Colorectal Cancer is back in the spotlight with the tragic demise of the “Black Panther” star, Chadwick Boseman. Learn more about his cancer including its incidence and death rates, symptoms, treatment and risk factors and the possible impact that different foods and supplements can have on colorectal cancer risk and treatments.
The tragic and untimely death of Chadwick Boseman, best known for his role as “King T’Challa” in the 2018 movie “Black Panther” from the Marvel Cinematic Universe, has sent shockwaves around the world. After a four year battle with colon cancer, the Hollywood actor died on 28th August 2020 due to complications related to the illness. Boseman was only 43 when he succumbed to the disease. The news of his death left the world stunned, as Boseman kept his battle with colon cancer private and persevered through it all.
According to the statement provided by his family on social media, Chadwick Boseman was diagnosed with Stage 3 colon cancer in 2016 which eventually progressed to Stage 4, indicating that the cancer had spread to other parts of the body beyond the digestive tract. During his cancer treatment which involved multiple surgeries and chemotherapy, Boseman continued to work and brought us several films including Marshall, Da 5 Bloods, Ma Rainey’s Black Bottom and many others. While battling his own cancer privately, a very kind and humble Chadwick Boseman had visited children who were diagnosed with cancer at the St. Jude Children’s Research Hospital in Memphis, in 2018.
Chadwick Boseman died in his home with his wife and family by his side. After the shocking news of his death, tributes poured in on social media from his co-actors and fans all over the world.
The tragic death of Boseman at a young age of 43, has put colon cancer back into the spotlight. Here is all that we should know about Chadwick Boseman’s Cancer.
All About Boseman’s Cancer
What are Colon and Colorectal Cancers?
Colon cancer is a type of cancer that arises from the inner wall of the large intestine known as colon. Colon cancers are often grouped with rectal cancers which arise from rectum (the back passage) and are collectively called colorectal cancers or bowel cancers.
Globally, colorectal cancer is the third most commonly occurring cancer in men and the second most commonly occurring cancer in women (World Cancer Research Fund). It is also the third most deadly and fourth most commonly diagnosed cancer in the world (GLOBOCAN 2018).
The National Cancer Institute estimated 1,47,950 newly diagnosed colorectal cancer cases in the United States in 2020, including 104,610 colon cancer and 43,340 rectal cancer cases. (Rebecca L Siegel et al, CA Cancer J Clin., 2020)
What are the symptoms of Colorectal Cancer?
Colorectal cancer mostly starts as small growths on the inner lining of the colon or rectum called polyps. There are two types of polyps :
- Adenomatous polyps or adenomas – which can turn into cancer
- Hyperplastic and inflammatory polyps – which generally do not turn into cancer.
Since polyps are usually small, many people with colorectal cancer may not experience any symptoms during the early stages of the cancer.
Some of the signs and symptoms reported for colorectal cancer are: change in bowel habits such as diarrhea, constipation, or narrowing of the stool that persists for many days, blood in the stool, stomach cramps, weakness and fatigue and unintended weight loss. Many of these symptoms can be caused by health conditions other than colorectal cancer, such as irritable bowel syndrome. However, it is important to consult your doctor if you experience any of these signs and symptoms associated with colorectal cancer.
What are the chances of developing Colorectal Cancer?
According to the American Cancer Society, 1 in 23 men and 1 in 25 women are at risk of developing colorectal cancer. Older people above 55 years of age are more prone to developing colorectal cancer. With recent advances in medical sciences, colorectal polyps are now detected more often by screening and removed before they can develop into cancers.
However, the American Cancer Society added that, while the incidence rate in older people aged 55 years or above has dropped by 3.6% each year, it has increased by 2% each year in the younger group aged below 55 years. The increased colorectal cancer incidence rate in the younger people may be attributed to lesser routine screening in this group owing to lack of symptoms, unhealthy lifestyle and intake of high fat, low fiber foods.
Can someone so young as Chadwick Boseman die of Colon Cancer?
Let us see what the stats say!
With improved treatments for colorectal cancer and routine screening to diagnose the cancer at an earlier stage (which is easier to treat), the overall death rate has continued to drop over the years. However, according to the American Cancer Society, the deaths from colorectal cancer among people aged below 55 years have increased 1% per year from 2008 to 2017.
The American Cancer Society has also highlighted that among all racial groups in the United States, African Americans have the highest colorectal cancer incidence and mortality rates. A person is also at risk if one of his/her blood relatives had colorectal cancer. If more than one member from the family had colorectal cancer, the person is at a higher risk of developing the disease.
