He was 37, constipated, and exhausted. What doctors thought was IBS was stage 3 colon cancer.

• Mohammad Samad experienced abdominal pain, bloating and constipation.

• He had colon cancer, which was initially misdiagnosed as stress, irritable bowel syndrome and Crohn’s disease.

• Colon cancer shares symptoms with other diseases, making it difficult for doctors to diagnose it in young, healthy patients.

Before Mohammad Samad was diagnosed with stage three colon cancer at age 37, he was feeling in the best shape of his life.

“I eat all my vegetables in the morning, make healthy smoothies. I ride my bike, I work out. I do yoga and meditate,” the UK-based former project manager told Business Insider.

In October 2020, Samad suddenly developed a stabbing pain in his lower abdomen that lasted for 20 seconds, which was the first sign that something was wrong.

“The power of it brought me to my knees,” he said.

By December, the pain became more severe and occurred every morning and evening. He also felt a hard lump about the size of a golf ball in the area.

Soon, he was exhausted, often constipated and bloated. His lunch break, which used to be spent playing basketball at the local park, turned into nap time.

Samad speculates that his symptoms are related to stress and diet, or that he may have COVID-19. “To me, it doesn’t seem that bad,” he said.

But in January 2021, when he started to feel a lump, he finally went to see a doctor at his wife’s request.

Over the next five months, he visited three different doctors and was misdiagnosed with stress, irritable bowel syndrome and Crohn’s disease. Eventually, Samad was diagnosed with colon cancer.

“They’ll look at me and say, ‘You’re young, you’re healthy, you’re healthy. We can see that.’ So they think it’s a little thing,” he said of the doctor’s visit.

Symptoms of colon cancer overlap with conditions including irritable bowel syndrome, which means doctors have to walk a tightrope when diagnosing young, generally healthy patients.

Samad’s experience is not unusual for young cancer patients. A 2020 survey of 1,295 patients under the age of 50 diagnosed with colorectal cancer by the charity Bowel Cancer UK found that 42% said doctors told them they were too young to get the disease. Additionally, two-thirds were initially misdiagnosed with conditions with similar symptoms, such as irritable bowel syndrome, hemorrhoids or anemia. The survey echoes broader research into misdiagnosis in young cancer patients.

Common symptoms of early-onset colon cancer include bloody stools, abdominal pain, weight loss, loss of appetite, and constipation.

Samad was misdiagnosed with irritable bowel syndrome and Crohn’s disease

The first doctor Samad visited said she couldn’t feel the mass when she pressed on Samad’s abdomen and suggested he might have a “blockage,” possibly caused by pressure. She gave Samad laxatives and told him to come back if his symptoms didn’t improve.

Four weeks later, when laxatives didn’t work, another doctor prescribed irritable bowel syndrome medication and more laxatives. Doctors also recommend following an elimination diet to see if certain foods trigger IBS symptoms.

When there was no improvement after two weeks, Samad was told to continue taking his IBS medication and reduce his food intake, and he requested a blood test.

“I just firmly said, ‘I’m not leaving without testing,'” he said. Blood and stool tests in the emergency room confirmed high levels of inflammation in Samad’s body.

In May 2021, seven months after Samad first felt severe pain, he was referred to a specialist who believed he had Crohn’s disease.

A colonoscopy, in which a thin tube with a microscopic camera on the end is placed into the rectum and colon, revealed Samad had a tumor, which a biopsy confirmed was advanced colon cancer.

“Fortunately, the virus didn’t spread, but at that stage they said to me, ‘We’re going to throw the kitchen sink at it,'” Samad said.

As the oncologist described the next steps, his mind “went into a black hole.” Samad’s father recently died from COVID-19, and he worries about how his diagnosis will affect his family.

“How do I tell my mom who just lost her life partner? What do I tell my siblings? How do I tell my children who have just been introduced to the concept of death by a loved one?” said Samad, whose children were 8 and 6 years old at the time.

Samad’s treatment interrupted due to infection

Samad received chemotherapy to shrink the tumor and surgery to remove it, but after two cycles of chemotherapy lasting four weeks each, he was hospitalized for five months with a “severe” infection.

During that time, he was unwell and unable to receive chemotherapy, and the tumor grew to the size of a small watermelon.

“The tumors get bigger and bigger, and eventually they say, ‘Your intestines now have a perforation, and all these toxins are flowing into your system,'” he said.

Samad had to have emergency surgery to remove it, which was successful, but he suffered nerve damage in his leg and required an ostomy bag. He has had ongoing health issues but has been cancer-free for two years.

“I’m getting regular check-ups and everything comes out fine, which is great,” he said.

Tumor tests positive for Lynch syndrome

Samad’s tumor tested positive for a genetic disorder called Lynch syndrome, which increases a person’s risk of several cancers, including colon cancer.

Despite healthy lifestyles, colon cancer is increasing in young people without Lynch syndrome, and scientists are trying to figure out why.

Colon cancer is usually treatable if caught early. The U.S. Preventive Services Task Force recommends that people begin getting screened regularly at age 45, and people at higher than average risk should ask their health care professional when they should start testing.

Around March 2022, Samad started a blog to share his experiences and raise awareness about the rising rates of colon cancer in young people.

“People still think cancer only happens to older people. It can affect everyone,” he said, adding: “Just listen to your body, see a specialist, get those symptoms checked and then really push it.”

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