By Pam Belluck

In the wake of Chadwick Boseman’s death from colon cancer at age 43, many people have questions about the disease, especially about the risk of colon cancer in younger people. Here’s what is known and what experts recommend:

Q: Doesn’t colon cancer mostly affect older people?

A: Although the majority of cases are found in older people, there has been an increase in cases in younger people in recent years.

Among people over 65, rates of colorectal cancer, which includes tumours in the rectum or the colon, have actually been declining, probably because of more regular screening. Nonetheless, it is the second-leading cause of cancer deaths in the United States for men and women combined, and cases have been rising by about two percent annually in recent years in people under 50, according to a recent report by the American Cancer Society.

Experts aren’t sure exactly why. For some patients, obesity, diabetes, smoking or a family history of cancer may play a role, but not all people who develop colorectal cancer have these risk factors.

“The bottom line is we just don’t know,” said Dr Robin Mendelsohn, co-director of the Center for Young Onset Colorectal Cancer at Memorial Sloan Kettering Cancer Center, which was opened in 2018 to treat younger patients and study the reasons for their diagnoses.

She and her colleagues are exploring whether diet, medications like antibiotics, and the microbiome — which have all changed significantly for generations born in the 1960s and later — might be contributing to the cancer in younger people.

Q: When is screening recommended?

A: Everybody should begin getting screenings at age 45, the American Cancer Society and other expert groups recommend. But people with a family history of colon cancer should start getting tested at age 40, or at 10 years younger than the age at which their family member was diagnosed, whichever is sooner.

Mendelsohn recommends early screening also for people with a history of inflammatory bowel disease, like ulcerative colitis or Crohn’s disease, and for people who have previously received radiation in their abdomen or pelvis.

Screenings can be done with various tests on stool samples or with imaging-based tests like colonoscopies.

The risks from these tests are relatively small.

The prep for a colonoscopy, drinking liquid to cleanse the colon the day before, can be uncomfortable.

But the advantage of a colonoscopy is that if it reveals polyps that might be precancerous, they can be removed during the test, said Dr Mohamed Salem, an associate professor of medicine at the Levine Cancer Institute at Atrium Health in Charlotte, North Carolina.

“It makes a huge difference when you detect cancer early versus late,” he said.

“The five-year survival rate for young people for early-stage disease is 94 percent,” said Rebecca Siegel, the scientific director of surveillance research at the American Cancer Society.

For people with late stages of the disease, the survival rate can be as low as 20 percent, she said.

Early diagnosis, Siegel said, is “the difference between life and death”.

Boseman learned in 2016 that he had Stage 3 colon cancer, according to an Instagram post announcing his death.

Mendelsohn said that patients with Stage 3 “have an approximate 60 percent to 80 percent chance of cure,” depending on a number of factors, including whether the cancer is responsive to chemotherapy.

Q: Are there racial disparities in the risk of colon cancer?

A: Yes. According to the recent American Cancer Society report, rates of colorectal cancer are higher among black people.

From 2012 to 2016, the rate of new cases in non-Hispanic black people was 45.7 per 100 000, about 20 percent higher than the rate among non-Hispanic whites and 50 percent higher than the rate among Asian Americans and Pacific islanders.

Alaska Natives had the highest rate: 89 per 100 000.

Siegel also said that at any age, “African Americans are 40 percent more likely to die from colorectal cancer. It’s because of later-stage diagnosis, it’s because of systemic racism and all that this population has been dealing with for hundreds of years.”

Q: What symptoms should prompt someone to see a doctor for possible colon cancer?

A: Common symptoms include bloody stool or bleeding from the rectum, doctors say. Other symptoms can include constipation or diarrhoea, a change in bowel habits, dark sticky faeces, a feeling of anaemia, abdominal pain or cramps, nausea, vomiting or unexplained weight loss.

“If you feel something, you have to say something,” Salem said. “Don’t put it off because you’re busy or because you’re a young person or because you have too much on your plate.”

Q: Are younger people less likely to receive a diagnosis early, and are they less likely to discuss their disease?

A: Unfortunately, yes. The average time from symptoms to diagnosis for people under 50 is 271 days, Siegel said, compared with 29 days for people 50 and older.

“Both doctors and these young folks are not thinking they have cancer,” she said.

“Part of that is screening, but it’s not all screening. Young patients have symptoms, sometimes for years. For one thing, they’re much less likely to have health insurance than older people, and so they have less money. And they’re thinking, ‘I’m a 30-year-old, what could be wrong with me — it’s going to go away.’”

Also, she said, “There’s the embarrassment factor. ‘I’m bleeding from the rectum.’”

Salem said “there is a lot of shame somehow. Nobody likes to have bleeding, especially from their butt. Especially young people; they don’t like to discuss this or disclose this information. That’s understandable. But it’s our obligation to change that culture. It’s OK to talk about your pain in that area, or your bleeding, or your constipation, or your diarrhoea.”

Doctors also need to get better at flagging a younger person’s symptoms as possible colorectal cancer, experts said.

“Anytime patients are 75 years old and have rectal bleeding, we say ‘Make sure and get checked out for colon cancer,’” Salem said.

“When younger people have rectal bleeding, sometimes we say ‘Oh, that’s haemorrhoids or stress from working too much.’ Those symptoms go on for many, many months or years, and now it’s not Stage 1 anymore, it’s Stage 3 or 4.”

