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​Nourish + WELL

Long Live the King

8/30/2020

 
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If only there were a heart shaped herb for the shining light that briefly graced the Earth.

The shock and devastating loss of actor Chadwick Boseman at the age of 43 from colon cancer is still unbelievable. His  journey began in South Carolina with a pivotal stop at Howard University and then  on to Hollywood where his leading roles in 42, Get On Up, Marshall,  Civil War, Black Panther , 21 Bridges and Da 5 Bloods  will live forever in our collective memories and on screens big and small. His portrayal of the Marvel superhero Black Panther,King  T'Challa  of Wakanda, along with a  cast of exceptional actors, delivered a self reflective, dignified, historic performance from a man described by many as humble,  courageous, disciplined ,multitalented and regal . 


Colon cancer is the third most common cancer in the US, the second leading cause of cancer deaths,  and  for an unknown reason, rates are increasing in younger adults with a disproportionate burden on African -Americans. African Americans continue to have the highest incidence and mortality rates from colon cancer with ongoing research to understand the predisposing factors.  Age >50, genetics,  inflammatory bowel disease such as ulcerative colitis, family history of colon polyps and cancer, and  specific lifestyle factors all increase the risk for  precancerous colon polyps and colon cancer.

Lifestyle risk factors - tobacco , alcohol use, obesity , lack of physical activity, low fiber, high  fat and processed meats -are also contributing risk factors for colon cancer. After colon cancer is diagnosed, an increased fiber intake may increase survival rates. Fiber rich foods- vegetables, food and whole grains- can all  help  maintain an ideal weight and lower your risk of colon cancer.  The benefits of fiber along with adequate water intake are well known. Soluble fiber helps maintain a sense of fullness  and satiety while insoluble fiber aids in food transit through the gastrointestinal track. 

The diagnosis of colon cancer has evolved over the years with a new  home screening option to detect blood  and abnormal DNA in a stool specimen- a sign of precancerous  colon polyps and cancerous colon tumors. Cologuard  is a home screening test  that detects blood and DNA from  precancerous  and cancerous polyps  and tumors.  A virtual   colonoscopy is a radiographic study that uses a CT scan  and X-ray images to  recreate 3D
images of the colon for review by a radiologist.  The gold standard screening and diagnostic test for colon cancer is a full colonoscopy  which offers a direct view of the colon and the possibility for colon polyp removal and biopsy.  A colonoscopy is  typically performed  by a gastroenterologist in an outpatient center under intravenous sedation; in  99% of  cases you will not remember any of the procedure. 

What age should you undergo a screening  colonoscopy or home screening? Symptoms such as change in bowel habits, noticeable blood in the stool, on toilet paper or in the toilet, family history of colon cancer and the presence of inflammatory bowel disease all warrant a discussion with your primary care physician and possible referral to a gastroenterologist. Self-advocacy  with your physician and, in some cases, your insurance company is a necessary skill to navigate the  current US healthcare maze. Colonoscopy screening is recommended at age 45 by the American Cancer Society for those without symptoms or increased risk factors. A  screening colonoscopy is  then recommended every 3 years if there are no increased risk factors. 

If there is a family history of colon cancer, screening colonoscopy is recommended at age 40 or 10 years younger than the age of diagnosis of your family member according to the American Cancer Society.. A colonoscopy is may also be recommended based on symptoms, physical exam findings, physician recommendation, and other individual risk factors. 

Recommendations  for colon cancer screening can change based on risk factors and symptoms and physical exam findings.  Once a diagnosis is made, the cancer is staged based on whether it is localized to the colon , Stage 1, spread to the colon wall, Stage 2, spread outside the colon wall , Stage 3  spread to the lymph nodes and  Stage 4, spread to distant organs and tissue. 

Colon cancer treatment varies with each patient and each stage of the cancer. In the 21st century, specific tumor markers can help oncologists determine the best course of chemotherapy if needed. Life after a diagnosis of colon cancer varies depending on the stage but a survivorship care plan can help outline recommended tests, appointment, lifestyle changes, and understand possible treatment side effects. 

Nourish Well. Eat more veggies, fruit, whole grains like barley, oatmeal, brown rice, nuts and seeds. Move more. Learn about the health of other family members and share information that may be helpful.Develop a plan to quit smoking. Limit alcohol usage. 

Below, Dr. Rachel Issaka, a gastroenterologist at the Fred Hutchinson Cancer Center  at the University of Washington, discusses the increasing incidence  of colon cancer in Black Americans and the importance of colon cancer screening. 

Our communities are reeling from the death of Chadwick Boseman. #colorectalcancer can affect anyone, but disproportionately impacts Black people. This short PSA includes facts about #screening and what we can all do. pic.twitter.com/4Wx3IHTnWG

— Rachel Issaka, MD MAS (@IssakaMD) August 30, 2020

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