When Dr. Edith Mitchell learned that the actor Chadwick Boseman had died from colorectal cancer last weekend, she was "blown away" like the rest of the world, she said, but also in another way.
"I was surprised that I didn't see it," said Mitchell, a renowned oncologist specializing in gastrointestinal and colorectal cancers who is a clinical professor of medicine and medical oncology at Thomas Jefferson University in Philadelphia.
As shocking as the news was, Boseman's death from cancer at age 43 also renewed concerns about colon cancer and the risk factors for Black men. Mitchell knows the data all too well: Black people are at a disproportionately high risk for colon cancer diagnoses, according to the American Cancer Society, and the mortality rate has increased in recent years, particularly among Black men.
"Colorectal cancer is the second deadliest cancer in the country," said Dr. Durado Brooks, vice president of prevention and early detection at the American Cancer Society. "This disease is ravaging the Black community, and it is as important as ever that everyone has access to and is receiving the recommended screenings. Even during the coronavirus pandemic, necessary screening tests remain available to prevent the disease or find it at an early, more treatable stage."
Significantly, the American Cancer Society now recommends screenings for colon cancer at 45 instead of 50, because younger people, especially Black men, were developing the disease earlier in life. Other organizations have followed the same recommendation.
William Allen, 67, of Northern Virginia, said he was diagnosed with colon cancer Jan. 8. He had visited his doctor every three months, he said, after his father was diagnosed with the disease 17 years previously.
Still, Allen was diagnosed at stage 3, a more advanced form. A week later, he was put on bed rest and had emergency surgery. "After the surgery, the doctor told me, 'You just had a baby,'" Allen said. "The tumor was 6 to 8 pounds."
Allen said he was shaken when he learned of Boseman's death. "My attitude is that I am in a fight for my life and I can't take anything but first place. Second place won't do it," he said.
Allen said that after Boseman died, he listened to his commencement speech at Howard University in 2018 and felt inspired.
"I'm using him as an inspiration," Allen said. "If he can shoot films for 18 hours and do the stunts he did in 'Black Panther' and his other work, I can get my you-know-what up and be productive."
For men under 50, the rate of colon cancer has increased by 2 percent every year for the last 10 years, Mitchell said.
John Johnson, a poet who lives in Washington, D.C., was 37 when he was diagnosed with stage 3 colon cancer two years ago. He went through chemotherapy, radiation and two operations.
"Hell" is how he described enduring the treatments and the post-surgery period. "It threw my life into turmoil. There's a fear that comes with it that you can't explain. I was married with a young child. I didn't need that drama."
Dr. Lynn O'Connor, chief of colon and rectal surgery at Mercy Medical Center and St. Joseph Hospital in New York, said she is alarmed by the consistent increase in cases of colorectal cancer in young adults under 50 and the disproportionate increase in Black Americans. The problem may be also exacerbated by the lack of recognition of early signs by both patients and doctors due to their young age.
"Chadwick Boseman's death is an opportunity to raise awareness," O'Connor said. "We lost a real hero. And there are a lot more cases out there. The men in their 50s, 60s and 70s have gotten the message. But there will be 140,000 new cases by the end of 2020, and 11 percent of them will be under 50 years old."
The numbers can mean more devastation for the Black community "when you consider Blacks have a higher mortality rate and less survival rate," she said.
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It would help if younger men took symptoms seriously, eliminated fast foods and incorporated fresh vegetables and fruits while adhering to the new guidelines for having colonoscopy exams.
But it would also help if physicians did not dismiss the possibility of colon cancer when younger men complain of stomach issues or blood in their stool.
O'Connor said doctors cannot dismiss potential symptoms of colorectal cancer, even if patients seem too young for the disease.
Mitchell said: "When some younger patients have vague abdominal pain, most doctors don't think of colon cancer as a possibility. That has to change."
To mitigate the chances of having colorectal cancer, doctors strongly suggest minimizing fast food and processed foods, cutting down on smoking, exercising at least 30 minutes a day and loading up on fresh fruits and vegetables. Obesity also is a factor in this disease.
Allen said he called his son, William Jr., 32, to encourage him to see his doctor regularly and to insist on preventive care. "My father got it. I got it," Allen said. "That's not to say that he will, but it's critical to catch it early if you do get it. That's the key."