This is the story of Joseph, a 28-year-old man who's made a very difficult choice. On December 2024, Joseph Awuah-Darko shared the difficult decision of choosing euthanasia on Instagram. He's not physically sick, but he's been battling a severe mental illness called bipolar disorder for many years. He's tried many treatments, but nothing has helped him feel better. He feels like the pain of his illness is too much to bear. He's shared his story publicly to help people understand what he's going through and to show how serious mental illness can be. Joseph shared a post that explained why he is making this decision, in the caption of the post he shared, “I am not saying that life (as a phenomenon) isn’t worth living. It ABSOLUTELY is. What I am saying is that the mental weight of MINE has become entirely unbearable.”

Joseph has bipolar disorder, which means his moods swing very high and very low. He's had this illness for a long time, and it makes his life very difficult. On his Instagram, he has shared his journey with bipolar, he explained that he tried many different medicines and therapies, but they haven't worked. He feels constant pain and suffering because of his illness. He's reached a point where he feels like he can't go on anymore. He's been open about his struggles on social media, hoping to raise awareness about mental health. He wants people to understand how much he suffers and why he's made this decision.

Euthanasia in the Netherlands

Government of the Netherlands explain that in the Netherlands, it's legal for a doctor to help someone end their life if they meet certain conditions. This is called euthanasia. Joseph has applied for this because he feels his mental illness is causing him unbearable suffering. There are rules and procedures that doctors must follow. They have to make sure the person understands their decision and that there are no other options. The process can take a long time, sometimes years. Joseph believes that having the option of a peaceful and dignified death is important. He wants to have control over how his life ends.

The Last Supper Project

When Joseph shared his decision, people had many different reactions. Some people understood and supported him. Others were sad and hoped he would change his mind. He even received some negative comments. But he also received many kind messages, including invitations to have dinner. This inspired him to start "The Last Supper Project," where he travels and shares meals with strangers. In the caption he explained, “‘The Last Supper Project’ is based on the Harvard Study of Adult Development which speaks to the importance of quality relationships and community as the greatest predictor for happiness. And I feel connecting this way around food as a great unifying vessel could be beautiful.”

The Last Supper Project is one of the longest studies, lasting for more than 80 years, done on adult development. In an Author Speaks edition of McKinsey & Company, the study’s director Robert Waldinger explained the study wanted to know what helps people have happy and healthy lives, even if they had problems when they were young. Most studies only looked at what goes wrong, but this one wanted to know what goes right. The study emphasizes that it is never too late for positive changes. People often believe they are too old or incapable of forming good relationships. They may think happiness is out of reach. However, the study has observed individuals who found happiness unexpectedly.

Joseph wants to connect with people and enjoy these moments while he waits for his euthanasia request to be approved. He sees these dinners as a way to find joy and connection in his final chapter. He still has bad days, but he finds comfort in these shared experiences.

India faces a substantial hepatitis C burden, with the World Health Organization (WHO) estimating that 5.5 million to 12 million people are living with chronic hepatitis C virus (HCV) infection.

Untreated chronic HCV infection can lead to liver scarring, cirrhosis and liver cancer. Could shortening treatment by four weeks help more patients access a cure?

A multi-center trial led by researchers from the Indian Council of Medical Research (ICMR) found that an eight-week course of a commonly used antiviral combination was as effective as the standard 12-week regimen in patients without cirrhosis. Published in The Lancet, the findings could have implications for treatment costs and access to care.

The treatment combines sofosbuvir (400 mg) and velpatasvir (100 mg), two direct-acting antivirals that target the hepatitis C virus.

What Did The Indian Trial Find?

Also read: Punjab To Start Screening For HIV, Hepatitis B & C At De-Addiction Centres

The RESOLVE trial, led by researchers from Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, evaluated whether eight weeks of sofosbuvir and velpatasvir could match the effectiveness of the standard 12-week course.

The trial enrolled 880 patients without cirrhosis across five publicly funded hospitals in Lucknow, New Delhi and Varanasi. Half received the combination for eight weeks, while the other half received it for 12 weeks.

Among participants who completed treatment and follow-up, 98.8% in the eight-week group achieved a sustained virological response, compared with 99% in the 12-week group. This means the virus remained undetectable after treatment, indicating a cure.

