Somehow it's my first time visiting, which is crazy for someone who loves Greek mythology! After all, Hercules is one of my role models in the gym 💪🏻
Anyway, I would try to carry on with my usual humorous intro, but I'm not really feeling that today, and you'll find out why below.
Let's dive into this week's newsletter...
Man, this f*cking sucks!
On Sunday, Ireland lost one of its best athletes, Ciara Mageean, after a courageous battle with bowel cancer.
The scariest part of it?
She was only 34 🥺
Ciara Mageean celebrates with her 1500m European gold medal in 2024 (Image courtesy of RTE.ie
F*ck me, even writing that feels painful. I didn't know Ciara; I've never met her, and I won't pretend I've heard a whole lot about her, as I'm not massively into athletics, but I still have this sick feeling in my stomach.
I'm 35 and live a very healthy life compared to your average Joe Soap, but my routine doesn't mean jack sh*t compared to an Olympian's, yet the big C still got her.
If the name isn’t familiar, the CV is extraordinary. A two-time Olympian. The 2024 European 1500m champion and Ireland’s first individual European athletics champion since the legend that is Sonia O’Sullivan.
She died of stage four bowel cancer.
She was an elite endurance athlete. Lean, active, a lifetime of training, none of the usual risk factors.
If anyone was doing everything right, it was her, yet this sh*t still happened. That hard, unfair truth is exactly why I want to talk about this today.
I wanted this week's newsletter to make a few things clear:
Practice gratitude daily. I've been doing it a lot this year, and I can feel the difference in how I view the world and my life overall. You don't know when your life will get taken from under your feet.
Prioritise your health: Don't gamble with your health. Keep the gambling for other parts of your life. If an Olympian can see her life cut short due to cancer, what makes you or me think we'll get away with taking shortcuts with our health?
Get checked: Regular health checks are a must. It's crazy how people will bring their car in for a yearly service but won't do the same with their own damn body!
We'll focus on 2 & 3 for the rest of this email and discuss what bowel cancer is, what you can control in your lifestyle to fight it, and why early testing is key.
It’s not only an older person’s disease
Most of us file bowel cancer away as something that happens later in life.
For the most part, the statistics still agree with that, but the picture is shifting, and Ciara’s death is part of a trend researchers have been watching with growing concern.
Bowel cancer in younger adults is rising.
A major 2024 study led by Hyuna Sung and colleagues, published in The Lancet Oncology, looked at 50 countries and found early-onset bowel cancer, in the under-50s, climbing in 27 of them.
In England, it rose around 3.6% a year in the decade to 2017, the fourth-fastest rise of any country studied.
I want to be careful here, because the goal isn’t to scare you. In absolute terms, bowel cancer in young people is still uncommon. Of the roughly 48,000 cases diagnosed in the UK each year, only about 2,500 are in the under-50s. As Cancer Research UK put it, rates in younger adults remain much lower than in those over 50.
So this isn’t a reason to panic. It’s a reason not to assume you’re automatically too young.
As for why it’s rising, the honest answer is that nobody really knows yet. Diet, ultra-processed food, obesity, gut health and sedentary living are all suspects, but they’re hypotheses, not proven causes. A lot of it remains genuinely unexplained.
What you can actually control
Now for the better news, because there is some.
A large share of bowel cancer is linked to how we live, which means there are real levers you can pull.
Cancer Research UK estimates that around 54% of UK bowel cancers are preventable.
The biggest contributors they list are:
A lack of fibre
Processed and red meat
Excess body fat
Smoking
Alcohol
Inactivity
I'm not being funny but I think 9/10 would have guessed all of them. We're not reinventing the wheel here.
In practice:
Eat more fibre. This is the big one because low fibre is the single largest preventable factor. The World Cancer Research Fund found that around three servings of wholegrains a day is linked to roughly 17% lower risk. Most people get nowhere near enough.
Go easy on processed meat. Of all the dietary risks, this has the strongest evidence behind it. The World Health Organisation’s cancer agency classes processed meat as a definite cause of bowel cancer, with each 50g a day- think a couple of rashers of bacon- raising risk by around 18%. (Red meat is probably a risk too, but the evidence there is weaker, so I won’t overstate it.)
Watch the alcohol. Risk climbs with intake, at roughly 7% per daily drink.
Keep moving. Physically active people have around 20% lower risk of colon cancer specifically.
And the usual suspects: keep your body fat in a healthy range, and don’t smoke.
None of this will surprise you if you’ve read my stuff before. They’re the same boring fundamentals that protect you against nearly everything.
The part we have to be honest about
This is where I owe you the truth, because Ciara’s story demands it.
You can do all of the above, perfectly, for your whole life, and still get bowel cancer.
A lot of cancer begins with simple bad luck. When your cells divide, they copy their DNA, and sometimes that copying goes wrong at random (thanks, Claude, for the explanation because I did not know that).
