As a lifelong vegetarian who ran every day and never called in sick to work, Laurie Koshers does not fit the bill of a cancer patient.
Yet in 2018, doctors told the North Carolinian there were ‘tumors everywhere’ in her intestines and she was diagnosed with terminal colon cancer.
The mother-of-three was 44 at the time — much younger than the average age of diagnosis of this type of cancer, which is 66 — and she had no family history of the disease.
But she is one of a rising number of people diagnosed with early-onset colon cancer — cases that occur in people under 50 years old — and doctors say diagnoses are mysteriously rising at an alarming rate.
While no definitive answer has been discovered, experts are increasingly blaming ultra-processed foods and red meat, as well as obesity and a low fiber diet.
But doctors say patients like Mrs Koshers highlight that other factors could be behind the surge.
Laurie Koshers, pictured above with two of her children, revealed her story as part of the Colon Cancer Coalition’s series to raise awareness over the disease
Mrs Koshers was active and ran every day. She also ate healthy and avoided meat
Laurie said she had barely ever touched red or processed meat during an interview with charity the Colon Cancer Coalition.
She also said she never called in sick for work, unless one of her children came down with something.
Dr Cedrek McFadden, an oncologist in South Carolina who works with early-onset colon cancer patients, is among doctors who no longer believe obesity and red meat explain why so many healthy young adults are developing colon cancer.
He told DailyMail.com: ‘I suspect it is going to be an environmental agent, perhaps there is something in environmental exposure — so before our 30s and 40s — that leaves your body predisposed to it.’
He said this agent could be a pesticide or food additive, pollution in the air or even microplastics from food containers.
He added: ‘What baffles me and is equally frustrating for them is that when we talk about risk factors for colon cancer, we talk about obesity, smoking, having a diet high in red and processed meat.
‘But these are patients that are participating in running clubs, that have an entirely organic diet, that may even be vegan, and consume very little meat products.
‘There is some kind of exposure that is happening to the population — around the 1980s to the early 2000s — that is causing this increase.
‘I think it’s going to be down to something we are eating or drinking and how it is altering our gut microbiome — although we haven’t fully elucidated it yet.
‘This could be food additives or pesticides. But I definitely think that there is not going to be just one culprit, it is going to be more of a cumulative effect.
‘So, an effect of having too many parts per million or billion of a pesticide and then this other additive and then together these might lead to excessive mutations in the cells that causes the cancer.’
Dr Suneel Kamath, an oncologist at the Cleveland Clinic in Ohio, said red meats and processed foods were likely behind many cases — although he also felt other factors were causing the disease.
In 2018, Laurie began experiencing bloating and irregular bowel movements — but she blamed it on a gluten sensitivity and aging.
After suffering from severe abdominal pain, she visited doctors who diagnosed her with irritable bowel syndrome (IBS) and a ruptured abscess.
It was only after she collapsed in the bathroom and was rushed to the hospital that a large tumor was detected in her colon.
Doctors removed 12 inches of her colon and the tumor in an operation, saying she had stage three cancer, and ordered three months of chemotherapy.
But at her next check-up she was told the cancer had progressed to stage four, when it spread from her colon to numerous areas in her abdominal cavity.
Doctors said they could see so many growths in the scan of her abdomen that it appeared as though someone had ‘taken a salt shaker and sprinkled cancer throughout’ her body.
Now, she is taking part in a clinical trial at Duke University. While the drugs are not expected to eradicate the cancer, they are expected to slow it down — giving her more time with her family.
In a similar situation, 72-year-old Irena Aistrop from Florida, also a lifelong vegetarian, was diagnosed with colon cancer in July.
She revealed her diagnosis in a Facebook post, writing: ‘I still find it hard to believe that as a vegetarian and most times vegan, that I could get colon cancer. This is the reason I had always avoided getting a colonoscopy.
‘[But now] I am kicking myself for my foolishness and… I just ask you all to go ahead and schedule your colonoscopy if you are over 45 or haven’t had one yet.’
Ms Aistrop received the diagnosis in early July and was sent for surgery in August to remove the tumor that had been detected in her colon, which had not spread.
Ms Aistrop, pictured above, said she didn’t think she could get the cancer because of her diet choices
Much research as to what may be behind the colon cancer epidemic in young adults has been conducted.
A number of studies have suggested there may be a link with eating ‘too much sugar’ and too little fiber, with researchers suggesting that this could speed the aging of gut cells and make them more prone to cancer.
Others have even suggested that having older siblings could leave someone at higher risk, because it may expose children to diseases earlier and cause inflammation in the gut — pre-disposing them to cancer in later life.
Previously, doctors have suggested red meat and diets high in processed food are behind the rise — with a 2015 paper from Harvard finding that vegetarians had a 22 percent lower risk of colon cancer compared to meat eaters, while a 2023 meta-analysis of eight studies said they had a 23 percent reduced risk.
Other studies have also gone after red meat, with one suggesting eating half a steak everyday for six years can increase the risk of colon cancer by a fifth.
But experts have been quick to sound skepticism over the research.
Many studies on red meat fail to clarify that heavy red meat eaters also tend to not get enough servings of essential fruits, vegetables and whole grains, which could put them at further risk for adverse health issues. Vegetables are high in fiber, which is key for promoting healthy digestion.
And a 2020 study published in Cambridge University Press found meat eaters are more likely than vegetarians to be overweight or obese.
Irena Aistrop from Florida had been a lifelong vegetarian and sometimes vegan, so was shocked when she was diagnosed with colon cancer
Countless high quality studies have shown that, regardless of diet, carrying excess weight – particularly around the middle – can raise the risk of a host of cancers, including bowel and stomach, making it difficult to truly tell if meat or another lifestyle component is causing the cancer.
Researchers from the University of Missouri-Kansas City found the rate of colorectal cancers grew 500 percent among children ages 10 to 14 years and 333 percent among teenagers aged 15 to 19 years.
The researchers looked at rates of colorectal cancer in children and adults aged 10 to 44, and found that cases had risen in all age groups.
The study also found that rates rose by 71 percent to 6.5 colon cancer cases per 100,000 people in aged 30 to 34 over the two-decade study period, and by 58 percent to 11.7 per 100,000 in ages 35 to 39 in 2020.
Officials are now starting to order new studies to investigate what is behind the growing trend.
