The New Face of Colorectal Cancer: Celebrity Legacies, the Screening Gap and How to Advocate for Yourself

Colorectal cancer (cancer of the colon and rectum) is now the leading cause of cancer deaths in adults younger than 50. Rates have increased steadily over the past three decades, with the most dramatic rise seen in people in their 20s and 30s. 

In this episode we break down what that means for you and the people you love.  https://bit.ly/3OpPlk8

Early colorectal cancer often has no symptoms at all, which is why screening guidelines were recently lowered to begin at age 45. When caught early, the five-year survival rate is 91%. When detected after it has spread, survival drops dramatically.

We discuss:

• Why colorectal cancer is increasing in younger adults
• The subtle symptoms many people ignore
• How blood clots can complicate cancer
• Lifestyle factors linked to risk
• Why early-onset colorectal cancer tends to be more aggressive
• How to advocate for yourself if something feels “off”

If you notice blood in your stool, persistent abdominal pain, changes in bowel habits, unexplained weight loss, or fatigue from anemia — do not dismiss it. Speak up. Get evaluated. Early detection can save your life.

In this Episode:

• 0:00 – Intro: Colorectal Cancer Cancer in Young Adults
• 02:35 – Recipe: Yummy Ham & Pickle Rollups
• 02:50 – “André Is An Idiot”: André Ricciardi’s Terminal Creative Legacy
•  05:38 – Celebrity Case Studies: James Van Der Beek & Catherine O’Hara
• 14:32 – Super Bowl Ad Alert: Multi-Cancer Tests & False Negatives
• 16:54 – The Reality Check: Lifestyle Risks & Charlie’s Personal Disclosure
• 30:44 – Tracey Emin: Reclaiming Life After Radical Pelvic Surgery
• 34:00 – Outro

#ColorectalCancer #AndréRicciardi #TraceyEmin #JamesVanDerBeek #CatherineOHara #ColonCancer #CancerScreening #EarlyDetection #YoungAdultsHealth #CancerAwareness #PreventCancer #EveryoneDiesPodcast #KnowTheSigns #AdvocateForYourHealth 

Transcript

Hello and welcome to Everyone Dies. Relax and settle in for our podcast about serious illness, dying, death, and bereavement. Because even though everyone dies, no one must face it unprepared.

This week we're talking about this month's celebrity deaths from colorectal cancer. Colon cancer is now the leaning cause of death in adults under age 50, and early symptoms are often so subtle that they tend to be ignored. I'm Marianne Matzo, a nurse practitioner, and I use my experience from working as a nurse for 47 years to help answer your questions about what happens at the end of life.

And I'm Charlie Navarrette, an actor in New York City, and here to offer an every person viewpoint to our podcast. We're both here because we believe that the more you know, the better prepared you are to make difficult decisions when a crisis hits. And please remember that this podcast does not provide medical or legal advice.

Please listen to the complete disclosure at the end of the recording. In the first half, Charlie discusses a film about Andre Ricciardi, who, when he found out he had cancer, asks a friend to film his final years of life. The result, Andre is an idiot, mixes in stop-motion puppetry to create an astonishing record of an extraordinary life.

In the second half, we're talking about the recent celebrity deaths related to colorectal cancer. And in the third half, Charlie has an excerpt from an interview with artist Tracey Emin, who candidly talks about how her cancer diagnosis has impacted her life. Hi, Charles.

Who? Oh, yes, me. Yes, fine. How are you? Good.

Good. Wait a minute. You guys are getting big, ugly storms, aren't you, right now? It is.

Yeah. So warm. Oh, it's the opposite.

Okay. Okay. Yeah.

That I opened both doors in our bedroom for a crosswind and slept with the doors open all night. It is that warm. Hmm.

It's so warm that we sat down on the porch yesterday and ate an ice cream cone. Oh, oh, jinkies. So, hey, listen, let's get on with the show.

For our first half, our funeral lunch recipe is a recipe from our youth. Yummy roll-ups. Mom would send us to the Kresge Deli for ham, sliced thin.

That with a pickle and cream cheese rolled up was a great appetizer and will be sure to please the crowd gathered at your next funeral lunch. Bon appétit. Andre Ricciardi worked as an advertising executive, calling himself an idiot for not having gotten his colonoscopy sooner.

