The passing of Black Panther star Chadwick Boseman due to colon cancer is tragic. He was young, he was successful, and he carried the weight of his devastating diagnosis quietly and privately. He is also not alone. “Colon cancer is one of the most common cancers in the United States,” says Dr. Mazen Alastie, gastroenterologist at Ascension St. Vincent in Indianapolis. Here’s what you should know about it—the risks, the signs and what you can do about it.
What is colorectal cancer?
According to The American Cancer Society, colorectal cancers start in either the colon (the main part of the large intestine) or the rectum (the last few inches of the large intestine). Where the cancer begins will decide whether it will be called colon or rectal cancer. A majority of colorectal cancers begin with a growth called a polyp in the inner lining of the colon or rectum. Not all types of polyps will become cancer, but some types can change over time and become cancerous. When it comes to polyps, the key is to find them and to find them early. “Finding polyps before they become bigger decreases the risk of them developing into colon cancer,” Alastie says.
Who is at risk?
“In the past, colon cancer has targeted older patients,” Alastie says. As such, people over the age of 50 have been encouraged to undergo screening procedures such as colonoscopies and testing of stool samples in an effort for early detection. The work has paid off. According to Alastie, over the past 20 years the number of colon cancer patients over the age of 50 has been shown to have decreased.
That said, the numbers are trending in the wrong direction when it comes to patients under 50. “In the past 15 years, we have seen an increase in polyps in people younger than 50, and an increase in colon cancer in people younger than 50,” Alastie says.
The full landscape of this increase and age shift is not fully known, but experts are seeing trends. “We believe diet plays a role,” Alastie notes. High fatty foods, certain ingredients in our meals, as well as genetics are all under consideration when it comes pinpointing the reasons for the increases in risk. In response to the rise in younger patients, the American Cancer Society now recommends that those with an average risk of colorectal cancer begin regular screenings at age 45.
While the answer to why is still unknown, Dr. Alastie also notes that African American patients tend to present with symptoms earlier and with a higher mortality rate than that of caucacsian patients. With these disturbing statistics in mind, multiple societies have recommended that African Americans must begin the screening process at the age of 45.
What should we not do?
If you are experiencing symptoms, do not ignore them. “Do not ignore blood in the stool, new abdominal pain that is not explained and does not resolve very quickly,” Alastie advises. “Not every GI [gastrointestinal] symptom is related to a serious problem, but we need to be able to identify patients early on.”
Do not avoid preventive healthcare screenings or tests. If you are leery of a colonoscopy, options such as testing of stool or blood draws can be helpful in helping experts determine whether additional steps or screenings are necessary. Ask your doctor which options are best for you.
Another preventive hack—and a good rule of thumb for the majority of what ails us—is to watch what you eat. “We recommend diet changes to people in general,” Alastie says. “What is healthy for the heart is healthy for the colon.” Trimming back on processed foods and saturated fats are steps in the right direction.
Alastie also recommends getting a sense of the full scope of your family medical history. “Genetics can play a role in colon cancer,” he notes. “Anyone with a first degree relative with colon cancer”—meaning a parent, sibling, or child—“should be screening earlier than other patients.”
Research indicates that when diagnosed early, colon cancer survival rates are usually very good. Early diagnosis and treatment has been shown to produce better outcomes and much higher patient survival rates.
While Chadwick Boseman kept his struggles out of the public eye, his passing has put a very public face on a very real issue. Youth does not mean absolution. If you feel something, say something. If you are 45 or above, schedule your annual screening. If you are outside the age of recommended screening, do not live in fear, but be aware. If you experience any of the symptoms listed above, consult your doctor.
Trust your gut, friends. It may just save your ass.
