The patient was 22 years old and a recent college graduate, suffering from inexplicable stomach pain.
She’d had the pain off and on for about a year and assumed it was stress-related. She finished her studies and spent a busy summer working at an animal shelter, preparing to apply to veterinary school.
When she saw a doctor, she was told to wait and see if the pain resolved on its own. But when it became so severe, she went to the emergency room. Scans found a tumor large enough to cause a near blockage of her colon. She had no family history of the disease.
It was colon cancer: a growing concern for younger patients, according to Dr. Marc Greenwald, who ultimately treated the patient and wrote a case study on her care.
Dr. Marc Greenwald, of North Shore University Hospital in New York, said he has been seeing more and more young patients with colorectal cancer.
Courtesy of Northwell Health
Greenwald, the chief of colorectal clinical services and surgeon-in-chief at North Shore University Hospital in New York, told Business Insider that while colon cancer cases are decreasing in older adults, they’re on the rise in people under 45 as a growing number of young cancer patients are showing up at his hospital.
“There’s no doubt that we’re seeing more people,” he said. “The problem is that a lot of the symptoms are somewhat subtle. If there are new symptoms for somebody, regardless of age, they should seek medical attention.”
Here’s what Greenwald said everyone should know about the symptoms and your options for cancer screening that could catch the disease in time for effective treatment.
Colon cancer symptoms that everyone should know
Decades ago, colon cancer cases in young people were rare.
Stomach pain and indigestion in 20- or 30-something patients would often be attributed to irritable bowel syndrome or dismissed as a minor ailment.
Today, colon cancer is the top cause of cancer-related death in people under 50, prompting doctors and patients alike to be on high alert for possible symptoms.
Most concerning is that in early-onset colon cancers, symptoms may be subtle or may not appear at all until the cancer has advanced.
Greenwald said his 22-year-old patient likely developed the tumor in her colon as a teenager, and it may have continued to grow unnoticed for years.
“The most dangerous misconception is that I have no symptoms, so I must be fine,” he said. “That is really the wrong attitude because if colorectal cancer is caught before symptoms occur, your chance of a cure is much higher than if you wait for symptoms.”
How to get tested for colon cancer
Early onset cases of colon cancer include patients in their 40s, 30s, and as young as their 20s. That’s a problem because there are currently no screening guidelines for people under 45.
Colonoscopies, recommended starting at age 45, help detect cancer and also prevent it by removing any existing polyps or abnormal growths that can develop into tumors.
If you’re too young for a regular colonoscopy, it’s even more crucial to monitor any changes in your health and seek early screening if necessary.
Greenwald said patients can sometimes postpone or avoid a colonoscopy because they’re anxious about the procedure or colonoscopy prep (although a Business Insider health reporter previously shared that it’s easier than you might think).
Samples to screen for colon cancer can be taken in the privacy of your own home, then set to a lab for analysis.
Business Wire/AP
There are also less-invasive alternatives to colonoscopies, such as stool tests that can be collected at home and mailed to a lab. Blood tests for cancer are currently under development, too, although their reliability can be mixed.
If you have symptoms, even minor ones like a change in bowel habits or digestion, it’s important to talk to your doctor as soon as possible and find a testing option to rule out cancer.
“If you’re not going to do a colonoscopy, do something to get screened,” Greenwald said.
This article is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your qualified physician or healthcare provider.
The winter months were a blur of holiday activities and family gatherings. It felt like I was running on a treadmill from Thanksgiving into the new year, without the opportunity to get off.
As the unofficial “bringer of cheer” in my family, I feel a heavy burden to make sure we have enough fun over the holidays and work hard to create all the memories. Cookies must be baked, and decorations must be put up. And then they need to come down and get put away as I ready the family for the new year and the months ahead.
On top of that, I’m doing weekly chemo for breast cancer, which didn’t let up throughout the holiday madness. Life doesn’t stop for cancer. Eventually, I learned I needed to stop and do something for myself, though.
My diagnosis meant a change of plans
When I got my cancer diagnosis, I had to cancel planned trips to St. Maarten, Boston, and Dollywood. Not having those to look forward to was hard for me. As a travel writer, I love getting out of my regular routine for a few days to snorkel with sea turtles and dine on new cuisines.