The researchers found that the shorter regimen was non-inferior to the standard course, meaning it was not less effective beyond the trial's prespecified statistical margin.

The study also reported no drug-related serious adverse events or treatment discontinuations due to adverse events.

How Shorter Treatment Help Reduce Hepatitis C Burden In India?

Direct-acting antivirals transformed hepatitis C treatment nearly a decade ago, making it possible to cure most patients with relatively few side effects. However, treatment costs and access remain important considerations for large public health programmes.

A 12-week course of sofosbuvir and velpatasvir costs approximately ₹15,000. Shortening treatment by four weeks could save around ₹5,000 per patient.

If adopted for a population of 60 lakh people requiring treatment, the shorter regimen could potentially save ₹3,000 crore. However, these are projected savings, and the actual impact would depend on patient eligibility, treatment costs and adoption in clinical practice.

Who Can Receive The Shorter Treatment?

The findings apply to patients without cirrhosis, as the trial excluded those with the condition. Patients with cirrhosis may require different treatment approaches depending on the severity of their liver disease and other clinical factors.

The trial's results do not mean that everyone with hepatitis C can switch to an eight-week course. Further evaluation and changes to relevant clinical guidance may be needed before the shorter regimen becomes routine practice.

Patients should consult their treating physician before making any changes to their prescribed treatment.

How Does Hepatitis C Spread?

Hepatitis C can cause illness ranging from mild infection to serious, long-term liver disease. Although some acute infections resolve spontaneously, chronic infection can progress to cirrhosis and hepatocellular carcinoma, a type of liver cancer.

The virus can spread through infected blood, including via shared needles and unscreened blood transfusions.

Perinatal transmission is an important route of HCV acquisition in children. Early detection can help identify infected infants and ensure appropriate follow-up.

Colorectal cancer (CRC), a term encompassing cancer of the colon and rectum, is not only a growing burden in India, but a significant proportion of patients are now being diagnosed at a young age. While colorectal cancer is more common in older adults, Indian clinical studies have identified the phenomenon of young onset colorectal cancer (YO-CRC), typically diagnosed before the age of 50. An experts’ review on epidemiology of colorectal cancer with special emphasis on India, an article in 2025 was published in the Indian Journal of Gastroenterology. The review found that there has been an annual rise of 2-3% in the incidence of colorectal cancer over the past two decades.

In the area of Young Onset Colorectal Cancer, an editorial in 2024 in the South Asian Journal of Cancer noted that one quarter to one-third of colorectal cancer patients in India were below 40 years, and many were diagnosed at stage III or IV. Titled Clinicopathologic Profile and Treatment Outcomes of Colorectal Cancer in Young Adults, A Multicenter Study from India, an article published in JCO Global Oncology studied colorectal cancer among adolescents and young adults. The study revealed 62.70% had colon cancer and 37.30% rectal cancer, with 67% being aged 30-39 years and no significant gender predisposition, though females had a higher metastatic burden.

Why is colorectal cancer affecting younger Indians?

There is no single explanation. Researchers have studied factors like dietary changes, obesity, physical inactivity, altered metabolism, alcohol consumption, smoking, and environment as possible contributors. Increasing urbanisation and changing food habits could also be playing a role in India’s shifting colorectal cancer profile. But not all patients present with conventional risk factors, and in many patients, the causes remain unclear.

Genetic predispositions need special mention. Conditions such as Lynch syndrome and familial adenomatous polyposis (an inherited genetic condition that causes precancerous polyps to form in the large intestine) can raise the risk of colorectal cancer at a young age, but most young-onset cases are not explained by an inherited cancer syndrome.

Also read: Pope Leo XIV, Diagnosed With Lung Cancer, Undergoes Surgery As His Brother Battles Relapsed Multiple Myeloma

The problem of missed symptoms

One of the biggest problems in cancer treatment is delayed diagnosis. Because cancer is associated with older age, the symptoms in younger people may be mistaken for piles, constipation, diet-related problems or even irritable bowel syndrome. Rectal bleeding, persistent changes in bowel habits, unexplained weight loss, abdominal pain, iron-deficiency anaemia, persistent fatigue, or a feeling of incomplete bowel evacuation is usually dismissed as minor issues in younger people.

What should young Indians do?

