Q+A: Cancer In Young People on the Rise

As cancer rates surge in people under 50, our discoveries help tailor treatments.
Young male cancer patient in hospital

For the first time ever, new cancer diagnoses in the United States are projected to top two million this year, according to a report from the American Cancer Society. The report also shows that people under 50 experienced an increase in overall cancer incidence from 1995 to 2020, a startling finding given that there was a decline in cancer rates for people over 50.

Vermont and the North Country are following this concerning trend, says Randall Holcombe, MD, MBA, director of University of Vermont Cancer Center.

“We are seeing more patients who are younger. We’ve always seen a lot of younger women with breast cancer -- that’s been known for a long time. But we’re now seeing it in other diseases, including some gastrointestinal cancers, melanomas and pancreatic cancer,” Dr. Holcombe explains.

“We are concerned about that, as everybody is across the country,” continues Dr. Holcombe. “We want to make sure that we have the best treatments available for patients of all ages and get people into remission and hopefully cured.”

Q+A: Why Are Cancer Rates in Young People Increasing?

We talked to Dr. Holcombe about what you should know about how UVM Cancer Center is giving patients a better chance of living beyond cancer.

Q: How is UVM Cancer Center improving what is known about cancer?

A: We are a hidden gem in this region, and a lot of people may not understand the full breadth of what goes on here. We provide clinical care for patients; that’s the public-facing, well-known side of things. But we also have education, community outreach and -- especially -- research.

To understand what’s causing the increase in cancer incidence among younger people, we need to look at a variety of factors: the cancer cells themselves; the genetics of both the cancer cells and the young people; and the potential contributing factors in the environment.

That means you need to do basic laboratory research, population-based research and clinical research. All those components are important to try to get to the bottom of this, and we’re involved in all those things.

Q: What are some examples of the cancer research taking place here?

A: We’re looking at the causes of DNA damage that can lead to cancer formation. There is research ongoing related to how the tumor interacts with the body’s own cells and understanding the specific signals sent between normal cells and cancer cells that allow cancer cells to grow.

We have immunology research, which is focused on how the immune system reacts against cancer. And other researchers are focusing on the collection of microbes that naturally live on our bodies and inside us, such as bacteria, fungi, viruses and their genes. We’re studying how they influence the development of cancer.

All these things are very important to better understand cancer, and they are all ongoing here.

Q: What role do clinical trials play in the prevention, diagnosis and treatment of cancer?

A: There are more than 100 clinical trials for cancer patients open at UVM Cancer Center. They’re focused on a variety of things, including screening and prevention, tobacco cessation and immunotherapy.

Related: Clinical Trials Are Best Option for Many Cancer Patients

Immunotherapy, which stimulates our immune system to fight cancer, has really revolutionized care over the last five to 10 years, and we’re finding more and more ways we can use it to benefit patients in our clinic. We also have some innovative studies that look at new technologies and how immunotherapy helps determine what kind of treatment we should give to patients.

Q: What’s one example of a cancer-focused clinical trial at UVM Cancer Center?

A: Right now, the recommended therapy for patients with stage 3 colon cancer is that they receive chemotherapy to try and prevent a relapse once the cancer is surgically removed. We have a clinical trial going on in which we are taking blood samples from patients after surgery and look for tumor DNA circulating in their blood. If we find it, we know the risk of relapse may be higher, so those patients are included in a clinical trial to receive one of two different kinds of chemotherapy.

If we don’t find circulating tumor DNA in the blood, we know the risk of relapse is lower. Those patients then either get the standard therapy or no treatment at all except for surveillance so we can keep on eye on their blood work every three months.

This means we can tailor our treatment to the individual patient. Some may be able to avoid chemotherapy altogether, which is something most patients would honestly like to do if possible. Studies like this are much different than what we use to do 20 years ago. It’s much more precise. And these types of trials can really provide overwhelming benefits for patients.

Q: What other kinds of discoveries made at UVM Cancer Center are making a difference for patients?

A: One of our goals is always to take discovery from the laboratory to directly help patients in the clinic.

We have a very strong research group here, which is called the Redox Biology Group. Redox stands for reduction oxidation. These are processes that occur within all cells but are especially important within cancer cells.

Brian Cunniff, PhD, one of our UVM Cancer Center members, has discovered a compound that blocks a specific step in those processes. He likes to describe it as causing cancer cells to choke on their own exhaust.

This is a new approach compared to other anti-cancer drugs. Early research on this mechanism has already been completed in the United Kingdom, and they’ve just opened up the next-level clinical trial for patients with mesothelioma, which is a cancer of the lining of the lung.

It’s really exciting because it’s a discovery that was made here at University of Vermont. And it’s important for our region because a lot of people in Vermont and northern New York have a history of asbestos exposure, which causes mesothelioma.

This is a great example of what we call our bench-to-bedside research, where the discoveries we make in the lab here can be used to save the lives of our loved ones, friends, neighbors and co-workers.

 Stay Informed

Sign up to receive the latest stories, information and guidance from our experts on a wide variety of health topics.