With only my weekly chemo sessions on the calendar, I was feeling down. I knew that limiting my exposure to germs was important, but I missed my time spent enjoying Guinness in Ireland and kayaking near glaciers in Alaska. I knew I had to go somewhere, even if it was nearby.
I booked a one-night staycation near home
My solution: I booked myself a night away at West Cliff Inn, a boutique hotel by the beach in Santa Cruz that’s just a 30-minute drive from my home. I knew this wouldn’t be the same as a week in the Caribbean, but it was the perfect combination of time by myself and relaxation.
The author said she enjoyed having time and space to herself while on this solo trip.
Courtesy of Kate Loweth.
When I checked in, I found that my room was extra spacious and could have accommodated a friend or two. Did I think maybe I should have brought someone with me? Yes. But that thought vanished as soon as I set out to explore the area on my own
Simple moments helped me reset
I took a long walk on the beach and hiked along the cliffs, watching surfers just offshore. I enjoyed an umbrella drink and coconut shrimp at a tiki restaurant on the water, where I sat in the rotating bar area. A friend texted me at the perfect time with some gossip, and it felt like we were enjoying the vibrant sunset together.
The writer said she enjoyed a long walk on the beach during her stay in Santa Cruz.
Courtesy of Kate Loweth.
Before it got too dark, I headed back to the hotel and enjoyed a salt soak in my massive tub before cozing up in my king-size bed at an early hour to enjoy the latest episode of “Below Deck.”
The next day, I visited a nearby spa and enjoyed a massage and a dip in a private hot tub before heading back home. Few things are perfect, but these 36 hours came pretty close.
I learned I don’t need a big trip to feel refreshed
This trip wasn’t about avoiding my family. It was about giving myself something to look forward to and acknowledging the difficult time I am going through.
I got home and felt ready to tackle what comes next, and I’m going to keep that in mind as I continue to move forward.
Laura Behnke did not have time to worry about cancer when she first saw blood in the toilet.
She was trying in vitro fertilization for the fourth and final time, and her focus was on getting pregnant after three failed rounds with no healthy embryos. Everything else could wait.
A few days before the implantation was scheduled, she saw a kind of red mucus coating her stool, and thought: “‘I have been under an immense amount of stress. I know I’ve been straining. This has to be hemorrhoids, right?'”
“I just told myself, ‘You know what? Calm down, take some deep breaths, stop straining, and this will all go away, and it’ll be fine, and you can go on and have a baby,'” Behnke told Business Insider.
It would be over a year before she discovered she had rectal cancer, joining a growing cohort of younger adults being diagnosed with the disease decades earlier thanexpected.
Cancer was not on her radar
“I felt good,” she said. “There was no way I could have cancer.”
courtesy of Laura Behnke
After that fourth round of IVF, at age 41, Behnke did get pregnant. At first, she was shocked. Hearing a heartbeat at five weeks made it finally feel real. She was overjoyed.
Behnke continued to see some blood in the toilet intermittently, but it was easy to brush off because hemorrhoids are common during pregnancy. She didn’t know the difference between the drops of blood typical for hemorrhoids, and the red mucus she saw that she now knows was characteristic of colorectal cancer.
“Nobody at any point asked me: ‘What’s the bleeding like? How often is it happening?'” Behnke said. “We all just said, ‘Oh, hemorrhoids, cool. Moving on. We have other things to worry about.'”
In her third trimester, Behnke did develop a swollen external hemorrhoid, which made it hurt to sit down. For two days, she tried not to put any pressure on her bottom. In the car, she sat on a donut pillow. On the couch, she laid on her side. This bleeding looked and felt different, like bright red food dye coloring the toilet bowl. She took medication to manage the pain, and got on with the business of getting ready to be a new mom. A few months later, her daughter was born.
Behnke was enjoying being a new mom, and felt fine. She assumed the blood she saw in the toilet was caused by hemorrhoids, swollen veins that can develop around the anus, which are a common side effect of pregnancy.
courtesy of Laura Behnke
After six months of sleepless nights and newborn feedings, Behnke was finally starting to feel like herself again. She was regaining her strength, losing weight, and feeling in control of her body after years of IVF treatments and a pregnancy.
