In this series of first-person articles, Florida Courier Publisher Charles W. Cherry II describes how he’s facing health issues and risks common to Black men. This week: colon cancer.
BY CHARLES W. CHERRY II
My father, Charles W. Cherry, Sr., was one of the strongest men I’ve ever known. As far as I know, he had few fears (other than drowning. He survived a near-drowning incident as a child and another one later as an adult).
Daddy was an old-school “race man” who was all about Black advancement “by any means necessary.” And when you combine a “Black-first” mindset with fearlessness; multiple cash-flowing businesses and no personal debt; a devoted wife holding things down at home; and an appreciation of the Second Amendment’s right to bear arms ‒ you end up with a free Black man who’s so vociferous and radical that he scares even Black people.
But it was colon cancer ‒ not the Ku Klux Klan, radical White supremacists, or his handkerchief-headed, jealous Negro haters ‒ that killed him in 2004 at the relatively young age of 76.
He had known risk factors. According to the American Cancer Society, these factors include age (older is riskier); polyps (growths inside the colon and rectum) that may become cancerous; a high-fat diet; a family history of colon cancer or polyps; inflammatory bowel diseases involving the colon; a sedentary lifestyle; diabetes; obesity; smoking; and alcohol use.
Blacks have the highest rates of colon cancer (also known as colorectal cancer), which is the third-leading cause of cancer related deaths in the Black community. We face a 20 percent higher risk of developing colon cancer and a 45 percent higher mortality rate than any other race. And it’s highly preventable.
According to BlackDoctor.org, “The American College of Gastroenterologists recommends Black men be screened starting at age 45 – five years earlier than Whites. The reason? Colon cancer is often diagnosed in African Americans at a younger age…(and) the current compliance rate for colonoscopies is at a mere 38 percent.”
Typical ‘Black’ diet
Dad was a meat eater. As a Black son of the South who grew up in south central Georgia, he was used to having hearty Southern breakfasts every day: bacon, eggs, grits, sausage, coffee. He was a pork ribs aficionado and could go through a slab during a typical weekend.
He didn’t care much for fresh vegetables (except pork-flavored collard greens boiled to death), nutritious salads, or fibrous foods. He’d be considered obese for his size, didn’t exercise, and had hypertension (high blood pressure), among some other medical issues.
He found the cancer when a spot appeared on a routine X-ray. My brother Glenn moved quickly to get Dad examined at Tampa’s Moffitt Cancer Center, where he was prescribed chemotherapy (he hated it because ironically it killed his taste buds). The treatment shrunk the cancer to the point doctors thought it could be surgically removed.
It was during a routine pre-surgery exam that Dad was told he had severe heart blockages that would make any surgery risky. He got three second opinions, and each was different.
One doctor said, “No cancer or heart surgery. Too risky. Take your chances of dying of a heart attack. Your cancer is under control.” Another said, “It’s a toss-up. The cancer could come back after surgery ‒ or maybe it won’t. And if you don’t want the cancer surgery, you don’t need the heart surgery.”
But the third doctor is the one Dad listened to. “Get the heart surgery and when you recover, you’ll be set to get the cancer surgery and be done with all of this.”
Long story short: Dad, being the risk taker he is, swings for the fences and gets the heart surgery. While he’s on the operating table, the surgeon discovers Dad’s heart blockages are less severe than everyone was led to believe.
Cancer roars back
At age 76, Dad’s gotta face a recovery from major surgery; his chest had been cracked open, and a vein stripped from his leg. That means he can’t get the chemotherapy treatment that kept his cancer at bay. Without the chemo, the cancer turns aggressive and kills him relatively quickly.
He’s missed so much over the past 15 years ‒ from world events, to Morehouse College homecomings with his classmates who would start drinking Hennessey watching the Saturday morning parade ‒ that it’s hard for me to list it all.
America’s first Black president. One grandson playing high school basketball, going to prestigious schools, and working on an oil rig in Alaska. Another grandson becoming a talented public speaker and playing trumpet in his high-performing high school band. (Dad was a saxophone player.) A granddaughter becoming an allstar volleyball player and scholar in her own right.
Dad never saw any of that. That’s one of my motivations to live. I don’t want to miss a damn thing.
Every five years
That’s why last week, I had my fourth colonoscopy since the year of my father’s death. That’s why I’ll continue to have them for as long as I live.
