How to reduce the disparities in colon cancer outcomes

Freddie Muse, center, and other members of The Men's Cancer Network
Freddie Muse, center, and other members of The Men’s Cancer Network

This week we’ve been looking at colorectal cancer, the second leading cause of cancer-related deaths in the United States for men and women, combined. It is expected to kill about 50,000 people this year. And African-Americans are at the highest risk of getting diagnosed with the disease, and dying from it. In this third and final part of our series, we’ll hear from activists and doctors about how that disparity can be erased.

In a church meeting room in South LA’s Leimert Park neighborhood, Reverend Elihu Osby offers a prayer to begin The Men’s Cancer Network support group.

“We are here assembled to give you praise and to thank you for saving our lives and for this cancer network, society, where we can meet once a month and discuss our problems and be collective as people and as researchers and find a way to help other people discover their needs,” Rev. Osby said. “And we ask that in Jesus’ name, and we say Amen.”

Freddie Muse, left, offers cancer survivor James Tinsley balloons and cupcakes in honor of his wife's birthday. Photo by Avishay Artsy
Freddie Muse, left, offers cancer survivor James Tinsley balloons and cupcakes in honor of his wife’s birthday.

Reverend Osby is 72. When he was 66 he had a colonoscopy, which led to having a tumor removed from his colon. He and about a dozen others have been meeting at Bryant Temple AME church for the past four years to share advice about their recovery. Today they have a guest speaker, Siri Singh, a psychotherapist and yoga teacher. His advice about eating was blunt and to the point: stop consuming meat, and switch to a vegetarian diet.

“We have to change this filthy diet. I’m going to use the word filthy. Because if you see how animals are killed, you probably wouldn’t eat it,” Singh said.

Studies have shown that diet and proper nutrition do play a role in preventing colon cancer. Researchers say limiting the consumption of red meat and avoiding excess salt and saturated fats are important, along with eating produce rich in vitamins, minerals and antioxidants.

“If you start putting this good stuff in your body, you’re gonna see a change. You’re gonna see a change. But you gotta be willing to change,” Singh said.

Groups like this give cancer survivors a way to stay informed about their health – and offers a venue for outreach.

“That’s part of what we do. That’s part of why we’re here. That’s part of why I started this,” said Freddie Muse, president of The Men’s Cancer Network and the support group leader. “Because as a prostate cancer survivor, when I was diagnosed, I tried to talk to men, and the men that I was talking to had no clue about what was going on.”

Muse talks to men at church, at barber shops, everywhere he goes. This, researchers say, is the best way to reduce the disparity among cancer screening and survival rates. Dr. Zuri Murrell, a colorectal surgeon, often speaks publicly about the value of colonoscopies.

“I go to a lot of churches and I go and talk to people, and I always start off by making everybody say the words colon and rectum. And then if they’re able to do that I make them say colon and anus. Colorectal and anus. And people kind of laugh in the middle of church, some people are a little disgusted, and I always try to remind them that you should never die from fear and you should never die from embarrassment,” said Dr. Murrell. “And too many African-Americans are doing just that.”

Dr. Donald Henderson, a gastroenterologist in his Inglewood office. Photo by Avishay Artsy
Dr. Donald Henderson, a gastroenterologist in his Inglewood office. Photo by Avishay Artsy

A lot of outreach can also be done one-on-one, with friends telling each other to get screened. But just telling a friend doesn’t necessarily lead to a colonoscopy. For Dr. Donald Henderson, who is African-American and treats patients both in Inglewood and in Beverly Hills, this issue hits close to home.

“I’ve lost two close friends within the past two years who were close friends of mine, who heard my mantra about getting screened and who did not follow that and unfortunately we later diagnosed advanced stage colon cancer,” Dr. Henderson said.

Both were high-income African-American men. Dr. Henderson runs into examples of this fear and stubbornness all the time.

“I have a physician friend who’s African-American, who I had dinner with last night, and his wife alerted me to the fact that he’s almost 60 and never had a colonoscopy. And that’s very upsetting,” Dr. Henderson said. Then he threatened he’d stop playing golf with his friend until he gets a colonoscopy.

“I was not going to invite him to play golf, that our dinner appointments for the future were cancelled, and there would be no trips together,” he said.

“You think that did it?,” I asked.

“I think it has an impact. It has an impact because he knows that we’re serious about this, and that he should wear the stigma, or the scarlet letter, of saying he didn’t get his colonoscopy.”

In 2000, Katie Couric underwent a live colonoscopy on the “Today” show. She wanted to encourage screening after her husband died of colon cancer in 1998.

“So the bottom line, so to speak, it’s not that bad, I had a nice little nap this morning,” Couric said in the segment.

Millions of people watched and learned that the procedure is relatively easy and painless. It lead to a 20 percent spike in colonoscopies in the years that followed. But, not among African-Americans.

“It was clearly shown after the fact that African-Americans did not respond to Katie Couric,” said Dr. Brennan Spiegel, director of Health Services Research at Cedars-Sinai. “This white woman getting screened for colon cancer did not resonate with them. And one of the things we learned from patients is they need the equivalent of a black Katie Couric. They’ve literally said, if Kobe Bryant gets screened on TV, if President Obama gets screened on TV, if one of my role models who’s African American gets screened, then I’m going to get screened.”

This series by Avishay Artsy on African-Americans and colon cancer was undertaken as a 2015 California Health Journalism Fellow at the University of Southern California’s Annenberg School of Journalism. This is the third part of a three part series. Listen to part one of the series here and part two of the series here.