By now though, Behnke saw bloody mucus in the toilet even when she didn’t have a bowel movement, which she attributed to that pesky external hemorrhoid. Her bowels were also changing shape, and her stools sometimes coming out pencil thin.
Behnke decided to see a colorectal surgeon to get the swollen hemorrhoid removed. The doctor asked her about all of her symptoms, sparing no details about the blood or the poop, and then, to her surprise, told Behnke she urgently needed a colonoscopy.
“It could be a whole lot of things other than cancer, but we need a colonoscopy to find out for sure,” Behnke remembers her doctor saying.
After over a year of bloody stools, that was the first time Behnke heard the word “cancer” uttered.
Rectal cancer is on the rise among people in their 40s
Behnke went through radiation, chemotherapy, and then surgery to remove part of her colon.
courtesy of Laura Behnke
When the doctor told Behnke she had late-stage 3b colorectal cancer, she broke down crying. “But we have a seven-month-old!” she wailed into her husband’s shoulder.
“How could I be that sick and feel that good?” she wondered. “I had just had a completely normal and healthy pregnancy.” Suddenly, she felt a debt of gratitude to that annoying little hemorrhoid that led to her diagnosis.
The colonoscopy revealed that cancer had spread to some of the lymph nodes around her rectum, and was edging closer to other parts of her body. She was thankful that the prognosis was still relatively good. With radiation, then chemotherapy, and surgery afterwards to remove part of her colon and rectum, doctors were confident they could wipe the organ clean.
At 42-years-old, Behnke was diagnosed with what has quickly become the deadliest cancer for people under 50 in America.
“The landscape of colorectal cancer is changing rapidly,” Rebecca Siegel, an epidemiologist and the senior scientific director of surveillance research at the American Cancer Society, told Business Insider.
Experts don’t know why, but many of these new, young-onset colon cancer cases are rectal, prompting bloody stools. Other common symptoms in this age group include persistent stomach cramping or severe abdominal pain, low iron levels, and changes to bowel movements, including the narrower stools Behnke saw.
Research suggests that bloody stools are an early warning sign for about 40% of rectal cancer patients. “There’s an opportunity for earlier diagnosis, but the problem is, especially for younger people, they’re not aware of the symptoms and they don’t want to talk about the symptoms,” Siegel said. “And sometimes they even do go to the doctor with these symptoms, and they’re diagnosed with hemorrhoids or something else.”
A couple of weeks after Behnke had her first dose of radiation, she stopped bleeding into the toilet.After 25 sessions of radiation, then four months of chemotherapy, and finally, surgery that removed parts of her colon and rectum, she landed in diapers alongside her daughter for a few weeks. Doctors said every visible trace of the cancer was gone.
Slowly, over time, her colon has healed and she’s readjusted to a more normal bathroom routine, but she says things will never be quite the same down there. She prioritizes getting plenty of fiber in her diet from colorful vegetables, and also takes fiber pills twice a day, to help with the lingering symptoms.
“I am alive and I am healthy and all of this is workable,” she said.
This is not an ‘old man’s disease’ — talk to your doctor about bloody stools or unexplained stomach pain
Her daughter will start going in for colonoscopies at age 32, since that is 10 years younger than Behnke’s age at diagnosis.
courtesy of Laura Behnke
Colorectal cancer, Behnke said, is not an “old man’s disease” anymore. After her diagnosis, she urged her younger brother to get a colonoscopy, and doctors discovered he had precancerous polyps developing. Her young daughter, she said, will start having colonoscopies in her early 30s, because of her increased risk of developing colorectal cancer.
Behnke said she’s grateful she met “the right surgeon at the right time,” a doctor who asked the right questions, and didn’t dismiss her symptoms because she was too young or postpartum.
“No rectal bleeding is okay,” she said. “If you do have any sort of symptoms, any sort of concerns, anything that doesn’t feel right, you have every right to go ask a doctor about it and to demand some answers.”
