When you're diagnosed at 18 with a disease that's associated with people over 50, how do you talk about your condition with your peers?

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When you're Hailey Duff, now nearly 20, you laugh it off and refer to yourself as a freak of nature.  

An upbeat nursing student with a passion for cheerleading, Duff was diagnosed with colon cancer during finals week in her first year of college.

"What happened is that all during my junior and senior year of high school, I never felt good," she says. "I felt super-constipated all the time, and was constantly nauseated, like my whole body was backed up."

In hindsight, Duff says blood in her stool was the biggest sign, but "it was on and off and I didn't worry about it."

Eventually, it got to be too much to ignore. After an initial diagnosis of mild irritable bowel syndrome, a follow-up colonoscopy found a golf ball-sized tumor in the bend of Duff's colon. Surgery was quickly scheduled.

"They took out half of my large intestine and all of the lymph nodes on my right side as a precaution," says Duff. "Once they got the tumor out, they were like: 'Surprise! It was full of cancer!'"

Fortunately, the cancer was caught at an early stage, and biopsies of her lymph nodes came back negative. It was determined that she would not require chemotherapy or radiation.

Now all that was left was the healing. Duff took that on with the determination and stamina of a competitive cheerleader.

"I think I have a really high tolerance for a lot of things, and I think that's from an athlete's perspective," says Duff. "You develop mental toughness. In cheer, we flip around, crash and burn, and get up and do it again. I'm used to physically being pushed. I know how to push myself and how not to break, and how to get through things. I think that played a big role in recovery and the surgery itself."

Genetic links

Though still considered rare, colorectal cancers are on the rise for younger people, and have been since the 1990s.

SEE ALSO: Should Young People Get a Colon Cancer Screening? It Depends on Their Risk

"Most of the younger patients are being diagnosed when they present with symptoms like rectal bleeding, abdominal pain, weight loss and anemia," says Elena Stoffel, M.D., assistant professor of internal medicine at the University of Michigan Medical School and director of the Cancer Genetics Clinic at the U-M Comprehensive Cancer Center. "People typically don't think of colon cancer in young people because we're so used to seeing it in older people."

Family history is a big factor for those diagnosed at younger ages. Stoffel says that roughly 1 in 5 people under age 50 with colon cancer has a genetic predisposition to it.

The most common hereditary colon cancer condition is Lynch syndrome, which affects approximately 1 out of 300 Americans.

"After my surgery, my doctors told me that the fact that I had this was weird for my age," says Duff. "There's a lot of colon cancer on my dad's side of the family, so they put us in contact with the Cancer Genetics Clinic at U-M. They said, 'We think you have this disease called Lynch syndrome; that's a genetic condition that makes it more likely for you to get cancer.'"

Duff's test results showed that she did, indeed, have Lynch syndrome. The rest of her family was tested and is waiting for results.

Although the risk for colorectal cancer is high for patients with Lynch syndrome, early and frequent colonoscopy exams are effective at preventing colorectal cancers.

Life after cancer

Spend even a few minutes with Duff and you'll see that nothing slows her down. Certainly not cancer. Less than two years after her diagnosis and surgery, she's balancing jobs as a high school cheer coach and as a nanny along with her nursing studies.

But she's also aware that her cancer — and her Lynch syndrome diagnosis — mean that life has changed for her.

"I'll have colonoscopies every year for the rest of my life," she says. "Then I will have to have mammograms and Paps every year once I turn 21. I will have to spend a lot of time at the GI doc because of my risk for more colon cancer — and now I have a high risk for stomach, cervical and vaginal cancer, too.

"It sucks, but I feel like if I didn't know about this I would be so much worse off. The doctor appointments will be hard, but at least I know. At least I can take care of myself now. At least I won't get slammed with a random cancer diagnosis. At least now I have a warning."

Duff says that having cancer has helped put her life into perspective, but it didn't force her to grow up any faster.

"To be honest, I am an extremely mature person," she says. "I'm always the leader on teams, and I'm a mentor for my two younger sisters. This is how I have always been."

Duff will get to apply those mentoring and leadership skills to her forthcoming nursing career. And after the care she received during her cancer journey, Duff's dream is to join the team at University of Michigan C.S. Mott Children's Hospital when she completes her studies because "it's the best of the best, and I want to work with children and babies!"

As a young colon cancer patient, Duff has advice for anyone experiencing any unexplained symptoms: Talk to your doctor.

"Don't put it off," she warns. "I ignored the symptoms for at least two years. My doctor said if I had waited even longer, I'd have been even sicker. Talk to your doctor if you've got problems. Tell them about your family history. Maybe you can prevent cancer, or detect it early."

Photos by Leisa Thompson