According to the details shared in social media, at the time of diagnosis, Chadwick Boseman’s cancer was categorized as a Stage III colon cancer. This means that the cancer has already grown through the inner lining or into the muscle layers of the intestine and has either spread to lymph nodes or to a nodule of tumor in tissues around the colon that do not appear to be lymph nodes. The chances of surviving this cancer largely depends on when it is diagnosed. If Chadwick Boseman had experienced symptoms earlier and screening was done much before, probably, the doctors could have removed the polyps before it turned into colorectal cancer or could have caught the cancer at an earlier stage which is much easier to treat.
The American Cancer Society recommends that people at an average risk of colorectal cancer should start regular screening at the age of 45.
Can we control certain risk factors to stay away from Chadwick Boseman’s Cancer ?
Some of the risk factors for colorectal cancers including age, racial and ethnic background, personal and familial history of colorectal polyps or colorectal cancer, history of inflammatory bowel disease, type 2 diabetes and inherited syndromes linked with colorectal cancers, are not under our control (American Cancer Society).
However, other risk factors such as being overweight/obese, lack of physical activity, unhealthy eating patterns, intake of wrong foods and supplements, smoking and drinking alcohol, can be managed/controlled by us. Following a healthy life-style along with taking the right nutrition and doing regular exercises can help us reduce the chances of developing cancer.
Can Genomic testing help in identifying the chances of developing Colorectal Cancer?
According to the American Cancer Society, approximately 5% of people who develop colorectal cancer have inherited gene mutations that cause different syndromes linked to colorectal cancer. Genetic testing can help to identify whether a person has inherited gene mutations that can cause such syndromes which can lead to colorectal cancer including Lynch syndrome, familial adenomatous polyposis (FAP), Peutz-Jeghers syndrome and MUTYH-associated polyposis.
- Lynch syndrome, which accounts for about 2% to 4% of all colorectal cancers, is mostly caused by an inherited defect in either the MLH1, MSH2 or MSH6 genes which normally help to repair the damaged DNA.
- Inherited mutations in the adenomatous polyposis coli (APC) gene are linked to familial adenomatous polyposis (FAP) which accounts for 1% of all colorectal cancers.
- Peutz-Jeghers syndrome, a rare inherited syndrome linked to colorectal cancer, is caused by mutations in the STK11 (LKB1) gene.
- Another rare inherited syndrome called MUTYH-associated polyposis often leads to cancer at a younger age and is caused by mutations in the MUTYH gene, a gene involved in “proofreading” the DNA and fixing any mistakes.
Genetic test results can provide your health care professionals with important information which can help them plan and make better decisions for you, even before the onset of the disease. This can also help young people with a familial history of colorectal cancer, to avoid getting diagnosed at later stages when the cancer has already spread to other parts of the body.
Can Foods/Supplements impact Colorectal Cancer Risk or Colorectal Cancer Treatment?
Researchers across the world have carried out many studies and meta-analyses to evaluate the association of various foods and supplements with the risk of developing Colorectal Cancer and their impact on cancer patients. Let us have a look at the key findings of some of these studies!
Foods/Supplements that may decrease Colorectal Cancer Risk
- Dietary Fiber/Whole Grains/Rice bran
- In a recent meta-analysis done by the researchers from Henan, China, they found that when compared to those with the lowest whole grain intake, people with the highest-intake may have a significant reduction in colorectal, gastric and esophageal cancers. (Xiao-Feng Zhang et al, Nutr J., 2020)
- In another meta-analysis done by the researchers of South Korea and the United States in 2019, they found that all dietary fiber sources may provide benefits in colorectal cancer prevention, with the strongest benefit found for dietary fiber from cereals/whole grains.(Hannah Oh et al, Br J Nutr., 2019)
- A study published in the Nutrition and Cancer Journal in 2016 suggested that adding rice bran and navy bean powder to the meals may alter the gut microbiota in a way that can help in reducing the risk of colorectal cancer. (Erica C Borresen et al, Nutr Cancer., 2016)
In a meta-analysis done by the researchers from Wuhan, China, they found that a higher consumption of legumes such as peas, beans and soybeans may be associated with a reduced risk of colorectal cancer, especially in Asians. (Beibei Zhu et al, Sci Rep., 2015)