After his diagnosis, he decided to make a documentary. Andre is an idiot. Andre says he shifts his obsession with his diagnosis away from the consuming anxiety of a terminal sentence and instead focuses on making one more creative project, this time using himself as the message to help spread awareness for those who think, it won't happen to me.

Death is surprisingly boring, says Andre in one scene. He isn't an idiot, but he is dying from stage four colon cancer when he says that death is boring. He isn't wrong.

He points out how much of his time is spent waiting, sleeping, and caught in a routine of taking medications or going through treatments. This man who caused the term terror marketing to be coined in advertising is anything but boring or an idiot. He is raw and truthful and he committed to capturing his body's battle on camera to subvert modern taboos around the subjects of dying and terminal illness.

Andre left a remarkable personal legacy that includes his 88-minute gift to the public, reminding us all, get your effing colonoscopy. The film had won the audience award at last year's Sundance Festival. Nobody expected the film to even get a showing there.

The reactions to the film have been profound. People came up to me and said they wished they'd seen it when they'd been diagnosed because they would have felt less afraid, less angry, less isolated. Then there are all those who got colonoscopies because of the film.

I've had at least three dozen people say the film saved their life because they got checked and caught something early. Get your colonoscopy starting at age 45 and available at a screening facility near you. Please go to our webpage for this week's recipe, yummy roll-ups, and additional resources for this program.

This is the part where we ask for your financial support. Your tax-deductible gift will go directly to supporting our nonprofit journalism so that we can remain accessible to everyone. You can donate at www.everyonedies.org. That's every, the number one, dies.org. Or at our site on Patreon under Everyone Dies.

Marianne? Thanks, Charlie. February has had two celebrity deaths related to colorectal cancer. Emmy award-winning actress Catherine O'Hara was diagnosed with rectal cancer before her sudden death at age 71 following a blood clot to her lung.

This is called a pulmonary embolism, thought to be caused by her cancer. Actor James Van Der Beek, best known for his 1990 TV series Dawson's Creek, died at 48 after living for two years with stage 3 colon cancer. Colorectal cancer, which is cancer of the colon and rectum, is now the leading cause of cancer deaths in people younger than age 50.

So I guess, Charlie, you and I don't have to worry about it. But, spoiler alert, that would be wrong. The rate of colorectal cancer has increased one to two percent per year.

That's one to two percent per year for the last 30 years. The biggest increase is being seen in people ages 20 to 29. This trend prompted changes in colorectal cancer screening, recommending that adults begin screening at the age of 45 rather than age 50, as has been previously recommended.

The National Cancer Institute notes that five-year survival rate for colorectal cancer is 91 percent if the disease is diagnosed early at a localized stage, meaning that 9 percent will die from localized disease, meaning if it stays just in the colon. The survival rates dropped to 16 percent for colorectal cancer detected in later distant stages, meaning 84 percent will die from the disease. The thing with colorectal cancer is that it does not announce its presence.

The symptoms are very subtle in the beginning. Van Der Beek said he went in for a colonoscopy, which is how colorectal cancer is looked for, when he was 46 because he noticed minor changes in his bowel movements. Quote, there wasn't any red flag or something glaring.

I was healthy. I was doing the cold plunge. I was in amazing cardiovascular shape and I had stage 3 cancer and I had no idea.

End quote. Van Der Beek said he hoped the publicity around his disease would educate younger adults about the need to be screened for colon cancer. He said, quote, I really want to impress upon people that you don't need symptoms to get screened.

If you are 45 or older or have a family history, talk to your doctor about screening options. End quote. So I put a link in the show notes about a woman who at age 32 noticed rectal bleeding, thought it was a hemorrhoid, and never told her doctor.

Six years later, she felt down, lost her appetite, and noticed that her bowel habits had changed. She had a colonoscopy done and was diagnosed with stage 4 colon cancer. Early colorectal cancer often has no symptoms, which is one of the reasons screening colonoscopies are so important.

As a tumor grows, it may bleed or block the intestine. The most common symptoms of colorectal cancer are bleeding from the rectum, blood in the stools or in the toilet after having a bowel movement, dark or black stools. This is from blood that's further up the colon, so we can tell if it's toward the end because it would be bright red, or further up it's dark or black.