Katie Davis lived the typical busy college student life when she first started feeling stomach pain.
Then a 20-year-old junior and marketing major at Westchester University in Pennsylvania, Davis split her time between classes, her job at Playa Bowls, and her sorority. The pain in the top right of her abdomen was easy to ignore because it was so sporadic and fleeting.
Davis was living the normal life of a college student when she started experiencing pain in her abdomen.
Katie Davis
“It was on and off, it would come in waves,” Davis, now 21, told Business Insider. “I would go a good while without it, and then it would come and only last a few minutes, sometimes even a few seconds.”
Over time, the pain — when it showed up — got more severe, sometimes causing her to double over in pain. Three months after it started, she went to a local urgent care while at her boyfriend’s family beach house. There was no ultrasound equipment at the facility, and she was told that, based on her symptoms, it could be an ovarian cyst that would hopefully go away after her next period.
Her doctor suspected colon cancer before the biopsy
Davis had a feeling she had colon cancer because of the private room she was placed in after her colonoscopy.
Katie Davis
Davis was told to keep an eye on the pain and go to an emergency room if she felt other symptoms like fever or nausea. A few days later, when she started getting chills and vomited at her parents’ home, Davis did just that.
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“That was the first time anything more serious than an ovarian cyst was brought up to me,” Davis said. According to her ultrasound and CAT scan, her colon was inflamed and appeared to have free fluid, a potential indication of infection, trauma, or cancer.
The ER doctor thought it could be Crohn’s or ulcerative colitis, or, in more serious cases, colon cancer. He scheduled a colonoscopy.
“I didn’t think I was going to come out of it having cancer or anything really serious,” Davis said. Her first clue that something was wrong was when she woke up from the procedure. She noticed she was placed in a separate room from the other colonoscopy patients.
The doctor who performed the procedure told Davis and her mom that he was “pretty positive” the mass in Davis’ colon was cancerous. “He said he’d been doing it for long enough that he could kind of tell,” she said.
Shortly after, Davis was diagnosed with stage 2 colon cancer.
“I didn’t really know what to think or feel,” Davis said about learning her diagnosis. “Definitely just numb and confused at first, like ‘how did I get this?'”
Treatment dragged on due to side effects like vision loss
Davis had to switch to a milder and prolonged treatment plan when traditional chemo led to serious side effects.
Katie Davis
After diagnosis, Davis had surgery on her colon and was supposed to start three months of chemotherapy soon after. But, the side effects complicated her treatment.
“I couldn’t tolerate the more hardcore chemotherapy,” Davis said. She developed extreme fatigue, nausea, and neuropathy, which she said felt like “pins and needles” in her hands every time she encountered temperature changes.
The most alarming side effect was her vision loss. “My vision would go completely black,” Davis said. Her parents researched the drug,oxaliplatin, which can cause vision issues in some patients. Davis also found the Colorectal Cancer Alliance (CCA) and said hearing similar stories around common side effects helped her stay informed about alternative treatment options.
Davis was put on oral-only chemotherapy medication, prolonging her treatment from three to six months. The only upside was that she no longer had to travel back and forth for treatment, since she could take it wherever she was.
Davis tried to keep her life as normal as possible during treatment.
Katie Davis
All the while, she was still attending her college classes in person as often as she could, even though her professors knew about her colon cancer diagnosis. “My boyfriend lives there, all my friends live there, so I tried to be there as much as possible,” she said. “I tried to keep up with my stuff as much as I could, but it definitely was difficult to do schoolwork when I felt as horrible as I did on the chemo.”
She’s glad she listened to her body
Davis finished chemo in June 2025 and was declared cancer-free shortly after. Going forward, she’ll have blood tests every three months and an annual colonoscopy.
Now a senior, she’s a marketing intern at a financial advisory firm and is trying to figure out her plans post-graduation. She said finishing treatment made her feel “excited to be normal again” and get back to her normal college life without worrying about doctor’s appointments or treatment side effects.
Now cancer-free, Davis advocates for more awareness of colon cancer symptoms in young people.
