James Van Der Beek and the Rise of Colorectal Cancer in Younger Adults

James Van Der Beek’s death from colorectal cancer at 48 brought a difficult question into a lot of conversations: how does someone develop this cancer so young?

He had spoken about noticing a persistent change in his bowel habits before he was diagnosed. When patients hear that, some start worrying about every change they notice. Others reassure themselves that they are too young for it to matter. What helps is looking closely at the pattern of symptoms and finding out whether there is a good explanation.

What counts as a change worth checking?

Suppose you have always had a bowel movement once a day, and now you are going three or four times a day. Or you have developed constipation that keeps returning, despite no clear change in medication or diet. I would want to know when it started, whether it is getting worse, and whether you are seeing blood.

I also ask about abdominal pain, unintended weight loss, unusual fatigue, and iron-deficiency anemia. Then I would ask about your family. Has a parent, sibling, or child had colorectal cancer or an advanced polyp? How old were they when it was found?

Many bowel changes turn out to have another cause. Bleeding may come from hemorrhoids. Diarrhea may follow an infection. But an explanation needs to fit the rest of your history. If bleeding recurs or a change persists, you deserve an assessment. Sometimes that includes a colonoscopy.

What about the screening age?

Routine colorectal cancer screening begins at 45 for most adults at average risk. Screening is intended to find disease in people who feel well. Your own starting age may be earlier if you have a strong family history, inflammatory bowel disease, an inherited cancer syndrome, or a history of certain polyps.

I mention this because patients sometimes tell me, “I thought I couldn’t get a colonoscopy until 45.” If you have symptoms, we are evaluating those symptoms. We do not have to wait for your screening birthday.

What I want you to do

If your bowel habits have changed and stayed changed, tell your clinician what your normal pattern was and what it is now. Mention any bleeding, even if you suspect hemorrhoids. Bring whatever you know about your family history.

You do not need to arrive with a diagnosis. Most people who come in with a bowel change will have something other than colorectal cancer. Finding out what is going on is still worth the visit.