Either way, you need to go see your doctor if you see any kind of blood in your stool. Another symptom is a change in bowel habits or the shape of the stool, meaning it comes more narrow than usual. Cramping pain or discomfort in the lower abdomen, an urge to have a bowel movement when the bowel is empty, constipation or diarrhea that lasts more than a few days, decreased appetite, and unintentional weight loss.

This means that you're not on a diet, you're not on ozempic, you think you're eating normal but your weight is dropping. Sometimes the blood loss from cancer leads to anemia. Anemia is a low number of red blood cells causing symptoms such as weakness, excessive fatigue, and sometimes shortness of breath.

Now what about Katherine O'Hara's death? She had been diagnosed with rectal cancer about nine months before her death and died from a blood clot to her lung. The link between blood clots and cancer has been documented for over 100 years and is associated with considerable ill health in people with cancer and decreased survival. Analysis of two eMERGE databases in California, included over 68,000 people with colorectal cancer, showed that blood clots were a significant predictor of death within one year of colo-cancer diagnosis.

So why are we seeing this increase in colorectal cancer? Healthcare practitioners suspect it's a combination of genetics and lifestyle factors, such as being inactive, overweight, or a diet high in processed foods. In the United States, 55% of all colorectal cancers are attributable to lifestyle factors, including an unhealthy diet, insufficient physical activity, high alcohol consumption, and smoking. These behaviors are traditionally associated with high-income countries where colorectal cancer rates are highest.

Numerous studies have documented that people with healthy lifestyle behaviors have 27% to 52% lower risk of colorectal cancer compared to those without these behaviors. A 2019 study documented that among early-onset colorectal cancer patients, defined as those under 50 years of age with rectal bleeding symptoms, the average time from the symptoms to diagnosis was 271 days. That's like almost a year.

By then, nearly half of the patients' cancer had already metastasized. In early-onset colorectal cancer, lower awareness of colorectal cancer, lack of screening, ignoring symptoms, and reluctance to seek medical care may contribute to delayed diagnosis and an advanced stage at diagnosis. Also, healthcare practitioners are not looking for colon cancer in people in their 20s and 30s.

The increase in colon cancer in younger people needs to be known by younger people themselves and those that love them to help them get an earlier diagnosis. Here's what you need to know about your own health. If you experience pain in your lower abdomen, blood in your stools, or unexplained weight loss, or you feel like something is off, and if your symptoms are just not going away, you need to get checked out.

Go to your healthcare practitioner. But no, they probably aren't going to think first off colon cancer because of your young age. If you have these symptoms, you need to speak up.

And don't give up until your doctor gets to the root cause of your symptoms. Don't let them say, well, it's just a hemorrhoid. It's like, you know, I want you to go in there and look and, you know, show me that hemorrhoid.

What you really want is you want to get a colonoscopy to make sure that there aren't any problems there. Early onset colorectal cancer tends to be more aggressive. It is often diagnosed later in the course of the disease when it's harder to treat.

Sometimes it's misdiagnosed as diverticulitis or some other problem. Don't let your fear of what the diagnosis may be by ignoring pain, blood in your stool, or weight loss. Listen to your body, even if you believe you're healthy, and advocate for yourself.

Doing nothing is not a good option. The life you save could be your own or somebody you really care about. Our producer just sent me a, I guess, Sandy, you stay up on things, um, that the Super Bowl this last week, um, had an ad for Galeri Multi-Cancer Detecting Test from Grail.

It's a blood test capable of detecting over 50 types of cancer, including colon cancer, before symptoms appear. The ad, which highlighted, uh, no cancer signal detected results, has really sparked some controversy among experts. Um, one of the things about this test, um, first off, the test is $700, um, and it's looking for DNA fragments from cancer cells.

But you just get a no cancer signal detected. But this test has been shown to produce false negatives, meaning it's saying, it's giving you that message, but it's not really true, um, which could lead to really a false sense of security, causing people to skip standard proven screenings like colonoscopies. So if you have an extra $700 laying around, um, you can donate it to Everyone Dies, and then go to your doctor and use your insurance and get a colonoscopy.

