middle of kicking off your life. You're getting your career off the ground. Maybe you have young kids. Maybe you're trying to date. You're still sort of like figuring out who you are. That's what happened to May.

By the time her doctors found the cancer, it was so advanced that they told her she needed chemotherapy and after that, major surgery. And so very suddenly, May was thrust into a world she'd never spent much time in. A world of insurance paperwork and doctor's appointments. I had to get a port put in for the chemo infusions. That was a surgical procedure. I had to do the diagnostic laparoscopy. I had to do endoscopies with a camera. I had to do CT scans with dyes. I had to do MRIs. Oh, wow. So it was a lot of appointments. Yeah. A lot of

pain. And I was just spending so many hours in hospitals, in waiting rooms. It was also just a whole, all right, I'm not taking the bar. So I had to withdraw. And I had gotten a job offer before graduation. So that also came to my mind like, oh God, how do I tell my employers? What are they going to do? Am I still going to have a job? How is this going to affect my life? Before being diagnosed with cancer, May says she was very focused on law school and wasn't very social. Because I was introverted and I liked my time in, I knew that I had good friends, so I was like, oh, why do I need more? So I didn't really push myself to expand my comfort zone because I was pretty comfortable. What was it like to tell your friends that you had cancer? I couldn't

verbally say anything because I don't even think hearing that I had cancer had registered. So I had to type it out in a text message. And even like wording the text message, I was like, how do I even write this? But I ended up sending a pretty long message. And a lot of people responded with, oh my God, I'm so sorry. You're so strong. We're here for you. That must have been hard for you. Yeah, it was definitely hard and I had to sort of grieve the life that I thought I

would live, as in I had to grieve the idea of me taking the bar, passing, celebrating with all my law school friends and being happy and moving on with my life. So that was super difficult. It felt surreal. Did you fear for your life? In a way, yes, because it opened Pandora's box to unknowns. And I didn't even know which questions to ask because I didn't really know what answers I was looking for 100% at that time. I knew I had to do chemo, which meant I knew I was going to lose my hair. And we didn't know 100% whether the chemo was going to affect my fertility. So my parents,

well, my mom wanted me to do IVF. So I went through that briefly. May tried to freeze her eggs, but she stopped because it was expensive and exhausting. Then May started chemo. I had really long, straight black hair before the diagnosis, and that had become part of my personality. And I felt very feminine and pretty, and I put looks and appearance on a pedestal, and that definitely was something I had to let go of when I lost my hair. May was horrified when her hair started coming out in clumps. So I went to a Supercuts, and I was like, please just take it all off. The hairstylist was so sweet. I had to tell her I was diagnosed with cancer.

So she charged me for, I think, a little boy's haircut to buzz cut my hair. May was still waiting on a big decision from her doctors. Whether to have part of her stomach removed or all of it. Living without a stomach is possible. The esophagus is connected straight to the small intestines. But it changes when, how much, and what food you eat. So my oncologist and surgeon ultimately decided on the total gastrectomy. So I got my stomach removed in December, early December,

and I had about six weeks off of work to recover. The first two weeks were the absolute worst. I had to sleep on my couch. I couldn't stand up straight because the stitches would like kind of pull at my skin and I thought I was going to burst like a piñata. And that's kind of gross. Yeah. A few days before surgery, May got dressed up, donned a wig of long black hair, and went out with a group of friends to a restaurant for a feast. It was the last time she'd ever be able to pig out.

It was the last time she'd ever be able to pig out. Coming up, what we know and don't know about why so many young people are getting cancer. Picture this. You finally get to the party, and it's the usual drinks and small talk. Suddenly, you spot something different. The Bold Seagram 13. A 13% cosmopolitan cocktail. You grab a can and take a sip.

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Now extended to flights within Canada and the U.S. Cheers to taking off this summer. More details at aircanada.com. The rise of cancer among young people is happening around the world. But researchers say rates are highest in Western countries. We asked our colleague Brianna about this. What does that tell us?

It's probably something that has to do with the changes in the way that we live in Western cultures. Some researchers have proposed that it might have something to do with the microbiome, which is basically, you know... Your gut. Yes. The bacteria and all the other pathogens in our gut that influence our health. So an idea that researchers are thinking about is, you know, whether or not our diet or maybe our antibiotic use or other factors have sort of impacted our microbiomes in ways that increase inflammation and ultimately increase risk. What else could be behind this?

increased risk. What else could be behind this? There is some data that can sort of give us a hint as to why this is going on. For example, there's less physical activity, and we know that exercise is really helpful in preventing cancer. Diet is really crucial here. Deep fried or sort of highly processed foods have been implicated. But meanwhile, diets with fiber, fruits and vegetables probably lower their risk. And obesity is also something that's looming over this as well. And so you have some doctors say, we have diet and lifestyle factors that are contributing to this. And that is true. But the researchers that you talk to say that they don't think that that fully accounts for what is going on here. And could this be the result of just better detection and diagnosis?

For colorectal cancer, they weren't screening people regularly under 50 until a couple of years ago. And some of these cancers do not have screening tests. And so screening is not something that researchers think is totally driving this. Brianna says that researchers don't fully understand what's causing the rise in cancer among young people. And research into the causes is just starting. In the U.S., you talk to sort of population health experts. They say that we're a very treatment-focused country where we could gain a lot of ground if we spent more time worrying about cancer prevention.

May finished chemo, had her surgery, and is now back at work. And she has plans to take the bar exam later this year. How has it been having your stomach removed? It's been interesting. I definitely, when I eat, I have to, it's a really trial by error sort of thing. I officially know I cannot eat carrots anymore. They have made me throw up multiple times, so surprisingly, no more carrots.

I'm good with apples and other foods, but carrots are just a huge no-no. So it's just being careful, small portions, eating slowly, and getting as much protein as I can. May is now cancer-free, but she still has to go back to her doctors to make sure the cancer doesn't come back. How has this experience changed how you think about the future, your future? Well, it delayed my whole dating experience. It's funny because when I was younger, I was like, ha ha, I'm going to be married with two kids and a house when I'm 27. No, I'm bald and I'm a cancer survivor at 27. So that's kind of something I have to accept.

My future, I'm hoping it's a bit better as I'm more social, more extroverted. So I'm not as scared to say no to things or no to people. I'm more open to doing things I might not have been comfortable with before. One of those things is bingo at a bar in Manhattan every Sunday night. I found an in-person bingo for cash winning bar sort of near me. So I've made some friends through bingo. Oh, come on. Where are you?

Look, I just need these two. Oh, wow. One and six. I actually won the first game of 2024. Congratulations. Thank you. Thank you. I won $39 from two games. So that's good.

How did it feel to shout out bingo? It's like, yes, I am a winner. Oh, bingo! What? That number again? Yes! That's all for today, Tuesday, February 20th. The Journal is a co-production of Spotify and The Wall Street Journal.

If you like our show, follow us on Spotify or wherever you get your podcasts. We're out every weekday afternoon. Thanks for listening. See you tomorrow.