‘I’m Not Too Young’: How to Advocate for Yourself When You Think You Have Colorectal Cancer Symptoms

Denelle Suranski was just 17 years old when she started having symptoms like severe fatigue, bloating, and constipation. "I thought I had IBS or Crohn's, or colitis," she says. Her doctors told her internal hemorrhoids were the likely cause of her symptoms, but they didn't go away.

She went back to her doctor every couple of months and said she wasn't getting better. Then her father was diagnosed with colon cancer in his early forties. "That's when all the alarms went off," she says.

Finally, Suranski's doctors performed a colonoscopy. She was diagnosed with stage 2 rectal cancer.

The experience taught her a lesson about the importance of self-advocacy in early-onset colorectal cancer. "I learned firsthand how important it is to not ignore what your body is telling you," she says.

Your Age Should Never Be a Barrier to Care

"Often because of age, these patients are being overlooked or dismissed by their primary care provider, the community, and even by their family members. Sometimes they are told they are overreacting," says Mohammed Najeeb Al Hallak, MD, a co-leader of the Gastrointestinal and Neuroendocrine Oncology Multidisciplinary Team at the Barbara Ann Karmanos Cancer Institute in Detroit.

Suranski says she was gaslighted. "I felt like I was being delusional, and that was really frustrating."

Luckily, Acosta insisted on getting a colonoscopy, which revealed stage 3 rectal cancer. "I think if it wasn't for me pushing back, she probably would have just … done whatever the treatment would have been for IBS."

How to Prepare for Your Appointment

• Abdominal pain
• Bleeding from the rectum
• Diarrhea
• Iron-deficiency anemia from blood loss, which has symptoms like shortness of breath, tiredness, dizziness, headache, and chest pain

  [7]

• Pencil-thin stools
• Cramps
• Bloating
• Unexplained weight loss
• Unusual tiredness or weakness

When listing your symptoms in preparation for your appointment, Dr. Al Hallak recommends including information like:

• The type of symptom (such as cramps or bleeding)
• When it started
• How often you have it
• What you ate before the symptom started
• The location and severity of pain
• What made the symptom better or worse

If you've already had a colonoscopy, bring notes to your appointment. Include the date, where the test was done, which doctor performed it, and the results, says Al Hallak.

What to Say to Your Doctor: Sample Scripts

If a doctor says you're too young to have colorectal cancer or you're too young for a colonoscopy, here are some scripts to guide your conversation, recommended by Al Hallak and Acosta.

• "The fact that I'm young doesn't rule out the possibility of cancer being responsible for my symptoms. I'd like a referral to a gastrointestinal specialist."
• "Thank you for your time, but I would like to get a second opinion, just to see what another doctor thinks."
• "I understand that you are an expert, but I am an expert in my own body and I feel like something is wrong. I would like more tests."

When to Seek a Second Opinion

Many people grow up thinking that their doctor is all-knowing. While doctors are experts, no one knows your body as well as you do. When something about your diagnosis feels off, speak up.

• You feel dismissed.
• You haven't gotten a clear diagnosis after multiple doctor visits.
• You're not satisfied with the diagnosis or treatment plan.
• You've had treatment but still have symptoms.

"Any red flag symptoms like rectal bleeding, iron deficiency anemia, or unexpected weight loss, or a strong family history of colorectal cancer means you need to insist on seeing a gastrointestinal specialist or scheduling and receiving a colonoscopy as soon as possible," Al Hallak says. And if your doctor doesn’t recommend this, seek a second opinion.

The Benefits of Self-Advocacy

Suranski was originally diagnosed and treated in 2003. She continues to have screening colonoscopies every year. Though the fear of a recurrence is always present, her cancer hasn't come back. Today, she advocates for other young people through organizations like Fight Colorectal Cancer and the American Cancer Society's Cancer Action Network.

Acosta agrees that self-advocacy works. She had her last treatment in August 2024, and she has been in remission ever since. "If I hadn't said something for myself, I would not be here," she says.

The Takeaway

• Colorectal cancer used to be a disease that mainly affected older adults, but rates are rising among people under 50.
• Medical gaslighting is when your doctor dismisses your symptoms without investigating them further.
• Come to your appointment prepared with a list of symptoms and your family medical history.
• If you don't feel like you've gotten the correct diagnosis, ask for a referral to another doctor for a second opinion.