On a recent Tuesday morning, Dr. Amanda Schwer told an audience about a phone call that she’d have to make in a few minutes, to a 30-year-old patient.
The breast cancer expert agonized over the call, knowing that if breast cancer stays in the breast, the survival rate over the subsequent five years is 99%. If it spreads to the lungs or brains, that survival rate falls to 31%.
“I laid awake last night worrying about telling her that her cancer has spread to her brain,” Schwer said in a voice that was cracking. “She has three young children.”
Schwer’s presentation was part of a press conference held by the City of Hope Orange County at its Irvine clinic to highlight a report showing that Orange County has the highest overall rate of cancer incidence in people under 50 years old in Southern California—98.3 cases per 100,000 residents.
Neighboring San Diego has 95 cases per 100,000 and Los Angeles has 89.6 cases.
Furthermore, the rate in Orange County is growing, while falling in neighboring counties.
“Even here in Orange County where we think of ourselves as living in such an amazing place and having healthy lifestyles, the numbers are unsettling,” said Annette Walker, president of City of Hope Orange County.
Young Faces
The report, “The Younger Face of Cancer,” said the most pronounced types of cancer in people under 50 in Orange County are breast, colon and lung cancer.
“It’s a growing epidemic that we’re observing in the clinic and is now being validated” by this report, said Dr. Edward Kim, physician-in-chief at City of Hope Orange County.
He’s personally witnessed something odd with young patients getting lung cancer, which is his specialty.
“It’s not just smoking anymore,” Kim said. “These people didn’t smoke 10 packs a day for 10 years and then got diagnosed. There is something else happening with their exposure, genetics that we need to find out.”
Typically, the median age of a person diagnosed with cancer is 66. Early onset cancer, which is defined as the disease occurring between ages 18 and 49, is expected to increase by 31% by 2030, the experts said.
The rise might be attributable to a sedentary lifestyle and increased use of alcohol and processed foods that can cause obesity.
Paradoxically, one of the reasons for the increase may be that more people are getting tested for cancer at a younger age.
“However, better screening is just one factor,” the report said. “There is substantial evidence indicating more troubling environmental causes for early-onset cancers.”
The City of Hope Orange County, where 18% of its patients are under age 50, is using the study to promote a campaign to prioritize early diagnosis of cancers. It notes that recommended ages for testing have been lowered from 50 to 45 for colon screenings and from 50 to 40 for mammograms.
City of Hope has launched a mobile program to provide testing in underserved communities.
“This initiative is a critical step in increasing awareness among our patients and the community,” Walker said. “Too often, patients and sometimes even their physicians think, ‘It cannot be cancer, they’re too young.’”
Such attitudes delay testing and detection at early stages when it’s most curable, she said.
Schwer, whose own sister had breast cancer at 41, said that at least once a week, a patient tells her that she felt something in her breast and their primary doctor recommended waiting because of her youth.
“We must empower younger women to speak up and for their physicians to listen.”