- Probiotic Foods/Yogurt
- Researchers from China and the United States analyzed data from 32,606 men in the Health Professionals Follow-up Study (HPFS) and 55,743 women in the Nurses’ Health Study (NHS) and found that taking yogurt twice or more per week had a 19% reduction in the risk for conventional colorectal polyps and 26% reduction in risk for serrated polyps in men, but not in women. (Xiaobin Zheng et al, Gut., 2020)
- In another study, the researchers from the United States analyzed data from 5446 men in the Tennessee Colorectal Polyp Study and 1061 women in the Johns Hopkins Biofilm Study and concluded that yogurt intake may be associated with a decreased risk of both hyperplastic and adenomatous (cancerous) polyps. (Samara B Rifkin et al, Br J Nutr., 2020)
- Allium Vegetables/Garlic
- A meta-analysis carried out by the researchers of Italy found that a high garlic intake may help in reducing the risk of colorectal cancer and a high intake of different allium vegetables may be associated with a decrease in the risk of colorectal adenomatous (cancerous) polyps. (Federica Turati et al, Mol Nutr Food Res., 2014)
- A hospital-based study done by researchers of the Hospital of China Medical University between June 2009 and November 2011, found a decreased colorectal cancer risk in both men and women with a high consumption of different allium vegetables including garlic, garlic stalks, leek, onion, and spring onion. (Xin Wu et al, Asia Pac J Clin Oncol., 2019)
Researchers from the University of Southern Denmark analyzed data from a large cohort study including 57,053 Danish people and found that a very high intake of raw, uncooked carrots might be beneficial in reducing colorectal cancer risk, but consuming cooked carrots might not reduce the risk. (Deding U et al, Nutrients., 2020)
- Magnesium supplements
- A meta-analysis of 7 prospective cohort studies found a statistically significant association of reduction in the risk of colorectal cancer with Magnesium intake in the range of 200-270mg/day. (Qu X et al, Eur J Gastroenterol Hepatol, 2013; Chen GC et al, Eur J Clin Nutr., 2012)
- A study that looked at prospective association of serum and dietary Magnesium with colorectal cancer incidence, found a higher risk of colorectal cancer with lower serum Magnesium among females, but not males. (Polter EJ et al, Cancer Epidemiol Biomarkers Prev, 2019)
In a meta-analysis done by the researchers of Korea, they found that a high consumption of nuts such as almonds, peanuts and walnuts may help in decreasing the risk of colorectal cancer among women and men.(Jeeyoo Lee et al, Nutr J., 2018)
Impact of different Foods/Supplements in Colorectal Cancer Patients
- Curcumin helps to improve FOLFOX chemotherapy response
A recent clinical trial done on patients with metastatic colorectal cancer (NCT01490996) found that the combination of Curcumin, a key ingredient found in the Turmeric spice, along with FOLFOX chemotherapy treatment may be safe and tolerable in colorectal cancer patients, with the progression free survival 120 days longer and overall survival more than doubled in patient group which received this combination, compared to the group that received FOLFOX chemotherapy alone (Howells LM et al, J Nutr, 2019).
- Genistein may be safe to take along with FOLFOX chemotherapy
Another recent clinical study done by the researchers at the Icahn School of Medicine at Mount Sinai, in New York has demonstrated that it is safe to use the soy isoflavone Genistein supplement along with FOLFOX chemotherapy for the treatment of metastatic colorectal cancer, with an improved best overall response (BOR) in patients taking the chemotherapy along with Genistein (61.5%), when compared to BOR reported in earlier studies for those undergoing chemotherapy treatment alone (38-49%). (NCT01985763; Pintova S et al, Cancer Chemotherapy & Pharmacol., 2019; Saltz LB et al, J Clin Oncol, 2008)
- Fisetin supplementation may reduce Pro-Inflammatory Markers
A small clinical study by the medical researchers from Iran showed the benefits of the flavonoid fisetin, from fruits such as strawberries, apples and grapes, on reducing pro-cancer inflammatory and metastatic markers such as IL-8, hs-CRP and MMP-7 in colorectal cancer patients when given along with their adjuvant chemotherapy. (Farsad-Naeimi A et al, Food Funct. 2018)
- Wheatgrass Juice may reduce chemotherapy associated vascular damage
A recent study done by the researchers of Rambam Health Care Campus in Israel demonstrated that wheatgrass juice given to stage II-III colorectal cancer patients along with their adjuvant chemotherapy may reduce the chemotherapy associated vascular damage, while having no impact on overall survival. (Gil Bar-Sela et al, Journal of Clinical Oncology, 2019).
