On March 24, Carly Douglas looked into her phone camera from a hospital bed and said what she wanted her followers to hear first. “Cancer picked the wrong girl,” she told them. She had been rushed in with severe abdominal pain and bloating. Only weeks before, her Instagram feed had shown her doing pull-ups in the home gym of her Greenville, South Carolina house.
She died on Saturday, June 13, aged 36, leaving her husband David and three children, River, Faye and Townes. Evoke reported that the family announced her death on Instagram. Doctors had found stage 4 stomach cancer, and Marca reported that she shared her chemotherapy and repeated hospital stays online, leaning on her Christian faith. The family wrote that she “fought cancer with grit and determination”. Her page had more than 140,000 followers, drawn by fitness, motherhood and family life.
A disease that was supposed to be fading
Her case fits a pattern that doctors in both the UK and the US say they are seeing. Stomach cancer was a leading cancer killer in the late 19th century. From the mid-20th century it fell away, and the Daily Mail put the fall in death rates since the 1970s at over 80 per cent. Better hygiene and antibiotics cut infection with Helicobacter pylori, the biggest single risk factor. Refrigeration meant fewer people lived on smoked, salted and pickled meat. Fewer people smoked.
Now the line is bending the other way, with diagnoses climbing among people under 50. Nobody has pinned down why.
Sheena Dewan, who directs Stomach Cancer UK, told the Daily Mail what she hears from patients. “I have been involved in this area for a decade, and when I started I would often speak to children whose parents had been diagnosed, but now it is almost entirely people aged 30 to 50 who have the disease,” she said. She added that big NHS cancer hospitals are setting up specialist units for young patients.
Dr Yanghee Woo, a gastroenterologist in California, sees it at her own clinic. “A large percentage of our patients that come to see us are very young,” she said, “in their 20s, 30s, 40s, with young children.” They are otherwise healthy, she said, and never imagined cancer.
Possible causes, and why it is caught late
Several theories are in play. Ultra-processed foods, roughly half of what the typical Briton eats according to the Daily Mail, have been tied to several cancers, although the evidence for stomach cancer is still emerging. Heavy salt intake has been linked to damage in the stomach lining. So has heavy drinking, put at about three drinks daily or more. Dr Constanza Camargo of the National Cancer Institute noted a higher risk in people born after 1950, which coincides with the arrival of antibiotics, and one idea is that antibiotics disturbed the gut microbiome.
The symptoms are the cruel part. Persistent abdominal pain, bloating once a meal is finished, indigestion and frequent burping are easy to put down to stress or diet. Woo said many patients had lived with them for months or years, assuming acid reflux. Across all stages, 37 per cent of patients are alive five years on. For stage 4, the figure is under 8 per cent.
Sources
- The real reasons for the surge in stomach cancers among the under-50s (Daily Mail)
- Fitness influencer dies three months after revealing stomach cancer (Evoke)
- Carly Douglas cause of death (Marca)