Fellas, one thing you have to get used to is talking about something that’s especially uncomfortable in American culture: having a bowel movement, or “taking a dump,” in the common vernacular.
Everything that eats, from bacteria to elephants and whales, has to eliminate the waste that’s not consumed by the body. That’s the way life is built here on Planet Earth.
Think of your fantasy dream girl. Could be your wife or girlfriend, a high school squeeze, an ex, somebody you just saw walking down the street, or some babe twerking on YouTube. Man, as fine as she is, she’s taking dumps too!
So fellas, we have to get over it. Taking a dump is NATURAL. EVERYONE does it. And our unwillingness to talk about our bowel movement habits, or have someone touch our bootyholes other than ourselves, is literally killing us.
Also, please forgive in advance any ass jokes I may tell.
Working with my team
I have a small team of Black female health care professionals who take care of me. The two most important team members ‒ my primary care physician and my dentist ‒ are Black females by choice.
Why sisters? They aren’t scared of me, don’t mind touching me, and you can’t BS them. They keep up with current research. They are keenly aware of the racial differences with regard to healthcare information and outcomes in America. (I won’t give names of the various health care workers involved to protect their privacy.)
Sister Doc, as I’ll call her, knows that given Dad’s history, I’m at higher risk for colon cancer. I must undergo a colonoscopy more often rather than every 10 years after the age of 50 as current medical practice recommends.
From the Mayo Clinic: “A colonoscopy is an exam used to detect changes or abnormalities in the large intestine (colon) and rectum. During a colonoscopy, a long, flexible tube (colonoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon.”
Generally speaking, a healthy colon is smooth, wet and shiny. But a “sick’’ colon could have sores, blisters, and other marks on it that indicate there’s a problem. If left alone, these lesions can develop into cancer. But if they are removed before they can become cancerous, the problem is solved and the cancer never happens.
If your colon gets “sick’’ with lesions, sores, etc. that are allowed to fester, it can become cancerous. Worst case is that it spreads throughout your body and kills you.
The process While you are in a pleasant, drug-induced dreamless sleep, a doctor inserts a colonoscope and examines your guts, so to speak.
The most important (and somewhat unpleasant) part of the whole process is the preparation. You have to clean your body’s “pipes” out over a 24-to 48-hour period so the doctor can get a good look. That means not eating solid food and taking laxatives that make you run to the toilet for about a day.
Even that process has improved in the 15 years or so that I’ve been getting this procedure done. The first time involved giving myself an enema ‒ sticking a tube up my rectum and flushing it out with water. I couldn’t do it myself ‒ it made me too queasy to insert something going the wrong way ‒ so I had to get female help. Talk about embarrassment…
Nowadays, the process has been somewhat streamlined. Rather than enemas, pills that take longer to work, and laxatives you have to mix, the doctor prescribed a concoction called ClenPiq. (Not cheap – $140 from Walmart, without insurance, before a $40 discount coupon.)
I took just two six-ounce bottles with a total of eight cups of water about eight hours apart. And since I scheduled my procedure for 9 a.m. on a Monday morning (when hopefully the doctor is fresh and rested after a good weekend), that meant I was up at 3 a.m. drinking the second bottle and running to the toilet.
The goal is for your bowel movement to become as watery as possible and to clear all the solid waste out so the doc can get a good look. You have to drink clear liquids; nothing red, blue or purple.
Think of it as a high-pressure wash for your innards, something most of us never do but a few times in a lifetime. The preparation is an opportunity to clean out a long-neglected part of the body. Maybe you can finally get rid of that first Happy Meal you ate as a kid. But I digress…
Time to go
After about 24 hours of drinking liquids and taking multiple squishy dumps, it’s time for me to go to the outpatient facility where all this magic is gonna happen. You aren’t allowed to drive yourself to or from the procedure. Thoughtfully, my doctor’s office has someone pick me up and drop me off.
My driver arrives at 7:45 a.m. for the 20-minute drive. I bring nothing but my insurance card and identification. No cash or credit cards. (Hey, health care workers sometimes steal too!) I go up to the waiting room, where there are maybe 10 other people, only one of whom is a Black male.
This whole thing is down to a science. The workers are all very friendly, but very businesslike. They don’t waste time. I sign a bunch of forms, they give me a restaurant style beeper, and they tell me to “go through that door on the left” when the beeper goes off ‒ which it does about 10 minutes later.
