Expert: Claes-Gustaf Nordquist, M.D. - 7/13/2007

Question
QUESTION: hello there. im horrified about colon cancer. im an 18 year old female. i have
been to doctor after doctor, even a gastroenterologist was unable to find
answers. your help would mean the world to me. i was on a very big diet, high in
protein and my stomach would make the funniest gurgling noises after i ate. i
also got terrible, explosive diarrhea from hard boiled eggs and too much greens.
i went back to my old eating habits (very unhealthy) and i was under alot of
stress. i had horrible stomach cramps and terrible diarrhea. the cramps were in
my lower left and right abdomen and my back. i also saw black in my stool. the
doctor wasn't sure what it could be and ran a fecal occult test. i did two
slides and both were negative for blood. the stomach pain continued and my
appetite went. it went into my back all of the time. i would also bloat after
meals. i felt constant pain in the lower right of my back. it feels like i have
to pass gas but i can't. my bowel movements would rotate between hard stools and
loose, watery stools that smelled and looked like diarrhea. my symptoms
continued so i went up for a full blood work up (which i would imagine reveal
any serious issues). i had a full CBC count (red & white bloods) cells, they
looked at my platelets, my liver function and my sugar..they looked at how
everything was functioning. everything came back great. my stomach pain
continued so i went to another doctor, she strongly felt my symptoms were
attributed to IBS & possibly crohn's or UC but i don't have bloody diarrhea so i
doubt it. these symptoms did come on when i became very stressed out. i finally
saw a gastroenterologist who believed my symptoms demonstrated IBS but he wanted
to do a colonoscopy. im only 18 years old so i said no and accepted the IBS
diagnosis. my stomach makes violent growling noises after i eat & gurgling. the
abdominal pain moves into my back. it almost feels like a big gas pain. my
bathroom habits have changed. i also have some stomach acid that comes up to my
throat at night. maybe stress has affected my digestive system? does this sound
like IBS? they thought it might've been a kidney infection because of the pain
in my back but they tested my urine. how about gallbladder attacks? it feels
like trapped gas but im really not sure. im not about to put myself through a
colonoscopy if it is believed to be IBS. does this sound like IBS? can IBS move
into your back? im sick of suffering & i want some advice from people who know
their stuff. i don't want to hear "just go for the colonoscopy." i want insight
based on the symptoms i have mentioned. i am mostly scared about colon cancer
because i read online that young people get it but then again i heard the
opposite that it is so extremely rare in teenagers. for a long time, i had a bad
habit of holding in my stool..does this lead to colon cancer or no? i heard it
just leads to stomach aches but i was worried you can get colon cancer from it. should i be worried about this? im not sure what to think. help please.


ANSWER: Dear Britt, I have answered all your questions on this! Why do we have to start all over again?! I did mean what I wrote previously! Stop thinking about this! It does not lead anywhere! Good luck!


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QUESTION: sorry i accidently re-posted the question lol. very sorry.
ANSWER: Ok, no problem!


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QUESTION: just one more thing i wanted to share with, it is very vital before i stop being a pain lol. as a result of my ongoing abdominal pains i had a full blood work up. i wanted to share with you, the tests they did. can you tell me what the tests would've revealed as far as intestinal issues (crohn's etc)?

they did a full work up.
i have had ongoing abdominal pain & as a result the doctor did a full blood work up. he did the following tests. can you tell me what issues (intestionally especially) the blood work would reveal? i also had a pelvic ultrasound, a urinalysis, a rectal exam....

i had a full CBC count
my platelets were looked at
they look at my hepatic function
renal function
blood sugar
albumin
bilirubin
blood glucose

all these tests came back normal. so what does that rule out? thankyou very much & sorry for being a big pain.
ANSWER: Well IF you had Crohn's or ulcerative colitis you would probably have had anemia and a high sedimentation rate for example that should have shown themselves in your lab. tests! Since they did not they are probably not there nor these illnesses! But again, to be 100% sure of this and your cancer concerns a colonoscopy is needed.


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QUESTION: well i really have no heard of colon cancer in my age group so im assuming as you said it's EXTREMELY RARE. i don't even think doctors consider colon cancer in such young people. i mean you're a doctor so you would know best.
ANSWER: If you remember my very first reply I wrote that it is so EXTREMELY RARE in your age group that it is almost unheard of!
Really you do NOT consider it in your age group! Dear Britt, you are now driving your questions on this subject almost to or even to a psychiatric level! Your symptoms are best explained as I have already told you by an irritable colon (spastic colitis) syndrome. However if you are so scared of a most improbable colon cancer, do have a colonoscopy and you will have a guaranteed correct reply on the existence of any such cancer AND of any Crohn's disease & ulcerative colitis or not beyond ANY doubt! Ok?
That was NOT what you wanted to hear but it is the only thing that remains! Take it or leave it!


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QUESTION: you're right. i rated you by the way, a 10 of course & voted you as member of the month. i heard stories on these message boards of 30 year old woman having colon cancer. i don't know why.
ANSWER: Thanks! Such cases do exist of course - but she was 30 NOT 18! But also 30 is normally far too young for a colon cancer unless it is due to some genetic disorder for example colonic polyposis (where the colon is filled up with polyps). This genetic condition mostly run in families and the results can be followed from generation to generation. As a young dr. - I was 25, almost 26 - in 1970, just beginning my career in medical oncology and radiation therapy in the Royal Karolinska University Hospital, Stockholm, Sweden - and myself walking with crutches after a difficult foot operation - I did have a young woman patient (but much older than you) with a colon cancer. Very sad her cancer was very advanced and she had a small baby! But do not let THAT worry you now! She was much older than you and it was a VERY different case! Good luck!


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QUESTION: okkk and one last thing because i cant find the answer to it anywhere else in the world. while im talking to a well informed, well versed doctor i might as well ask. what's the deal with the risk of anal sex and anal/colon cancers? im very confused about that whole concept. is it anal sex in itself that leads to this cancer or having anal sex with someone who is infected with the HPV virus that is a risk for anal/colon cancer? i had unprotected anal sex with my boyfriend several times. he is free of STD's, i know it for a fact but i was curious if anal sex in itself is a cancer risk or it's the STD's you can contract from it that potentially causes cancer of the anus and colon. my intestinal problems developed shortly after the anal incident. maybe it was coincidence? there is alot of misconception about anal sex and anal/colon cancer. that is one concept that really does confused me. if you can clarify for me, it would be greatly appreciated. then i will go on my merry way & be very thankful for all your help. i just finally need to have that clarified. thankyou dr!!

Answer
Well, colon or really rectal & anal cancer is most probably related to anal sex by the infection of a sexually transmitted disesase: Infection with the Human Papilloma Virus. This virus also causes sexually transmitted virus warts (papillomata acuminata) and cancer of the uterine cervix in women and probably also penis cancer in males and maybe vulva cancer in women so it is definitely involved in ordinary sex as well. It is also suspected as the cause in the recent increase in tonsillar cancer, so also involved in risks in oral sex (there also maybe in tongue cancer in non smokers). If your boyfriend is really free of this virus and you enjoy this habit I see no reason why you can not continue with it! There is also a vaccine available now! That vaccine should - if used properly - give a rather good protection against these cancers as well as the warts! Good luck!
Condoms also give rather good protection. MOST colon cancers have nothing at all to do with anal sex though!