Colonoscopy is not a solution that can be recommended for every young adult. Symptoms- and risk-based screening is a more reasonable approach. People with persistent symptoms, a strong family history of colorectal cancer, hereditary cancer syndromes, inflammatory bowel disease, or unexplained anaemia may require more intensive evaluation (including colonoscopy) if clinically indicated. This are high risk group, and they need regular screening lifelong. India’s colorectal cancer burden is rising, and younger patients are important segment of this burden.

The evidence available does not prove a nationwide explosion of colorectal cancer in under-50 age groups in India, but it does demonstrate an increasing overall incidence, a significant presence of young onset colorectal cancer, and frequent late presentation. If someone have a first degree relative with colon or rectal cancer like parents, ideally, they should have a colonoscopy done by the age of 45. For younger Indians, early recognition of warning signs may be one of the most critical steps for timely diagnosis and improved outcomes.

By Dr. Abhishek Gangopadhyay, Consultant - Surgical Gastroenterology, Surgical Oncology, Narayana RN Tagore Hospital, Mukundapur, Kolkata

At 42, Danielle Ripley-Burgess of Kansas City, Missouri, has survived colon cancer three times, at 17, 25 and 39.

The disease often begins as noncancerous growths called polyps in the colon or rectum. Early-stage cancer and precancerous polyps may cause no noticeable symptoms. Ripley-Burgess spotted her first symptom at the age of 14 but ignored.

Her First Symptom At 14

At 14, Ripley-Burgess noticed specks of blood in her stool but hid them out of embarrassment, believing red foods might be responsible.

“I thought, I’m eating something red and that’s probably what I see,” she told Today. “So I put myself on a ‘no red foods diet’ and stopped eating anything that was red in color: everything from candy to pizza to salsa to raspberry popsicles.”

After two years she eventually told her mother, who believed it to be a case of hemorrhoids. As her bleeding worsened, and she developed fatigue and severe stomach pain, she was taken to a gastroenterologist.

Colon Cancer Diagnosis At Age 17 And 25

A few weeks after her 17th birthday, Ripley-Burgess was diagnosed with stage 3 colon cancer. She underwent chemotherapy, radiation and surgery. But years later, a follow-up colonoscopy revealed another cancerous polyp.

“I thought I had beaten cancer. I was getting colonoscopies every three years, and after one of them, I woke up and saw the very same look on the doctor’s face that I had seen eight years prior,” she said. “He saw a polyp that later turned out to be cancerous. I had no symptoms. At 25, I had stage 1 colon cancer.”

The second diagnosis was emotionally difficult as she feared losing the life she had built with her husband and the future they had planned.

Lynch Syndrome Increased Her Cancer Risk

Further testing revealed that Ripley-Burgess had Lynch syndrome, an inherited condition that increases the risk of colorectal, uterine and other cancers, according to the Mayo Clinic.

She underwent a preventive hysterectomy and subtotal colectomy, which removed all but about 13 inches of her colon.

Despite these measures, a colonoscopy in 2023 yet again detected a recurrence. At 39, she opted to have the remaining colon removed and a permanent ileostomy.

“I wasn’t expecting it, but I also wasn’t completely shocked,” she said, explaining that living with Lynch syndrome meant knowing cancer could return.

Why Blood in Stool Should Not Be Ignored

Ripley-Burgess now shares her story to encourage people, especially younger adults, to seek medical attention for unusual symptoms.

“If I could go back and tell my younger self something, it would be: Don’t be embarrassed about your body,” she told the outlet. “If you’re seeing something with your body that’s uncomfortable and weird, and you’re not ready yet to tell a doctor, tell somebody — a friend or family member. Don’t sit in that place of: something is wrong with your body, and you don’t know what it is. Don’t sit there alone. Don’t downplay what you’re seeing,” she

Colorectal cancer is expected to cause 158,850 new cases and 55,230 deaths in the US in 2026, according to the American Cancer Society.

Dr. Sajjan Rajpurohit, medical oncologist at BLK-Max Super Speciality Hospital, said, “Blood in the stool is one of the most common and concerning signs. While it might be due to hemorrhoids or fissures, it’s important not to assume. A proper evaluation is critical.”

Rectal bleeding can have several causes, but it should not automatically be attributed to hemorrhoids. Timely medical evaluation can help identify the cause and ensure appropriate treatment.