That backless gown
I go through the door, where a friendly male nurse meets me and walks me down a corridor that looks like an emergency room, with privacy curtains and hospital beds. After confirming who I am and determining I’m in my right mind, I get the proverbial hospital gown with the split up the back. (They’ll need to medically access your ass, so there’s no need to cover it.)
We chit-chat as the nurse takes my pulse and blood pressure. We are both pleased that both measurements are well within the normal range. I’m happy that I didn’t suffer from “white coat syndrome” in which your measurements spike because you are nervous about being in a doctor’s office or a hospital. (I’ve learned to relax by picturing myself sitting on Daytona Beach with a drink in my hand.)
As the nurse puts an IV needle in my arm, the anesthesiologist strolls by, confirms who I am, cracks a few jokes, and leaves. I learn that the anesthesia will be light, meaning I will be breathing on my own rather than having a doctor or a machine “breathe” for me during the procedure.
Finally, I’m wheeled into a small room with lots of lights and equipment everywhere. The gastroenterologist who’s doing the procedure confirms with his two assistants that everyone’s ready to go. I lay on my left side with my left arm stretched out and my head on a pillow. Somebody clips an oxygen tube to my nose. I see the needle going into the intravenous tube in my arm, then I feel my whole body relaxing from toes to head. There was no “100, 99, 98” countdown. I just went to sleep instantaneously.
I woke up what seemed to be about two seconds later, but in one of those ER-curtained rooms. My ass didn’t feel any different than normal, and surprisingly, it wasn’t greasy. A nurse gave me some cranberry juice, the first of five or six sharp gas pains hit, and I started to fart. (That’s normal, as air enters the rectum during the process.)
I felt surprisingly good, considering I hadn’t slept much the night before, and the anesthesia drugs were still swirling around in my body. The nurse and I conversed, mostly for her to determine if I was still in my right mind, I think.
After about 10 minutes, I slowly put on my clothes ‒ I was still slightly woozy, like after having a few glasses of wine ‒ and she walked me to a recliner.
‘Good and clean’
The doctor strolls in and summarizes what he’s seen: “Good and clean. A small 2-millimeter polyp” ‒ essentially a pimple ‒ “removed. Slight benign diverticulitis (a fold in the intestine). A small hemorrhoid. See you in five years.” The nurse hands me a full narrative report, complete with color pictures. The polyp was sent to the pathology lab to confirm it’s non-cancerous. We’re done here!
As I’m waiting for my ride, I chat with a 58-year old brother getting his first procedure. He told me how prostate cancer was killing men in his small, predominately Black church congregation. Three had died over the past year, all under the age of 60. (I’ll discuss that in a future story.)
The rest of the day went as normal. Took a nap, picked up Charles III from school (contrary to medical advice not to drive the remainder of the day), ate solid food (it was glorious), then worked as usual. No rest for the weary.
Brothers, now you know why I’ll consent, for the rest of my life (or until the technology improves), to have a stranger insert a tube with a camera up my rear end and leisurely look around. For those of you who are ass-phobic, can’t afford it, or still don’t get it, there’s another option.
Again, from BlackDoctor.org: “Cologuard is an at-home stool test that detects certain genetic markers associated with colon cancer. It’s recommended for anyone over the age of 50 that doesn’t get the prescribed colonoscopy every five years. Users who test positive for these genetic markers are referred to get a colonoscopy at their doctor.
‘Poop in a cup’
“Cologuard is poised to change that low compliance rate by screening more people. Unlike other screening options ‒ patients take Cologuard in the comfort of their own home, with no prep (drinking of that solution), no invasive procedure, no sedation, no time off of work. Literally, all you have to do is provide a sample (poop in a cup that clips on to your toilet) and mail it to the lab for analysis (UPS will pick it up for you).
“Cologuard is a first of its kind test that looks for both blood and DNA in a person’s stool, flagging cancerous and precancerous cells (if pre-cancerous cells are found and removed, cancer is prevented from ever forming). A New England Journal of Medicine study found that the test identified 92 percent of colon cancers with 87 percent specificity.”
I know my motivation to live. What’s yours?
P.S. Five days later, I got a call from the doctor’s office confirm that the polyp was “benign,” meaning no evidence of cancer.
Next story: Sleep apnea ‒ Snoring ain’t funny anymore.
Editor’s note: This story has been edited from the original version appearing in the March 8, 2019 issue of the Florida Courier.