For years, Dominique McShain dreamed of becoming a psychologist for troubled youth in her native New Zealand.
She was on track to achieve her goal, studying psychology in college, but in April 2024 she was diagnosed with incurable colon cancer that had spread to her liver.
At the time, she said doctors had given her between one and five years to live. But in a heartbreaking update on Tuesday, she said: ‘I want to be direct with you all: this will be my final update on my cancer journey until I have passed away.’
‘I’ve recently been given a prognosis about five days ago of only a few days to a few weeks to live.’
Her chemotherapy treatments, which she had undergone for seven months, had to stop immediately as her liver failed, leaving her skin and eyes yellow.
‘At this point,’ she said, ‘I’ve transitioned into end-of-life care, focusing on pain relief and managing side effects, with so much time spent in both the hospital and hospice facilities.’
Her diagnosis at the age of 20, which came after months of fatigue, blood in her stool, and constipation, is just one amid a surge of early-onset colorectal cancer striking people under 50.
Rates of disease in people under 35 nearly doubled from 1990 to 2019, from 21,000 to 41,000, while deaths rose by 25 percent.
Dominique McShain, 21, was diagnosed last Spring with incurable colon cancer that had spread to her liver. She has since been given mere days to live
‘I’ve been really numb to everything like I haven’t really been crying,’ she said in an emotional video update, the whites of her eyes tinged yellow.
McShain continued: ‘It’s crazy to think that I got given one to five years originally – I got diagnosed the 19th of April – and I’m not even a year yet.’
‘It just feels so surreal how fast my cancer has taken over my body and how fast it grows.’
Colon cancer begins in the inner lining of the colon and grows into the deeper levels of cells before breaching the colon wall and invading nearby blood vessels and the lymph system.
When cancer cells break off and enter the bloodstream, they enter the liver with the blood that drains from the colon. Once there, cells can escape immune detection and take hold in liver tissue.
Tumor cells steal nutrients meant for liver tissue, hijack immune cells, and begin to create durable shields around tumors to survive attacks.
At the start of last year, Dominique began experiencing bouts of diarrhea and constipation. Then she saw blood in her stool, a common symptom of cancer.
A 2024 review in JAMA analyzed 81 studies involving nearly 25 million young colorectal cancer patients under 50. The most frequent early warning sign was blood in the stool.
Dominique McShain dreamed of becoming a psychologist for troubled youth in her native New Zealand. Her life plans and goals, including to be a mother, have been cut short
Other common symptoms included stomach pain, anemia, and changes in bowel habit
McShain was always fatigued to the point where she was not taking in any of her professors’ lectures.
‘I’d have a normal night’s sleep but then sleep another five to six hours every single day,’ she said.
She added: ‘I also started to develop severe abdominal pain and I also lost my appetite like, severely. I was just not feeling well.’
She waited three to four weeks before going to the doctor, fearing that if she went to the hospital before her symptoms got worse, doctors would be more likely to brush off her concerns, chalking it up to normal constipation that can be easily resolved with over-the-counter treatments.
Eventually, she underwent a blood test, and while her general markers were typical, ruling out myriad issues such as kidney disease or anemia, her liver blood samples showed ‘abnormally high’ amounts of enzymes and proteins, indicating organ damage.
She had to rush to Christchurch Hospital for an ultrasound, which revealed several lumps in her colon.
McShain continued to feel unwell and ultimately had a biopsy, which confirmed that she had colon cancer and only a year to five left to live.
The above graph shows the increase in US colorectal cancers in men and women from 2000 through 2021, the most recent year in which trendline data is available
But the drastic cut to that life expectancy came after her liver began failing. She went into the hospital because doctors believed she had a build-up of fluid in her stomach. She couldn’t walk or turn around and was in so much pain that she was in tears.
Doctors conducted an ultrasound to locate the pockets of fluid and found none.
She said days ago: ‘Unfortunately, later in the afternoon, after the oncologists had some discussion, they basically worked out that all the stuff I’m getting is caused by my cancer and liver failure and not anything to do with fluid. Which led them to tell me that I only have a few short days to a few short weeks to live.
‘I fought as hard as I could, truly,’ she added. ‘I find comfort in knowing I won’t have to suffer everyday soon.’
Doctors and researchers have sounded the alarm in recent years about rising instances of colorectal cancer in people under 50.
In 2024, an American Cancer Society study found that colorectal cancer cases among adults under 55 increased from one in 10 in 1995 to one in five in 2019.
Early diagnosis of colorectal cancer is crucial, as cancers detected in the early stages can often be cured with surgery alone.
But delays in diagnosis are common, as screening recommendations start at age 45. This means people can live several years with steadily advancing cancer unbeknownst to them until they begin experiencing symptoms.
