On August 28, 202o, the world lost Chadwick Boseman to colon cancer. He was 43.
His death shed light on how an illness that is typically associated with older people can also affect the young. Boseman was diagnosed with Stage 3 colon cancer in 2016 at the age of 43. He looked healthy and strong – based on his portrayal of iconic characters like baseball legend Jackie Robinson in 42, Godfather of Soul James Brown in Get On Up, and the mighty T’Challa in Black Panther.
“Chadwick Boseman’s death is a wake-up call,” says Carlo M. Cornejo, MD, Chair of the Department of Gastroenterology of the top hospital in the Philippines, Makati Medical Center (MakatiMed). “He showed us that colon cancer can occur in young people, and we must be vigilant in identifying red flags in our patients so that appropriate diagnostic tests can be performed.”
Filipinos are particularly at risk for colon cancer. According to Globocan 2020, an online database containing global cancer statistics and estimates of incidence and mortality for 36 types of cancers in 185 countries, colorectal cancer is the third most common cancer in the Philippines, after breast and lung cancer. In males, it is the second most frequent malignancy after lung cancer; among females, it ranks third after breast and cancer of the cervix uteri. The Department of Health’s data and research show that colon cancer may be linked to a diet high in fat and low in grains, fruits, and vegetables. A personal or family history of colon cancer also raises the risk of developing it.
MakatiMed’s Dr. Cornejo enumerates three takeaways from Chadwick Boseman’s tragic death from colon cancer.
You’re never too young to get it. The actor is one among many under the age of 50 to be diagnosed with colon cancer. Individuals born after 1990 are twice as likely to develop colon cancer and four times as likely to develop rectal cancer, according to the US-based non-profit organization Colon Cancer Coalition.
The occurrence of colon cancer in the young is still an area of active research in the medical community. “Experts think it is due to heredity as well as unhealthy lifestyle choices such as eating processed foods and being sedentary,” explains Dr. Cornejo. “We’ve also seen young people with colon cancer who didn’t have any of these risk factors.”
Pay attention to persistent warning signs. It is thought that early colon cancer usually does not cause symptoms. By the time symptoms appear, the cancer has progressed to an advanced stage.
That is not to say the warning signs aren’t there. “See your doctor if you have iron deficiency anemia, blood in your stool, unexplained weight loss, or you move ‘pencil stools,’ which are long, thin stools caused by a tumor constricting the colon or rectum,” says Dr. Cornejo. “Cramping, abdominal pain, and a persistent change in your bowel habits are not to be taken lightly.”
If detected early, patients have a 90-percent survival rate at 5 years or more after diagnosis. Surgery is usually curative. Survival drops with later stages, and additional treatment with chemotherapy may be required. Survival drops between 10-20 percent with metastatic disease.
Get a colonoscopy. Young people without warning signs are typically not advised to undergo routine screening colonoscopies. “Find out if you need to be screened earlier by talking with your family physician, your primary healthcare provider, or your gastroenterologist,” says Dr. Cornejo. “The American Cancer Society recommends that average-risk adults start screening at age 45. Those at greater risk should start earlier and undergo surveillance colonoscopies more often.”
Colonoscopy remains the gold standard for colon cancer screening. Laxatives are used to cleanse a patient’s colon before inserting a colonoscope (an instrument with a camera at the tip that allows gastroenterologists to see the inside of the colon) into the patient’s rectum. Despite being invasive and occasionally requiring sedation, the procedure is safer and more accurate than other tests for the colon.
For Dr. Cornejo, Chadwick Boseman’s death made it easier to talk about gut and colon cancer. “He raised awareness about colon cancer and challenged the stereotype and perception of a person with the illness,” he adds. “It is past time we hold dialogue and normalize conversations about colon cancer. The sooner we evaluate patients who are experiencing symptoms, the sooner we can treat them and save lives.”