And then that way, you would have a, um, a lower or no chance of finding a false negative and, um, thinking that you're all set because you did this little finger, finger-free blood test. Finger-free? It's, um, oh, there's other tests that, um, look for prostate cancer, and that's why it says they're encouraging finger, finger-free blood tests, meaning nobody's putting their finger inside of you. But you know what? Better to have a finger inside you.

Quit laughing at me, Charles. But better to have a finger inside you and know that, you know, it's been looked at properly. Quit smiling at me.

So, Charles, you have any questions before I dig a deeper hole for myself here? No, you're doing fine on your own. Thank you. Um, okay.

Yeah. First, um, okay. So, I mean, it's spreading, you know, to younger and younger people, just, but just basically, as you said, because of the food people are eating and, um, I mean, it's just, it's just that? Well, it's never, I don't know, it's never, but it's usually never just one thing.

Oh, yeah. You've got to think about these people who are under age 50, you know, grew up on, um, much more fast food than, than we certainly ever had because it didn't really exist. They hadn't really invented it.

You know, they were two kinds of chips. I mean, we just, there just wasn't the variety of quote unquote junk to eat. Right.

Plus, you know, my, my parents were processed foods. Right. Well, my parents were depression babies.

They weren't going to spend money on things that came in a box, you know? Yep. Yep. So, um, so it's lifestyle choices, it's alcohol, it's smoking, it's the high rate of obesity that we have in our country.

And it's the processed foods. I mean, if you look at, you know, all of the chips and things with the, God knows what they sprinkle on them that get all over your hands. Yeah.

Um, but none of that is grown in a field. Right. Yeah.

You know, and, um, going back to whole foods and, um, you know, eating things that are, are grown and closer to their natural state. We've talked about those in podcasts before. Like I, the one change I've made since the podcast where we talked about that was, um, I buy a lot more frozen vegetables and frozen fruit because I get tired with just the two of us of throwing things out if, that we don't get to.

But, um, the fruits and vegetables are fast frozen right after they're picked. So, and as long as you're not getting any additional sugar added or salt or other kinds of things added to it, they're a perfectly healthy alternative for making vegetables. Like I'll, I'll buy the frozen broccoli and make broccoli soup.

And so there's always vegetables to throw into soups or stews or things like that, what you're making. And, um, the fruit is perfectly fresh and good. We put that, I make homemade yogurt now and put, um, the frozen fruit right into the yogurt.

Oh, yeah. I do the same thing too with the yogurt. You make homemade yogurt? I make homemade yogurt at Trader Joe's.

Yeah. Thank you very much. Uh, yeah.

And, um, yeah. So often, you know, I just throw in, uh, you know, blueberries in there. Um, but you know, I, I found a pack of frozen blueberries.

Mm, mm, mm. That bad boy, you know, hits the spot. It's good.

And yeah. And I do that, you know, not like throughout the day, but once in a while, um, if I'm working and I just want something quick, uh, I'll do that. And it's, uh, it's good.

It's good. Yeah. And it doesn't go bad.

It's like, exactly. Yes. Yeah.

And it's so good. Blueberries are so good for, for your body. Yes.

Yes, they are. But even, even if you don't go all the way to the, you know, frozen blueberries, even if you just stop eating, you know, Doritos and the canned bean dip, you know, that'd be a good start. Yeah.

Or, or Doritos, um, with melted, uh, very sharp cheese and a little guacamole on the side. Yeah. You, you folks shouldn't be doing that on a regular basis.

Yeah, but you can get the, you can get the plain, you know, not that they're not the Doritos. Well, Doritos makes a plain brand. Oh yeah, there's a plain brand, yeah.

But you, but you can get, you know, a simpler version of that. There's nothing wrong with guacamole and cheese. I would miss the orange dust on my fingers.

Made of God knows what. Okay. Well, that's the thing.

Yeah, that is the thing, yes. It's made of colorectal cancer cells. It's not funny, but you know, it's a precursor.

No, no, I do. And, um, you know, just like, you know, as we discussed, um, you know, a few, uh, episodes ago when, uh, you talked about, you know, drinking and I, you know, I, you know, drinking alcohol and had to come clean that with all the jokes I make about it, you know, I'm not out there knocking back a couple of martinis every day, um, everything in moderation. Um, but yeah, I mean, a steady diet of that, or, you know, my favorite little snacky with, uh, you know, with the melted cheese and everything.

