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    Wakanda Forever – Take Action

    by Ngozi Osuagwu, MD | August 30th, 2020

    Wakanda Forever – Take Action

    I woke up Saturday morning to the following alert –

    ‘Black Panther’ actor Chadwick Boseman dies at 43.

    My initial thought was COVID and then I read on – cause of death – colon cancer. He was diagnosed in 2016 at the age of 39 with stage 3 colon cancer and then died four years later. So many questions came to mind – how did this happen? Did he have symptoms and ignored them? Does he have a family history of colon cancer? What does this all mean?

    Colon cancer is the third most common cancer diagnosed in both men and women in the United States. African-Americans are more likely to get colon cancer and die from colon cancer. They tend to get it at a younger age.  Black men are more affected than black women. When the cancer is found, it is usually found at an advanced stage.

    Although there continues to be research trying to find out why African-Americans are more affected, there are things that each one of us can do:

    1. Recognize the symptoms – If you have these symptoms, talk to your health care provider and it is okay to say that “I am worried about colon cancer”. It will be up to the health care provider to inform you of what they are doing to find out the cause of your symptoms.
      1. A change in bowel habits such as diarrhea, constipation, or narrowing of the stool, that last more than a few days
      1. A feeling that you need to have a bowel movement that is not relieved by having one
      1. Rectal bleeding with bright red blood
      1. Blood in the stool, which might make the stool look dark brown or black
      1. Discomfort in the abdomen (belly), including frequent gas pains, bloating, fullness, and cramps
      1. Constant tiredness or fatigue
      1. Weight loss with no known explanation
      1. If you are anemic (low blood count) and there is no obvious reason why
    2. Get screened for colorectal cancer – Most people without any risk factors should get screened at 45 years old. It used to be 50 years old but because colon cancer is being diagnosed in younger people, it has been changed to 45 year old and for African-Americans, the American College of Physicians is recommending age 40. A screening test is a test that you get before you have symptoms so some insurance companies may not pay before age 45 unless you have symptoms.  Call your insurance company to find out if it will be covered before age 45. If they give you a hard time, you might have to share the statistics of being in a high risk category.  The colonoscopy is the gold standard screening test. I know some people are scared of having this done and studies have shown that black men are more fearful than any other group of people. There are other screening tests and doing one of these tests is better than not doing any.  If any of these other tests come back positive, you will need the colonoscopy.
      1. Stool test
      1. Flexible sigmoidoscopy – I am not a big fan of this test. If you are going to have a tube go through your rectum, it is best to get a colonoscopy. Also, African-Americans tend to have their cancer on the right side of their intestine and this test does not get to the right side.
      1. Flexible sigmoidoscopy with stool testing
      1. Multi-targeted stool DNA testing  – Cologuard®
      1. CT colonography
    3. Know your family history – If you have a family history of colon cancer, you should be getting your screening test  at least 10 years earlier than when the relative was diagnosed. For example, in the case of Mr. Boseman, if he had siblings or children, they should be screened by age 29 years old.
    4. Make changes to your diet – Eating more red meat and processed meat puts you at risk for getting colon cancer. I really think it may be time to stop the bacon, ham, lunch meats, meat jerky, hot dogs, salami, and other cured meat products.  A diet rich in fruits and vegetables will help lower the risk of colon cancer. We also want to increase our fiber and water intake to help have regular bowel movements.
    5. Exercise, exercise, exercise – Mr. Boseman was relatively in shape when he was diagnosed with the cancer. He was in nine movies from the time he was diagnosed to his death. That is just amazing. I believe the reason he was able to go through surgery and chemotherapy and still do his work is because he was in shape prior to the diagnosis.

    The questions I asked earlier may never be completely answered. We will never know all that happened. All we can do is do our best to do our part. Please take action. Please share the information.

    “Wakanda forever”

    For more information on colon cancer see below:

    My journey – I blogged on my experience having a colonoscopy.

    It is not every day I get to talk about poop

    American Cancer Society

    American Society of Clinical Oncology

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