Katie Davis
Looking back, she’s grateful for noticing the warning signs early enough. “A lot of my doctors said that most people at my age or with my stage wouldn’t really have the symptoms that I had that let me know that something is wrong,” she said. “I’m glad that I learned to listen to my body.”
It’s her biggest piece of advice to young people with similar or subtle symptoms, as colon cancer recently became the leading cause of cancer death in people under 50. She said joining the CCA and colon cancer Facebook groups can also help raise awareness of potential symptoms.
“You’re not really alone going through it,” she said, whether you’re worried about symptoms or actively undergoing treatment. “There are other people who are experiencing it too who can help you.”
This as-told-to essay is based on a conversation with Mark Seguin, who was surprise-diagnosed with colon cancer five years ago at age 35. It’s been edited for length and clarity.
I’ll never know for sure why I got colon cancer at age 35.
Sure, I can look back now and point to things that weren’t perfect. Work stress, ultra-processed foods, having two young kids, I wasn’t taking care of my body in exactly the way that I used to — especially after weathering several snowboarding injuries, I kind of slowed down on my fitness. But I don’t feel like it’s healthy to “would have, could have, should have” about cancer or blame yourself. Especially because some people in peak physical fitness with the cleanest diets get this disease.
Ever since I was a teenager, I’ve loved snowboarding.
Courtesy of Mark Seguin
There weren’t really any obvious signs that I was sick. Just one day, I woke up and it hit me. A searing pain in the middle of my stomach as soon as I opened my eyes. I literally could not get out of bed. The pain was so bad, I couldn’t get my body upright. It felt like someone was ringing out a rag inside of me.
I’d later learn this was because — unbeknownst to anyone — food was getting stuck behind the tumor in my colon. Unable to move through my system properly, waste was building up and wreaking havoc.
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I just assumed I ate something bad the day before. I wondered what it could have been.
By the afternoon that day, I was feeling better, and I got up and carried on. But about a month later, it happened again. This time, it was the same type of stomach pain, but not as severe. Again, I was like, “Man, what am I eating that keeps doing this to me?”
A couple more months went by. Then again, the pain returned, this time on the right side of my belly. Alarm bells went off. I immediately thought of all the stories I’ve heard about people ignoring stomach pains, and then their appendix ruptures and bursts. That was my wake-up call to get myself to the ER and get checked out. Still, cancer was not on my radar. I never saw any blood in the toilet, so I didn’t think I had to worry about colon cancer.
After searing stomach pain, and a trip to the ER, a GI doctor finally found my cancer
I had to get part of my intestines taken out.
Courtesy of Mark Seguin
Thankfully, I didn’t have appendicitis, but my ER doctor referred me to a gastroenterologist for some follow-up tests. The GI doctor said I was young, healthy, and there was probably nothing to worry about, but suggested we do a colonoscopy, just to be safe.
I’ll never forget the look on his face when he walked in to deliver my results. He looked like he’d just seen a ghost. “I’m pretty sure you have cancer,” he said. It was serious too: late, stage 3 colon cancer that had spread to my lymph nodes. He said I won the bad luck lottery.
I reacted like I always do when I get hurt snowboarding, break a bone, or throw my back out: What’s the next step? I have to know what to do next.
I had trouble staying hydrated during chemotherapy. Even the smell of water repulsed me.
Courtesy of Mark Seguin
Surgery, draining high-dose chemotherapy treatments, and lots of days in bed. That’s what came next. The chemo made me super sensitive to cold. Breathing cold air or drinking cold water felt like pulling apart velcro in my throat. I couldn’t drink anything cold or enjoy popsicles to stay hydrated, but warm liquids made me nauseous. I became hyperattuned to even the smell of water, and it repulsed me. I had to get hooked up to intravenous hydration roughly half a dozen times while going through chemo because I just couldn’t eat or drink much of anything.
After colon cancer, I committed to more strength training
By the time I rang the bell and finished chemotherapy, about five months after my diagnosis, I felt so frail and small. I’d lost 30 pounds. I hated feeling that way. I wanted to be able to pick up my kids when I needed to. My youngest was only 5 years old when I was diagnosed. I can’t let my boys outrun me just yet! So at the end of my chemotherapy course, I started a strength training program. It was the same one I’d used in high school that helped me get stronger, a program from a baseball fitness coach who helps train pros, including the New York Yankees, Eric Cressey.