Yeah, not, no, that's, that's not my diet. You, you can't, because as, as you've been saying, it, you know, that, well, that shit'll kill you. Um, yeah, but you're not over 50.

I mean, you're not under 50. So Charlie, you just eat all those bad boys you want. Really? No.

Oh, I see. You were so happy for a second there. For one hot second.

Hope springs eternal. Marian says I could eat it. No kidding.

I'm gonna order DoorDash now. Um, oh, jinkies. Uh, oh, listen, uh, so, okay, so I got everything with the, you know, colorectal exams and everything.

Um, I had, actually I'm going to, I haven't had it yet, my appointment is for next week. I have an appointment for a prostate transrectal. Prostate.

There's no R. Oh, are you, are you sure? Because I'm looking at this form and there's no R in it either. So, um, you know, I hate when we're consistent. Yeah.

So, uh, prostate, uh, transrectal, what's the difference between that and having a colonoscopy? How far up they go. Oh. Um, so with a colonoscopy, it's, um, really good drugs and the scope that they use is longer.

Um, with the prostate, you can use your finger and go in through the rectum and it's, you can feel the prostate right at the tip of your finger, which is how they do, um, an exam. They feel it and it's, it's a, like a heart-shaped organ. You should feel sort of the bumps, those two bumps.

When they're doing a transrectal scope, they're using an actual camera instead of their finger to go and look at it. So it's a, it's a shorter, shorter distance. Okay.

And, um, they're focusing on the prostate and not on the architecture of the intestine. Got it. Okay.

So it's two separate, uh, things. Okay. Well, it's probably two separate heads that they put on the scope, you know, like a short one and a long one because they're not going very far with the prostate one.

Cause if I can put my finger in and feel the prostate, that gives you a sense of how far they're going, which is not very far. Okay. Good.

Good to know. Thank you. You know, our listeners are going to want a follow up because now they know you're having it and they're going to be sending you prayers and thoughts and, uh, you got to follow up on this.

Tell us what happened. Pressure. Uh, well, well then why, why bother with the, uh, prostate, uh, transrectal? Why not, why don't I just skip that and go for the, uh, big enchilada, um, just to get the colonoscopy or, or, or, or are both recommended? Well, what I'm, I don't even want to ask this question.

When was your last colonoscopy? Couple. Yeah. It's gotta be a couple of years now.

Oh, well, maybe, maybe even three years, let's say two to three years ago. So in that colonoscopy report, which was done by a gastroenterologist, enterologist, GI doctor. Oh, wait a minute.

No, no, no, no, no, no, no. Sorry. Sorry.

Sorry. No, it was not a colonoscopy. When's the last time you had a colonoscopy? Yeah.

I'm, I'm waiting. Go ahead. Say it.

Crap. I haven't. All right.

Honest, honest to God. So to your point. Yeah.

No, I haven't. You know, you're, you're 69 years old. You should have had back when the recommendations were what they were.

You should have had your first one at 50. Now the recommendations are 45. So it, it would make sense.

You can call the center and say, can I get a colonoscopy with a sat side of a post rectal prostate exam? They're two different kinds of doctors. So there'd have to be the two doctors there, but it would be one anesthesia. I don't know if it would be one copay or not, but you can call the center and ask them if you can set it up that way.

But I think when we did the show on all the details about colorectal cancer, which is a separate podcast, this is more focused on screening. I think we had that conversation then, but what they'll do when you have your colonoscopy is depending on if they find polyps. So polyps are these little sort of outgrowths of skin.

Usually what they do is they snip them off and send them off to see if they're cancerous or not. But if they do see polyps, even if they're not cancerous, they'll say, well, we want to do a follow-up and usually like two years because polyps are a precursor, meaning they come before the cancer. So if you have polyps, usually it's like a two-year follow-up.

If there are no polyps, I think it's like a, I don't know, five or seven-year follow-up for your next colonoscopy. So in the last, what, 19 years, you probably should have had three by now, but you don't feel it. There's like I said, the drugs are great.

