Maria Kang has never been one for keeping quiet. The Sacramento-based fitness influencer and mother of three has gone viral several times—first a little over a decade ago, when she posted a super-fit photo of herself in workout gear, surrounded by her three kids, and captioned it, “What’s your excuse?”
The post quickly racked up 16 million views and triggered endless ire from women who took umbrage over what they saw as a body-shaming attack. Kang was called obnoxious, a bully, an idiot. But it only fueled her fire, catapulting her into years of frenzied health-and-wellness entrepreneurism—she owns a collection of nursing homes, runs the organizations Fitness Without Borders and No Excuse Mom (with spinoffs including calendars and a book) and has recently become a breathwork instructor. And the media moments have continued, as she’s spoken candidly about everything from removing her breast implants to the dissolution of her marriage.
Now she’s raising her voice about a major life update: She’s been diagnosed with stage 4 colon cancer.
“I was thinking I’d never, ever talk about this,” Kang, 43, tells Fortune (though she’s shared the news on social media and her blog). “But I want to create awareness that it could happen to anyone … I was the symbol of health and wellness.”
She says she spent a year believing her digestive issues, anemia, and abdominal pain were symptoms of something benign, like hemorrhoids or irritable bowel syndrome (IBS), and doesn’t want others to make the same mistake. When her doctor discovered she had a low iron count he ordered a CT scan, which showed a mass. A colonoscopy and biopsy confirmed it was cancer, which had already spread to a lymph node, making it stage 4.
“You go through a range of emotions, and there was a part like, ‘Why me? I did everything. I meditate. I have no anger toward anybody. You start to get angry … but then you realize you’re not alone.”
That’s truer than ever, in fact, as rates of colorectal cancer have been rising rapidly for people under 50, even as rates are declining in people over 65, according to a report that the American Cancer Society published in January. (Rates have even been rising in kids and teens, according to just-released data.)
“We do not know exactly what is causing this spike in colorectal cancer cases in young people,” Dr. James McCormick, system chief of colon and rectal surgery for Pittsburgh’s Allegheny Health Network, tells Fortune. “While there are people who have a genetic predisposition to developing colorectal cancer, that does not explain the situation at hand. This must be caused by some environmental or dietary or lifestyle factors—or perhaps most likely a combination of all three.” That includes the air we breathe and the water we drink, he says, adding that known risk factors include “all the hallmarks of a Western diet,” such as high animal fat and processed meat intake and low fiber intake, as well as obesity and a sedentary lifestyle.
So, what about Kang and others like her?
“It is important to note though that I have seen many young patients who come into my office and report consuming a healthy diet and have maintained a highly active lifestyle and a healthy weight but still developed colorectal cancer in their 20s and 30s despite these intentional efforts,” says McCormick.
In other words, it can be a crapshoot.
Understanding colorectal cancer symptoms
The list of symptoms that are typically attributed to colorectal cancer, McCormick says, “are a change in your bowel habits, bleeding, fatigue, abdominal pain, bloating, or unintentional weight loss.” Bleeding and anemia—both of which Kang experienced—as well as unintentional weight loss, he adds, “always need to be evaluated.”
Regarding the other signs, he says, it’s true that many people experience abdominal pain, bloating, and fatigue and attribute it to IBS or other benign causes. But while doctors were comfortable making diagnoses of IBS and hemorrhoids in healthy young people in the absence of family colon cancer history 20 years ago, “not anymore,” he says, due to the incidence in that group doubling over that time.
“Be careful,” McCormick advises. “You cannot diagnose hemorrhoids or irritable bowel syndrome at home based upon descriptions found on the internet. The truth is irritable bowel syndrome is a diagnosis of exclusion—meaning that we cannot make the diagnosis without ruling out more ominous diagnoses—and the things that we’re excluding are things like colon cancer and inflammatory bowel disease.”
So, when is it important to get checked? Besides bleeding, anemia, and unintentional weight loss, he advises, “I think the most important differentiator is change—change in bowel habits, change in pain, change in bloating, and fatigue that hangs on. Pay attention to what is ‘normal’ for you and take notice if this changes.” If that persists for more than a few weeks then get checked, he suggests, and insist upon getting a colonoscopy.
Getting a handle on prevention
Preventative colonoscopies, currently recommended to begin at age 45 in the absence of major risk factors or symptoms, are the “gold standard,” McCormick says, as it allows removal of precancerous lesions and nip the cancer development in the bud. But alternatives, including stool testing in the form of an FIT test or Cologuard, are great options—as long as you follow up with a colonoscopy if results are positive. “But the most important thing is that people get something done to screen,” he says.
More advice from the doctor, is to focus on what you have control over: Eat a high-fiber diet with lots of fresh fruits and leafy green vegetables; minimize red and processed meats as well as alcohol; stick to nuts, seeds, legumes, fish, and chicken for protein sources; exercise 30 minutes 4 to 5 times a week at minimum; maintain a healthy weight; know your body and be vigilant. “Do not ignore symptoms and insist on a colonoscopy,” he stresses, “regardless of your age.”
Kang seconds that—and adds a bit of her own wisdom, too.
“One out of every two women is going to get cancer, and we keep thinking, ‘If I do that, if I do this, I’m not going to get it.’ But sometimes it doesn’t matter how young you are, or healthy,” she says. “I don’t want to create fear, I want to create awareness that it is possible. So, I want everyone to live their best life, be joyful, be happy. Live the life you want to live today.”
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