At first, I was worried: was training safe for a cancer patient? Could it derail my recovery? And would I even have the energy? Initially, after chemo, even short hikes were draining, but I pushed forward, including squats, presses, and broad jumps into my routine.
At first, even family hikes on flat terrain were super draining. But I kept trying.
Courtesy of Mark Seguin
It turns out, there’s a pretty wide and growing body of evidence suggesting that working out is great for cancer rehab — and especially for colon cancer. After about six months, I was thrilled to be setting all-time bests for my lifts and presses. It was such a proud moment.
There was a super compelling new study that I came across in 2025, which shows that exercise can be as effective at preventing colon cancer relapse as drugs. It was a wild finding that shook oncologists and excited doctors nationwide when it was revealed last year at the nation’s largest cancer conference. I’m just glad I have more reasons to keep doing what I’m doing. Right now, my routine is a basic two days a week of strength training, plus some cardio like hikes with a weighted vest or an incline treadmill jog when I can fit it in.
I cannot let these boys beat me just yet!
Courtesy of Mark Seguin
Part of what motivates me to work out is the idea of staying healthy and cancer-free, and — I must admit — part of it is just my dad pride. My youngest wants to race me all the time. He’s 10 now, I can’t let him beat me yet, okay?
I eat healthier now, but I’m a realist
I have also changed up my diet, incorporating more fiber-rich foods into my routine. I was raised in the “fast-food era,” but now I try to avoid the ultra-processed and cured meats that are so clearly linked to more colon cancer, like sausages, hot dogs, and bacon. (I rarely have bacon now, which sucks.)
I try to incorporate more veggies and beans into my diet, things that we know are good for colon health. In true Mediterranean Diet fashion, I try to make sure dinners include something green — if it’s chicken, I might add some broccoli, if it’s spaghetti, let’s dish up a side of green beans. I’m not perfect about it, but I think any little effort helps. When I make tacos now, I mix the ground beef with some mashed black beans. That way, it’s a little bit less meat, but also you’re getting fiber from the beans. I haven’t overhauled my diet completely, but I’ve been finding the little evidence-backed opportunities, which I think is honestly a more realistic strategy.
Exercise, a healthy diet, and managing stress have all been important to my recovery.
Courtesy of Mark Seguin
It’s been five years since my cancer diagnosis now, and I’m almost in the clear. My doctors say if my next scan looks good, and my blood work remains clean through the rest of the year, they’re going to release me completely. It’s kind of a scary prospect to go out into the open world without your oncology team looking out for cancer. I’ve found peace knowing I am doing a lot of the things we know decrease the odds of recurrence: exercising more, eating better, and decreasing stress. I also take a baby aspirin, which recent studies have suggested may reduce the risk of recurrence of certain types of colon cancer.
3 rules to live by for finding colon cancer
If you’re 45, get a colonoscopy. Don’t delay the care that could save your life.
Courtesy of Mark Seguin
I try to always remember a few things that can help identify colon cancer early, and share them with my friends when I can.
First of all, if something feels off, go get it checked out.
Second: make that follow-up appointment.
My doctor said the one thing I did that so many folks miss is actually going in for that next appointment, after leaving the ER. Don’t delay the care that might save your life.
Finally, if you’re 45, get a colonoscopy.
I know, we snowboarders like to tough things out sometimes. Don’t do that with your colon. I’m not going to miss an opportunity to say, “Hey, you’re 45, right? Did you get that colonoscopy booked?”
I still love to snowboard, and try to bring my colon cancer advocacy to the slopes as much as I can.
Courtesy of Mark Seguin
I try to keep it casual and not be the colon cancer weirdo out on the slopes, but I do want to advocate for more awareness of young colon cancer. Colon cancer is now the leading cause of cancer death in people under 50 — and the only cancer that’s becoming more deadly in my age group, not less. If I can help one more person get checked and find cancer earlier, that’s success.
