Health & Wellness

Survivor

The death of American actor and “Black Panther” star Chadwick Boseman shocked fans the world over. Even more stunning – it is reported he died as a result of complications related to cancer, four years after being diagnosed with stage three colon cancer. Boseman, who was 43 years old, had reportedly never spoken publicly of his illness.

This news was extremely disturbing for Terrell Cleare, 49, who was diagnosed with stage three colorectal cancer at age 42.

Cleare celebrated her eighth anniversary cancer-free on July 31.

“He [Boseman] was one of my favorite actors. When I first heard about it [Boseman’s death], I didn’t think it was cancer. When I first heard about his death, my daughter [Angel Cleare] came to me that night and said the actor from ‘Black Panther’ died, and she said ‘he died from the same cancer you had’. I got somehow depressed, and she [Angel] got a little sad, because she started thinking about what I went through.”

She told her daughter not to dwell on her former fight, adding that everyone has their time on earth, and that God decides when a person’s time is up. She says she let her daughter know that her time isn’t up yet because she’s still here.

Cleare, who was diagnosed at stage three, the same stage as Boseman, acknowledges that she went through a lot. But she recalled not vacillating in her decision making, which she said saved her life.

She was diagnosed on Thursday, July 31, 2012, after having a colonoscopy performed by Dr. Eugene Marcus Cooper at Gastro Care Bahamas, located at Centreville Medical Centre.

Two days later, on the Saturday, she underwent a nine-hour surgery to remove the softball-sized tumor from her colon.

“I didn’t waste time with making any decisions. I think because I had my surgery right away, it saved me,” said Cleare.

She recalls the doctors saying to her that after the tumor was removed, she might not have any colon left to use the bathroom normally, and that she would have to make use of a colostomy bag – a plastic bag that collects fecal matter from the digestive tract through an opening in the abdominal wall – for the rest of her life.

“After he said I wouldn’t be able to go to the bathroom again, I knew that if that had happened, I don’t think I could have survived,” Cleare told The Nassau Guardian yesterday.

“After he cut the tumor out, there was a way to save a small piece of colon, which allows me to still go to the bathroom naturally and regularly.”

Her doctors had thought the cancer had spread to her kidneys and liver, but it hadn’t. The cancer, however, was in her lymph nodes. As a result, she did six rounds of radiation and 12 rounds of chemotherapy. The radiation treatment infected her colon, which landed her back in the hospital for a two-week stint to treat the infection.

“I have been on a healthy road since then,” says Cleare.

“I rested a lot, and did what I was supposed to do.”

She’s also ensured she has her follow-up colonoscopies and physicals as scheduled, and says everything seems to be fine.

“I’m living proof that colorectal cancer is survivable,” says Cleare.

Cooper, who heads the gastroenterology practice and outpatient endoscopy facility, says he, too, was taken by surprise by the American actor’s death.

“I was absolutely take aback,” Cooper told The Nassau Guardian. “It says he was diagnosed four years ago, which would have put him at 39, which means he would have had evidence of polyps at 29, so in his late 20’s … early 30s, he would have had this process going on, and that’s unusual,” said the gastroenterologist. “He may have had some family history or predisposition.”

Colorectal cancer is cancer that occurs in the colon or rectum, according to the United States Centres for Disease Control (CDC). The colon is the large intestine or large bowel. The rectum is the passageway that connects the colon to the anus.

Sometimes, abnormal growths, called polyps, form in the colon or rectum. Over time, some polyps may turn into cancer.

Symptoms

Colorectal symptoms include blood in or on stool (bowel movement), stomach pains, aches or cramps that don’t go away, and unexplained weight loss.

Before she was diagnosed, Cleare says she suffered constipation – sometimes for weeks at a time, as well as severe stomach cramps. She treated those symptoms by taking laxatives in search of relief. She became concerned when she began to see blood in her stools.