Researchers Cristian Tomasetti and Bert Vogelstein at Johns Hopkins estimated in the journal Science that around two-thirds of the mutations that drive cancer come down to these random copying errors, rather than lifestyle or inherited genes. The exact share is debated, but the principle holds. And the bowel is a part of the body whose cells divide constantly, so those random errors stack up over a lifetime.
On top of that sit the things you can’t change: age, which is the single biggest risk factor; family history, which more than doubles your risk; and inherited conditions like Lynch syndrome.
Lynch syndrome is an inherited genetic condition—formerly called HNPCC—that significantly increases the risk of developing certain cancers, especially bowel (colorectal) and womb (endometrial) cancer.
Put plainly, around half of bowel cancers aren’t explained by lifestyle at all. So a good diet and regular training stack the odds in your favour. They don’t make you bulletproof. Ciara Mageean is heartbreaking proof.
Which brings me to what matters most.
The thing that actually saves lives
If lifestyle can only take you so far, the most powerful move you can make is catching it early, and here the numbers turn genuinely hopeful.
Caught at the earliest stage, around 90% of people survive bowel cancer for five years or more, based on NHS England data.
Caught at the latest stage, that drops to roughly 10%. It’s the same disease; the difference is almost entirely about when it’s found.
Two things catch it early ⬇️
The first is screening. In the UK, the NHS posts out a free home test, called the FIT kit, that checks for tiny traces of blood in your poo. England and Scotland now send it automatically to everyone aged 50 to 74 every two years, and if you’re over 75, you can request one. It takes two minutes and can flag a cancer long before you’d ever feel it.
Please do it. Fewer than 60% of the newly eligible group currently send theirs back. (In the US, screening starts earlier, at 45.)
Whereabouts you are decides the exact age and how it works, so here’s where to check and sign up:
Australia (National Bowel Cancer Screening Program): free FIT kit every 2 years — you can opt in from 45, and it’s sent automatically from 50. https://www.ncsr.gov.au/
The second is knowing your own body. The kit is for people with no symptoms. If something feels wrong, see a GP; don’t wait for a test in the post.
The NHS says the signs to watch for are: a change in your bowel habits that isn’t normal for you, blood in your poo or bleeding from your bottom, tummy pain or a lump, bloating, losing weight without trying, or feeling unusually tired or breathless.
Most of the time these are caused by something harmless, like piles or IBS. But if they stick around, get them checked. As the NHS itself says, try not to be embarrassed.
Ciara spoke openly about the early symptom she brushed aside, needing the toilet several times every morning. In her words:
“I kept finding logical reasons for it, which many people would.”
That’s the trap too many fall into... we explain it away.
And if you’re younger, you may have to push (no pun intended).
Among under-50s surveyed by the charity Bowel Cancer UK, 43% saw their GP three or more times before being referred, and more than 40% who asked whether it could be bowel cancer were told they were too young. If something is wrong and it won’t go away, go back. Ask again. Request a FIT test.
While you’re at it, learn your family history, and tell your GP if a close relative has had bowel cancer or polyps.
The bottom line
You cannot eliminate your risk of this disease, and Ciara’s sad death is the proof none of us wanted.
But between how you live and catching it early, you can tilt the odds far in your favour.
Lower the risk you can, and screen for the risk you can’t.
The rest. The cruel, random part that took one of Ireland’s greatest athletes at 34 is the part none of us can control. Which is exactly why the part you do hold matters so much.
Rest easy, Ciara ❤️ ☘️ 🇮🇪
Quote for the day
“
I’m going to fit as much living into the years that I have left. — Ciara Mageean speaking to RTÉ Radio in June.
P.S. Whenever you’re ready, here are a few ways I can help you:
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References
Sung, H., et al. (2024). Global trends in early-onset colorectal cancer incidence across 50 countries. The Lancet Oncology (11 December 2024).
Cancer Research UK. Bowel cancer risk factors and preventable-cases statistics. cancerresearchuk.org
International Agency for Research on Cancer (IARC / WHO) (2015). Monographs Volume 114: carcinogenicity of processed and red meat.
World Cancer Research Fund / AICR (2018). Continuous Update Project: Diet, Nutrition, Physical Activity and Colorectal Cancer.
Tomasetti, C., & Vogelstein, B. (2017). “Stem cell divisions, somatic mutations, cancer etiology, and cancer prevention.” Science, 355(6331), 1330–1334.
Cancer Research UK / NHS England. Survival for bowel cancer, by stage (patients diagnosed 2016–2020).
NHS. Bowel cancer: symptoms. nhs.uk
Bowel Cancer UK. Never Too Young report, and the NHS bowel cancer screening programme.
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Disclaimer: This newsletter is for educational and informational purposes only. It is not intended to provide medical advice, diagnosis, or treatment. Any guidance related to training, nutrition, supplementation, or lifestyle is general in nature and not a substitute for personalised medical advice. Always consult with a qualified healthcare professional before making changes to your health routine.
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