Josh Johnson was 42 when he was diagnosed with colon and rectal cancer.
“I’m a statistic,” said the now 44-year-old. “I’m the guy who got a cancer you are not typically diagnosed with until after the age of 50.”
In fact, age 50 is no longer the recommended age to begin colon cancer screenings. The American Cancer Society (ACS) now recommends Americans get their first colonoscopy at age 45.
“An increased incidence of colon cancer in younger people is the reason for this change of recommendations,” said Xin Yao, MD, Oncologist/Hematologist at the ThedaCare Regional Cancer Center where Johnson received his testing and treatment. “Colon cancer is now the second leading cause of death by cancer in people of all ages.”
Johnson believes his cancer started as much as three years before his diagnosis.
“For a few years, I was having random pain in my lower abdominal area whenever I had a bowel movement,” he recalled. “I would feel the pain of something pushing in my stomach. When doctors told me that I did not need to be screened for colon cancer until age 50, I did not really give it a second thought. Now I know that each person is different.”
In Johnson’s case, his doctor suspected irritable bowel syndrome, a fatty liver or his gall bladder.
“I truly did not think I had cancer,” Johnson said. “Other than random pain in my abdomen, I never had any colon cancer symptoms. I’m a strong, healthy guy – 6’2”, 250 pounds. I wasn’t losing weight, my appetite was fine, but I definitely thought it was something more than an upset stomach.”
Johnson’s colon cancer was discovered after he began having heart palpitations and sought care for a possible heart problem. An electrical engineer, Johnson repairs packaging machinery and travels for his job. One night in the summer of 2019, he was working in Tennessee when his heart began palpitating, and thought he might be having a heart attack.
“I went to a nearby hospital and they checked me over and said I wasn’t having a heart attack and released me,” he recalled. “I felt fine for the next few days and continued on with my job. Then, the last night I was there, at about 4 a.m., I had an atrial fibrillation attack; back to the hospital I went. Luckily, the atrial fibrillation resolved on its own, and I was released. I came home and contacted my doctor.”
In the course of checking out Johnson’s heart, his doctor discovered his hemoglobin level was low and suspected he might have internal bleeding somewhere. The doctor ordered an upper GI exam and a colonoscopy in early December 2019.
“The upper GI scope was fine,” Johnson said. “When the colonoscopy was complete, the doctor came back and said he found a tumor in my rectum. The doctor explained that he removed the tumor, and I had another tumor in my lower descending colon. He thought both were suspicious. Two days later, the doctor called and said both tumors were cancerous, and we needed to develop a treatment plan soon.”
Johnson immediately called his wife, Melissa, who is a registered nurse at ThedaCare. With her as his support system, they were ready to tackle the diagnosis head-on.
In early January 2020, Johnson had abdominal surgery where the tumor, a section of his colon and 13 lymph nodes were removed. One of the lymph nodes later tested positive for cancer.
“The cancer had moved through the colon wall, which is where the bleeding was happening and causing my low hemoglobin level,” he explained. “The cancer was graded as Stage IIIB.”
Six weeks after his surgery, Johnson began chemotherapy. Because of his frequent travel for work and his desire to not to be off work for an extended period of time, Johnson’s oncologists recommended four cycles of chemotherapy with Capecitabine and Fluorouracil.”
“They warned me that the two chemotherapy drugs they were recommending were very strong, and that I would not feel well for a few days after each treatment,” he recalled. “They were right. I had some very serious side effects, some that are still present two years after the treatment.”
The oncologists told Johnson he has a 70% five-year survival rate, at which point he might be considered cancer free.
The American Cancer Society (ACS) estimates that in 2022, there will be more than 106,000 new cases of colon cancer diagnosed. According to the ACS, the death rate from colorectal cancer has been dropping in both men and women for several decades. Dr. Yao noted that is likely due to several reasons including colorectal polyps are now being found more often by screening and removed before they can develop into cancers, or cancers are being found earlier when they are easier to treat. Also, treatments for colorectal cancer have improved over the last few decades.
“Previously when we saw younger patients diagnosed with colorectal cancer, we thought it was because of hereditary factors,” he said. “But as with many, that is not always the case. We want each person to feel empowered to take precautions and following screening guidelines to help prevent a colon cancer diagnosis in their lifetime.”
Johnson firmly believes people should listen to their body.
“Your body will not lie to you,” he said. “Trust your gut! People need to pay closer attention to their bodies, and I hope doctors hear their patients when they explain that something just does not feel right.”