The mother of two says she went to a private doctor’s office and was treated for hemorrhoids. But the symptoms persisted and got to the point where she wasn’t just passing blood, but passing clots of blood instead of feces.

She, again, sought medical attention at a hospital and was told she needed a colonoscopy. The closest date she could get was three months. She found the funds to have a colonoscopy done privately the next day.

Two days after having her colonoscopy, Cleare had what she believes was her lifesaving surgery.

In a colonoscopy, the doctor uses a long, thin, flexible, lighted tube to check for polyps or cancer inside the rectum and the entire colon. The colonoscopy also is used as a follow-up test if anything unusual is found.

Besides the colonoscopy, several other screening tests can be used to find polyps or colorectal cancer – stool tests, flexible sigmoidoscopy, and a CT colonograpy.

According to health officials, there is no single best test for any person, and each test has advantages and disadvantages. People are encouraged to talk to their doctor about the pros and cons of each test. The one they decide on will be chalked up to a patient’s preference, medical condition, likelihood they will get the test, and resources available for testing and following up.

Screening tests can find polyps, so they can be removed before turning into cancer. Screening also helps find colorectal cancer at an early stage when treatment works best.

The United States Preventive Services Task Force recommends that adults age 50 to 75 be screened for colorectal cancer. It also says people at an increased risk of getting colorectal cancer should talk to their doctor about when to begin screening, which test is right for them, and how often to get tested.

When Cleare and Boseman were diagnosed, neither was anywhere near the recommended minimum age.

“Age isn’t always the truth sometimes. I don’t believe that,” says Cleare, “because a lot of persons need to get these colonoscopies when they see signs.”

Internationally, Cooper says the recommendation as to when screening should start in people of color is age 45, as people of African descent are presenting with a more aggressive disease at a younger age.

“We have some evidence to suggest that people of African descent present at an earlier age but at a later stage [and] the likelihood of a cure is very low when you get to stage three and stage four,” said the doctor.

And then he said there are people like Cleare and Boseman who they refer to as outliers, who will be missed by the guidelines and present even before 45, particularly if they have a family history.

People who should be screened earlier, according to the CDC, are those who have a close relative or have had colorectal polyps or colorectal cancer. A person who has had an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis; or have a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colocrectal cancer (Lynch syndrome), if a person or a close relative has had colorectal polyps or colorectal cancer.

“So, the recommendations are, if you have a first degree relative, or second degree relative, whatever age they were diagnosed, you should be checked 10 years earlier,” said Cooper. “But the 45-year initial colonoscopy seems to catch most people.”

The doctor said the person with polyposis will have hundreds of polyps in their colon, and it starts in adolescence.

“You can have someone who is [age] 10 coming with blood in their stools, and need to have a colonoscopy immediately; the guidelines don’t apply to them. Their risk of colon cancer is 100 percent. These people get their first colonoscopy as a teenager [and] will have to have their colons removed to avoid developing colon cancer.”

Poor diet, obesity and genetics all increase a person’s risk of bowel cancers.

In The Bahamas, where the propensity is toward a high fat, low in fiber diet, Cooper says between 2012 and 2018, he was diagnosing 150 new cases of colon cancer a year.

Some protective measures he said people can take include eating a healthy diet and taking vitamin D and folic acid, which he said have been found to reduce the risk of polyps and colon cancer.

The gastroenterologist encourages men to not overlook and trivialize symptoms, but to seek medical attention right away for changes in their body, rather than wait. When they do address issues, he said it’s usually catastrophic.

Cooper said National Health Insurance (NHI) has as a part of its plan, to include colon cancer screening as a part of its initiative, at age 45.

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Shavaughn Moss

Shavaughn Moss joined The Nassau Guardian as a sports reporter in 1989. She was later promoted to sports editor. Shavaughn covered every major athletic championship from the CARIFTA to Central American and Caribbean Championships through to World Championships and Olympics. Shavaughn was appointed as the Lifestyles Editor a few years later.

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