- Coming up after the break,
the cancer that killed
after Chadwick Boseman
is one of the most common
forms of the disease.
Next, what you should know
about detecting colon cancer
before it kills.
Your streaming CBSN.
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Fans are reeling from the shocking news
of actor Chadwick Boseman's
sudden passing on Friday
from colon cancer.
The actor was famous for iconic
roles like Jackie Robinson,
Thurgood Marshall, and to
T'Challa, the King of Wakanda.
The tweet that described his legacy
and announced his passing
became the most liked post
in Twitter history.
Twitter made note of the record writing,
"Most like tweet ever.
A tribute fit for a King."
Along with Black Panther,
Boseman portrayed some of
the most important people
in civil rights history.
Our Michael George looks back at a decade
of stardom cut short
and the inspiring legacy
that he left behind.
- [Michael] Chadwick Boseman
brought black heroes to life
on the big screen.
A young Thurgood Marshall,
James Brown in "Get On Up",
(indistinct singing)
Jackie Robinson in "42."
- Give me a number on my
back, I'll give you the guts."
- [Michael] Marvel superhero
who broke barriers.
- Wakanda forever!
- [Michael] Boseman's
death stunned Hollywood
and fans everywhere.
His family says the
cause was colon cancer,
diagnosed four years ago,
a private battle endured while performing
in some of his biggest role.
If "42" was his breakout role,
the 2018 blockbuster "Black
Panther" changed everything.
(speaking indistinctly)
For so many black boys and girls
it was the first time they
saw a superhero on screen
who looked like them.
- It's taking on his
own meaning right now.
I'm seeing that it's
a cultural experience.
- [Michael] Today actress
Viola Davis tweeted,
"No words to express my
devastation of losing you."
Boseman also spoke out
against racial injustice,
defending Colin Kaepernick
for taking a knee.
- We're in a period of time
where people have to decide
what is patriotism?
- [Michael] His last
tweet, a message of support
for vice presidential
nominee Kamala Harris.
Former president Obama says,
"To be young, gifted, and black,
to use that power to give
them heroes to look up to,
to do it all while in pain.
What a use of his yearS."
Boseman died at home in Los
Angeles, his family at his side.
Michael George, CBS News.
- Boseman's colon cancer was
diagnosed four years ago,
but kept private and
his unexpected passing
has brought renewed public attention
to the third, most common type of cancer
in the United States.
To talk about the disease that
cut toward the actor's life,
I want to bring in Dr. David Spigel.
He's an oncologist and
chief scientific officer
at the Sarah Cannon
Cancer Research Institute.
And he joins us now from
Nashville, Tennessee.
Dr., it's good to have you with us.
- Yeah, thanks for having me.
- Chadwick Boseman was just 30
thank you.
He was just 39 when he was diagnosed.
How common is colon cancer
in someone that young?
- Well, it's uncommon.
I mean, most young
people don't get cancer.
Colon cancer can occur at any age,
but it typically occurs
after the age of 50
and actually in most patients
are over the age of 65.
But there can be patients
who are diagnosed
below the age of 50.
In fact, this is probably
the most concerning trend
over the last several years is an increase
in the identification of
patients under the age of 50.
- I wonder if because of that,
there might be a change
in the recommendations.
The American Cancer
Society is recommending
that the average person begin
regular screenings at age 45.
As we discussed Boseman was
diagnosed with an advanced case
in his late thirties.
Overall, are we screening enough?
Are we screening at a young enough age?
Can everyone who needs a
test or wants a test get one?
- Well, it's a great question.
We've been under the impression
that cancer occurs later.
So screening can occur later
and 50, as you point out
used to be the cutoff.
In fact, it's still the cutoff
for colonoscopy recommendations
for both men and women.
But as you pointed out in 2018,
the American Cancer Society
changed the recommendations
and increased or lowered
the age cutoff to 45.
Some have even wondered
whether African-Americans
should have a lower cutoff of 45 also,
but still some controversy
about the right age.
And certainly below the age of 45
is not a standard recommendation
unless there's some
personal family history,
strong history, otherwise.
- I'm glad you brought up that last point
about African-Americans and
perhaps changing their date
of screening because they
have higher mortality rates
from colon cancer, even after
adjusting for comorbidities.
What accounts for this
and is the age of screening different?
Does it tend to be younger
for African-American males
than their white counterparts?
- Well, we know that young
African-American males
will have a higher risk of colon cancer.