This is an as-told-to essay based on a conversation with David Ronca, a retired video systems engineer. He spent 12 years at Netflix and six years at Meta. This story has been edited for length and clarity.
My time at a startup in the early years of my engineering career was like a really bad relationship.
I joined a company that specialized in video playback around 2000. I loved working on video. I consider those seven years like going to school, and I came out with a Ph.D. in practical video systems. But it was the hardest seven years I’ve ever had in terms of work demands.
I was told when I joined that it would be really important that you’re seen around here a lot. So I would work until 7, 8, 9 — sometimes until 10 p.m. Then we started hitting delivery schedules, and I was getting to work around 10 in the morning and going home sometimes at 2:30 in the morning. We’re talking 14-hours days, six to seven days a week. Eighty hours a week would’ve been a break.
We didn’t have good direction. We’d be four or five months into solving a hard problem before leadership would stop us and say, “Go work on this instead.” It was madness.
We were using work hours to compensate for really bad decisions.
In January 2004, I started feeling ill. On a Sunday, I didn’t feel so good, and by midweek, I got worse.
On Friday night, January 17, my wife took me to the emergency room. The doctor told me, “This is likely colon cancer.” After the first surgery, he said, “There’s no way you have a tumor like this and it’s not cancer.”
Two weeks earlier, I had been running and feeling great. Within a week, I was in a hospital bed on machines.
It took another week before doctors could do the full surgery. And you spend that time with no idea what they’re going to find. That was a very dark week.
My mother died of breast cancer when she was 48. I was 16. Now, I’m in the hospital at 44. I remember thinking, “History doesn’t repeat, but it rhymes.”
My wife would bring the three kids. My oldest, who was seven, would sit quietly in the room with me. My youngest was two years old. He didn’t really know me.
I was looking at my young son, thinking he’s going to grow up without a dad.
After surgery, they told me it was stage 3 colon cancer. They removed 60% of my colon. There was lymph node metastasis. My five-year survival prognosis was about 25%.
‘I will not work like this’
I went back to work part-time at first.
I was told that I had used up all my sick leave and vacation and was put on California disability, which is around $200 a week.
By that time, this was a company I had spent four years working 24/7 for.
I told my boss, “I’m sorry, I will not do this. I still want to work here, but if I have to leave, I will quit. Because I will not work like this.”
From that point on, I didn’t. And that was the irony of it all.
I feel like I did some of my best engineering after that. The real change was that I was no longer wasting my brainpower and my thinking on junk.
You don’t do good work after 12 hours. You can’t work sustained all-nighters and be productive. The quality of your work is going to suck. I don’t care who you are. For most mere mortals, you try to work those hours, you’re just not going to be doing good work.
I also started making intentional decisions for life, not just work.
I coached soccer for all three of my kids. I went to their games. My daughter did ballet, and we were there all the time. We started planning and taking family vacations — hiking in the mountains, RV road trips, and Maui.
I realized you have to work to have a life, but you have to have a life to work. So you want to stand in the middle of those things.
Hours worked are not a performance metric
In 2007, after several clean scans, I joined Netflix. I delayed accepting the offer until I got my scan report. I didn’t want to change jobs yet because if you have positive liver metastasis, you’d be lucky to get two years.
In my interview, Patty McCord, the chief talent officer at the time, told me, “We don’t value 24/7 work. You won’t be successful here working all the time.”
That was almost foreign to me. But it also didn’t mean we didn’t work hard.
At Netflix, I was part of the early streaming team — maybe 12 to 16 people. We made aggressive schedules, and we didn’t miss them. We launched a Netflix app on the original iPad on Day One within two months.
The culture at the company was: If you have to work 24/7 for us to be successful, you’ve got a problem, and we’ve got a problem, and we’re going to fix it.
Even at Meta, my favorite poster had a silhouette of a rocking horse that said, “Don’t mistake motion for progress.”
In other words, high performance is not measured by how much work you do. It’s measured by how impactful your results are.
This is not to say that it’s wrong to work more than eight hours. Instead, you should understand why you’re working more hours. It should be intentional. Intentional exceptions.
If I were to tell my younger self anything, it would be to make work-life balance part of your DNA. Learn to take time off.