They give you the drugs. I'm telling you, they're wonderful. And you wake up and they say, okay, so here's what we found.

And they actually will show you pictures of the inside of your colon. And they'll say, we found no polyps or we sound three polyps or whatever we found. And it is such a non, I mean, going for a pap smear and a breast mammogram is far more uncomfortable than a colonoscopy.

But you wouldn't know about those either. No, no, I wouldn't. Okay.

Thank you. And folks, don't do what I've done. Well, and now you have to report back because now everybody's worried about you.

Thank you. No, really, in all seriousness, don't do what I did. You know, I always felt fine.

I've been very healthy. That doesn't mean anything. Well, yes, it does, but yeah, please.

No, when it comes to colon cancer, no, it doesn't. Yes, exactly. That's why I read you that quote from Vanderbeek.

I mean, he was stunned when he got his stage three colon cancer diagnosis. He felt great. Yeah.

Okay. For our third half, Tracey Emin is recognizably the same as she's ever been. The artist who scandalized and entranced Britain in the 1990s with her tent embroidered with the names of everyone she'd ever slept with, with her unmade bed and its rumpled sheets and detritus.

This is the Emin who worked hard, survived a great deal, and somewhat unpredictably ended up a national treasure. She pours out cups of green tea. Once it would have been vodka and a fag, but there's been no alcohol for nearly six years now, and she quit her 50 a day habit a long time back.

In the past few years, death almost claimed her and she clawed herself back to life again. In 2020, she was diagnosed with a vicious squamous cell cancer requiring dramatic surgery. I had to have my bladder removed.

I had a full hysterectomy. I had my lymph nodes removed. I had half my vagina removed.

I had my urethra removed. Part of my bowel removed, she says, ticking off the losses. She is contained, quiet spoken, and there are none of the flashes of anger she was once famous for.

Seven hours and more the operation took. She also had a urostomy, surgery to create a stoma, a hole in the abdomen so urine can pass out into a collection bag. She often has hers beside her in a tote bag.

She has bowel problems on top of everything else. You've got the blood. You've got the shit.

You've got the pills. It really can get you down because you can't be free. Nothing can be improvised.

Nothing can be spontaneous. When I go away, half my suitcase is full of medical supplies. She's not moaning, she keeps telling me.

She knows she's lucky, but it's hard work. She got really upset, she says, about what to wear for her investiture as a dame last year. She had her urine bags trapped to her leg, which was okay, but uncomfortable.

I didn't want to do my photo op with the king holding a bag of urine, she says. This is, then, her second life, and second life is also the title of her forthcoming show, At Date Modern, her largest to date. Her brush with death changed everything.

It was the spur to relocate permanently to Margate, to set up a foundation, to put in place things that could give back to her hometown and carry on after her eventual death. After the cancer, she says, the big thing that I discovered was that I don't want to die right now. You might think that's obvious, but it's not.

I have spent a lot of my life being sad, being nihilistic, and punishing myself mentally, and drinking and smoking, and then I realized I could have my time back again. And so ends this week's episode. Please stay tuned for the continuing saga of Everyone Dies, and thank you for listening.

You can find most episodes from our series on Spotify, Apple Podcasts, or your favorite podcast app. Follow and subscribe to the show. Share it with someone who needs a little hope today.

This is Charlie Navarette, and from Violet Ranney Lang, in an unnamed poem, dying is the last place love can go. And I'm Marianne Matzo, and we'll see you next week. Remember, every day is a gift.

This podcast does not provide medical advice. All discussion on this podcast, such as treatments, dosages, outcomes, charts, patient profiles, advice, messages, and any other discussion are for informational purposes only, and are not a substitute for professional medical advice or treatment. Always seek the advice of your primary care practitioner or other qualified health providers with any questions that you may have regarding your health.

Never disregard professional medical advice or delay in seeking it because of something you have heard from this podcast. If you think you may have a medical emergency, call your doctor or 911 immediately. Everyone Dies does not recommend or endorse any specific tests, practitioners, products, procedures, opinions, or other information that may be mentioned in this podcast.

Reliance on any information provided in this podcast by persons appearing on this podcast at the invitation of Everyone Dies or by other members is solely at your own risk. Transcribed by https://otter.ai