So if you look...
let me say that another way.
If you look at young people
who have colon cancer,
an African-American individuals
more likely to have that.
We know that colonoscopy can find it.
We don't know what causes it though.
We think about things like
dietary lifestyle changes,
family history, as I've mentioned,
but at the end of the day
we don't know why it would
be that younger individuals
would be at a higher risk of colon cancer.
Moreover, we don't know
why African-Americans
would be at a higher risk than Caucasians.
It's just not clear.
There's a lot of folks looking
at this issue in particular,
kind of an emerging topic
is something called the microbiome,
kind of this innate colonization
of bacteria in the bowel.
And maybe changes in that
over the last 10 or 20 years
has something to do with the
changes in incident rates.
But the bottom line is we don't know,
we don't have a good explanation.
And so screening is really our only tool
to try to find cancer early
to do something about it.
- Well, in the case of Mr. Boseman,
his cancer was at stage
three when it was discovered.
Could you briefly tell us
about the different stages
of colon cancer and the warning signs?
- Yeah, sure.
So for like any cancer we
try to know where it is
and it starts with
something called staging.
And so most individuals
are probably familiar
with the term called stage four,
which means advanced
or metastatic disease.
And that implies cancer
that has already spread
to some other location
from where it started.
Stage three cancer in
the case of Mr. Boseman
implies a cancer that was in
what are called the lymph nodes
or glands outside of the colon.
And then the stages go down from there
in terms of less spread
through the bowel wall
and then a then a smaller lesion.
We know that for younger individuals
who often don't think that
they might have cancer
and certainly their
physicians managing them
don't necessarily expect that
that when they do get diagnosed,
it can be at a later stage.
And so stage three,
certainly a curable stage is
still a higher risk stage.
And of course, stage four
cancer is when cancer has spread
and in general is not gonna
be a curable condition.
But all stages of cancer
of course are treatable.
And we don't have a lot of
details about Mr. Boseman's care,
what has happened over
the last four years,
but not really an unusual story
to be diagnosed with cancer
and to fight it.
What's a bit unusual I've learned
is how quiet he kept this story
and really how heroic he
was at fighting through that
without really a lot of people
around him knowing about it.
- Truly heroic.
The movies that he was filming
while all of this was going on,
his strength and power while
he was battling so hard
against this colon cancer.
Obviously colon cancer
occurs more often in men
and we're talking about
a man in this case,
but it's obviously worth a
reminder also that 25,000 women
die from it annually.
I truly don't know,
are there any differences
between men and women
in terms of how it presents,
some of the symptoms that people
want to be looking out for?
- Yeah.
You asked me about that
earlier and I apologize.
I didn't get to that.
So what are the symptoms?
Well, it depends on the stage, right?
So if somebody had advanced cancer
where to spread to say another organ,
the symptoms that present
to a person or family
or their physician might be related
to where that cancer spread
to say another organ.
For early stage cancer,
stage one, two or three,
sometimes it can be subtle.
It might be changes in the bowel habits.
It might be blood in the stool.
It might be bright blood,
or it might be black kind of black tarry
coloring to the stool,
which now which can be
a surprise, of course,
a big change for individuals.
For more advanced disease
it might be a change in weight
or a change in appetite,
but I guess the bottom
line is it can be subtle.
And for that reason we have to screen,
we have to go looking for cancer.
In terms of gender issues,
so it's important to note
for both men and women
it is the third, most
common cancer that we see.
But we bet 150,000 individuals
will be diagnosed with colon cancer.
In an average year, about
40 to 50,000 of individuals
will die from colon cancer.
So you can see most fortunately
get diagnosed hopefully early enough
that they can be cured from it,
but there still are a
large number of individuals
who will die from colon cancer.
I don't think we know that
there's a true difference
in gender that's been discussed.
There might be some reasons
in terms of biology for that,
but like with African-Americans
and Caucasians,
we really don't understand that well,
and it's important to say this,
that for both men and women
there is no difference in
how you should be screened.
Both men and women should
undergo colonoscopy.
That is the best tool
we can use to find it,
whether that's at age 45 or 50,
I think depends on some
of these guidelines.
I personally think that 45
is probably more appropriate guideline
for both men and women across the board.
- [Lana] All right Dr. David Spigel,
thank you for joining
us, chief medical officer
at the Sarah Cannon
Cancer Research Institute.
- Thank you.
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