Don’t wait until you have cancer or some other near-death experience to realize this.
Over the past five to 10 years, OB-GYN Dr. Thaïs Aliabadi noticed an uptick in younger cancer patients in her practice.
Suddenly, more in their 30s and 40s were getting diagnosed with breast, uterine, and colon cancer, the latter of which is now the leading cause of cancer death in people under 50.
As to the causes, Aliabadi has her own theories.
“I think our lifestyles, our metabolic changes, the rates of obesity, the increase in insulin resistance, our poor diet, lack of exercise, chronic inflammation — these have all played a huge role,” she told Business Insider. She also mentioned environmental pollutants that can disrupt the endocrine system and the fact that women are getting pregnant later or not at all, which can change hormone exposure and increase the risk of breast cancer.
In better news, she also said higher rates of diagnoses also mean “we’ve gotten better and better at cancer detection and risk assessment,” as awareness around early symptoms have also improved.
While so many factors can feel out of our control, “I wish every woman knew that cancer is not always completely random,” Aliabadi said. In some cases, “we can actually see risk long, long before the disease appears.”
Aliabadi shared her three tips for preventing cancers in women (such as breast and ovarian cancer), from analyzing your risk to focusing on your metabolic health.
Improve your metabolic health with diet, sleep, and exercise
Regular exercise can lower the risk of multiple cancers.
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In terms of overall prevention, Aliabadi said starting a few healthy habits as early as possible is key.
“If you want to lower your risk of cancer, number one on the list is to maintain a healthy metabolic profile,” she said. It means lowering cholesterol, inflammation, and visceral fat — the fat surrounding your internal organs.
She said exercise, such as strength training and cardio, improves insulin sensitivity, reduces inflammation, and balances hormones, lowering the risk of multiple cancers.
Eating a diet “rich in whole foods” and cutting back on ultra-processed foods can also make a huge difference by boosting gut health and cutting down cholesterol.
Other good habits for metabolic health include stress reduction and getting adequate sleep. “Sleep deprivation is poison to our longevity, and persistent stress can affect our hormones and our immune pathways,” she said.
These habits don’t just decrease cancer risk — they also reduce the risk of cardiovascular disease, diabetes, and other chronic illnesses.
Cut down on carcinogens where you can
Even moderate drinking increases cancer risk.
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Aliabadi said environmental toxins, like chemicals in food packaging, can be “a little tougher” to be aware of because of how ubiquitous they are.
However, there are still ways to reduce exposure to carcinogens (cancer-causing agents) and endocrine disruptors. A commonly spoken about one is tobacco, so abstaining from smoking cigarettes or vaping “can significantly lower many cancer risks,” she said.
The one she really emphasized cutting back on is alcohol, as even moderate drinking can increase cancer risks.
“In my office, I have zero tolerance for alcohol,” she said. “Not even a couple of glasses a week.”
Collect data on your body
Depending on risk factors, you might need to start screening earlier.
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While cancer screenings have recommended starting ages — some of which have been recently lowered to reflect an uptick in younger patients — Aliabadi says you shouldn’t rely on them.
“We need to stop thinking that prevention starts at 40, that mammograms start at 40,” she said. “Prevention starts in our teens and in our 20s, believe it or not.”
She urges women to take a two-minute online test and learn their lifetime risk assessment score for breast cancer, which uses information like family history, genetic mutations, and breast density to more accurately estimate when you should get screened. Olivia Munn, a patient of Aliabadi’s, famously took the test and was diagnosed with early-stage breast cancer despite having no symptoms.
Aliabadi said that testing for seemingly unrelated conditions, like PCOS, endometriosis, fertility, genetic conditions, and insulin resistance, can all play a role in evaluating your cancer risk and give you a better idea of how vigilant you should be.
Aliabadi, who herself had a high lifetime risk assessment score for breast cancer and was initially dismissed by doctors, said a patient knowing their body helps them better advocate for themselves and seek out second opinions if needed.
“If someone at the front desk tries to scare her away, she will be her own health advocate,” Aliabadi said. “She will know exactly why she’s there and why she needs that mammogram.”
