What we can learn from Chadwick Boseman’s tragic death
Chadwick Boseman played the superhero Black Panther in the Avengers movies. But, sadly, his lasting superpower might come from the publicity surrounding his death last month from colon cancer at the age of 43.
Boseman personified a troubling trend: the rise in colorectal cancers among young people.
While the overall rate of colon or rectal cancer has dropped since the 1980s, it has increased about 2 percent a year in people under 55, according to the American Cancer Society (ACS). And it remains the second leading cause of cancer deaths, the society says.
“I think this is something we’re starting to get out to physicians and the community: that even young people can have colon cancer,” said Peter Hopewood, MD, FACS, a surgeon at Falmouth Hospital who specializes in cancer care.
Boseman also starred in “42,” about baseball legend Jackie Robinson; “Marshall,” about Supreme Court justice Thurgood Marshall; and “Get on Up,” about singer James Brown. Although he was diagnosed in 2016 -- even before he was 40 -- Boseman never spoke publicly about his cancer, and continued working on films despite surgeries and chemotherapy, according to information released at his death.
His health struggle is one shared by more young people. The number of people between ages 30 and 39 diagnosed with colorectal cancer increased more than 50 percent between 2008 and 2017, said Dr. Hopewood, citing statistics from the National Cancer Database, a registry maintained by ACS and the American College of Surgeons.
The cause for the increase seems to be a number of factors, he said, including family history, sedentary lifestyles, obesity rates, genetics, diets low in fiber and high in processed foods, and even our decrease in the use of aspirin and non-steroidal anti-inflammatory drugs, such as ibuprofen, that decrease the incidence of colon polyps.
“Colon cancer is very uncommon in the other half of the globe,” Dr. Hopewood said. “This is a disease of the Western Hemisphere.”
Know Your Colon Cancer Facts
Here are five more things to know about colorectal cancer, because knowledge is the best superpower:
- Your colon is shaped a bit like a broad, collapsed question mark. Your appendix is at one end, and your rectum and anus are at the lower part. Rectal cancer is also increasing in younger people and makes up most of the colorectal cancers detected in people under 50, Dr. Hopewood said.
- Symptoms of colorectal cancer, according to the ACS, include
- A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days,
- Blood in your stool,
- Persistent stomach cramps or pain,
- Unintended weight loss,
- The feeling that you need to have a bowel movement that's not relieved by having one
- Testing a stool sample for blood and
- Colonoscopy, in which you are sedated, and the doctor uses a thin, flexible, lighted tube to check for polyps or cancer inside the rectum and the entire colon. Colonoscopy also allows the doctor to remove any precancerous polyps.
- The ACS recommends those at average risk be screened for colorectal cancer beginning at age 45. There are two main methods
Doctors used to recommend the first colonoscopy screening at 50, Dr. Hopewood said, but that’s starting to creep back to age 45. “It becomes more of a conversation with your doctor looking at risk factors but also knowing if you have some cramps, a little blood in your bowels, it may not be hemorrhoids, it may be something serious. When you have your annual exam, there’s no reason not to have either a rectal exam and check for blood or send off a stool sample in a 40-to-45-year-old. And if you have a significant family history, then consider getting a colonoscopy in your mid-40s, before you are 50.”
- Pay attention to family history, Dr. Hopewood said. Genetic testing may indicate a tendency toward polyps, for example. “We usually recommend screening 10 years before the youngest member of your family developed cancer. So, if you had a parent who was 55 when they had colon cancer, you probably should get screened when you’re 45.”
- Don’t be lulled into complacency by a lack of family history of colorectal cancer. “You’ve got to remember the environmental factors, the things that you might be exposed to or have had something that might trigger it in you,” Dr. Hopewood said.
And don’t be put off by the idea of colonoscopy or its prep. Talk with your doctor. At least get checked for blood in the stool.
“Remember,” Dr. Hopewood said, “the best screening is any screening.”