- Magnesium along with adequate levels of Vitamin D3 may reduce all cause mortality risk
A recent study found a decreased all-cause mortality risk in colorectal cancer patients with a higher intake of Magnesium along with adequate levels of Vitamin D3 when compared to patients who were Vitamin D3 deficient and had a low intake of Magnesium. (Wesselink E, The Am J of Clin Nutr., 2020)
- Probiotics may help in preventing postoperative infections
A meta-analysis done by the researchers in China found that intake of probiotics may contribute to the reduction of overall infection rate after colorectal surgery. They also found that the incidence of surgical wound infections and pneumonia were also reduced by probiotics.(Xiaojing Ouyang et al, Int J Colorectal Dis., 2019)
- Probiotic Supplementation may reduce Radiation-induced diarrhea
A study done by the researchers from Malaysia found that, compared to those who didn’t take probiotics, the patients who took probiotics were associated with a lower risk of radiation-induced diarrhea. However, the study didn’t find any significant reduction in radiation-induced diarrhea in patients receiving both radiation therapy and chemotherapy. (Navin Kumar Devaraj et al, Nutrients., 2019)
- Polyphenol Rich Foods/Pomegranate Extract may reduce Endotoxemia
Unhealthy diet and stress levels can increase the release of endotoxins in the blood that trigger inflammation and could be a precursor to colorectal cancer. A clinical study conducted by a hospital in Murcia, Spain found that consuming polyphenol rich foods such as pomegranate can help in lowering endotoxemia in newly diagnosed colorectal cancer patients. (González-Sarrías et al, Food and Function 2018 )
Foods/Supplements that may increase Colorectal Cancer Risk or harm Cancer Treatment
- Red and Processed Meat
- Analysis of data from 48,704 women aged between 35 to 74 years who were participants of the US and Puerto Rico-based nationwide prospective cohort Sister Study found that a higher daily intake of processed meats and barbecued/grilled red meat products including steaks and hamburgers were associated with an increased risk of colorectal cancer in women. (Suril S Mehta et al, Cancer Epidemiol Biomarkers Prev., 2020)
- The researchers of China evaluated the causes of colorectal cancers in China and found that the third major cause was high intake of red and processed meat which accounted for 8.6% of colorectal cancer incidence. (Gu MJ et al, BMC Cancer., 2018)
- Sugary Drinks/Beverages
Regular intake of sugary drinks and beverages results in high blood sugar levels. In a retrospective study done by the researchers in Taiwan, they found that high blood sugar levels can impact the oxaliplatin treatment outcomes in Colorectal cancer patients. (Yang IP et al, Ther Adv Med Oncol., 2019)
Researchers of the University of Tromsø-The Arctic University of Norway and Danish Cancer Society Research Center, Denmark evaluated data from 79,778 women aged between 41 and 70 years in the Norwegian Women and Cancer study and found that a high potato consumption may be associated with a higher risk of colorectal cancer. (Lene A Åsli et al, Nutr Cancer., May-Jun 2017)
- Vitamin B12 and Folic Acid supplements
Analysis of data from a clinical trial study named the B-PROOF (B Vitamins for the Prevention of Osteoporotic Fractures) trial done in Netherlands found that long term folic acid and vitamin-B12 supplementation was associated with a significantly higher risk of colorectal cancer. (Oliai Araghi S et al, Cancer Epidemiol Biomarkers Prev., 2019).
A meta-analysis done by the researchers of Zhejiang University School of Public Health, China found that heavy alcohol drinking corresponding to ≥50 g/day of ethanol may increase the risk of colorectal cancer deaths. (Shaofang Cai et al, Eur J Cancer Prev., 2014)
A recent meta-analysis of 16 studies which included 14,276 colorectal cancer cases and 15,802 controls found that very heavy drinking (more than 3 drinks/day) may be associated with a significant increase in colorectal cancer risk. (Sarah McNabb, Int J Cancer., 2020)
Chadwick Boseman’s tragic demise from colon/colorectal cancer at the age of 43 has raised awareness about the risk of developing this disease earlier in life (with minimal symptoms in early stages). If you have a family history of cancer, get a genetic test done to ensure that you have not inherited the gene mutations associated with certain syndromes that can lead to colorectal cancer.
While undergoing treatment or trying to stay away from cancers such as the one Chadwick Boseman succumbed to, taking the right nutrition which includes the right foods and supplements matters. Following a healthy life-style and diet including fiber rich foods such as whole grains, legumes, vegetables, nuts and fruits, along with doing regular exercises may help in reducing the risk of cancers such as colorectal cancer, supporting the treatment and alleviate its symptoms.
Cancer patients often have to deal with different chemotherapy side effects which affect their quality of life and look out for alternative therapies for cancer.Taking the right nutrition and supplements based on scientific considerations (avoiding guesswork and random selection) is the best natural remedy for cancer and treatment related side-effects.