Once they receive a diagnosis, doctors said, younger people should not feel ashamed.

“Increasing awareness and reducing stigma, all of this information could be saving lives now,” Siegel said.

“Keeping a secret is not the way to go.” – The New York Times

Staff Reporter

A few years of stormy battles with her little daughter each time she had to take her to the salon for a hairdo could have been a blessing in disguise for Bloemfontein mother Naledi Diradingwe who recently opened a hair salon exclusively for kids.

Tiny Fros Salon, situated at Bloem Plaza in the city centre, opened its doors on July 7.

Diradingwe, who prefers to call herself a mumpreneur, is excited about her venture and she says business is promising.

“I noticed there was a gap in the market because I used to struggle with my daughter each time I had to take her to the salon,” she told The Free Stater in an interview.

“I believe she was not comfortable seeing a lot of adults around her and having someone do her hair at the same time.

“I realised many other parents were experiencing the same challenge, so I decided to start a child-friendly hair salon.”

The salon, which she describes as revolutionary, strictly caters for children aged 0-13 years old.

She said to give it character and uniqueness, the salon has been painted with child-friendly colours and has a big play area where the tiny clients can burn off some energy while waiting for their hair to be done or taking a break.

“As a mother I know that children do not sit still for too long and a certain measure of distraction, ‘bribery’, patience and entertainment has to be induced to get perfect results when working on their tiny afros,” Diradingwe said.

“My daughter is turning five this year and it’s only now that she likes the idea of coming to a salon.

“I have also seen it with the other kids coming here.

“They really enjoy it because we have just made the environment ideal for them with the colours that we used, the seats, in fact, the whole set up.”

Asked how she was working around the COVID-19 issue given that fixing hair is a close contact exercise, the mumpreneur said they are implementing strict hygienic standards with each client and they have also started home visits.

“The whole place is sanitised regularly and we also sanitise before and after dealing with each client,” she said.

“The parents will be there to witness it and, I must say, most of them are happy with what we are doing.

“This week, we also started doing home visits for those parents who feel more comfortable with that.”

Diradingwe said the business was initially supposed to open in March but was delayed by the national lockdown.

And when the country was moved to a lower level of the lockdown, she did not think twice about resuscitating her dream.

“I was determined not to let this virus kill my dream hence I jumped to action as soon as our President (Cyril Ramaphosa) announced that salons could be opened,” she said.

“The safety of our staff and our little princes and princesses during these unprecedented times is our highest priority.

“We have ensured that we adhere to our country’s COVID-19 regulations and implementing the necessary precautionary measures to curb the spread of the virus.”

And despite a slow start, Diradingwe is confident business will pick up as the country recovers from the pandemic.

EXCLUSIVELY FOR KIDS . . . The new hair salon in town that caters for the young ones

You have probably come across dream-come-true headlines of a 16-year-old Bloemfontein model, Tatum Macalagh, who graced the New York Fashion Week (NYFW) in February this year. And if you were wondering how the teen sensation has managed to set the runway abuzz at such a tender age, look no further than her mother.  Indeed, as the saying goes, the apple doesn’t fall far from the tree. A keen model herself in her youth, the 33-year-old Yolande Macalagh has not only inspired her daughter to become a model but has also set up a modelling academy where she is nurturing dozens of other aspiring models of all ages and shapes. The Free Stater this week caught up with Yolande, from Heidedal in Bloemfontein, to talk about her experience in New York and her passion for modelling and fashion. Excerpts:

Yolande Macalagh says she is working hard to produce top models at her Bloemfontein academy

How was your New York Fashion Week experience, watching your daughter strutting her stuff on one of the world’s most coveted runways?

My time at the New York Fashion Week was a life-changing experience. I always knew and believed that we were heading for the better, but it’s still amazing what God can do. Seeing Tatum walking at an international show got me in tears because I know her heart. I know her dreams. I know how hard she pushes to be an international model. Her words to me a few years back were: “Mommy, I will do NYFW at the age of 16.” And she did. It just shows that it’s very much important for us to teach our children to speak life over their own lives. So, yes, it still gives me goosebumps just thinking how blessed the experience was. One can just learn and better themselves from such a breath-taking experience.

We are sure you met influential people in the industry, including designers, agencies and media personalities. What would you say was your biggest take from New York?

Oh yes, definitely! I met a lot of influential people thanks especially to the great media coverage that was involved at the event. People from magazines. My biggest take must be Time Square . . . Hahahaha I want to spend my life there. Shopping and never stop shopping. It felt like I’m in a movie. The place is amazing. I must say we had a great time although we did not go there for fun. It was all about taking Tatum’s career to the next level. Models doing international fashion shows are serious about what they do. It’s no child’s play – it’s either you’re in or you’re out. And that’s what I’ve learnt from the experience. There are millions of models around the world that want to do these shows. You are super-privileged and blessed if you get a chance.

As a kid growing up in Bloemfontein, did you always have an interest in modelling?

Modelling was surely one of my dreams. I think that we were not as privileged back in the days as our children these days. We had to work hard on our own to make things happen. The support or opportunities were very rare. And it sometimes happens that your dreams are not that important to the people who are supposed to support you. So, yes, I have come a long way with modelling. I remember as a child I had to run around borrowing dresses and shoes from people to attend a competition. I went to a modelling school on my own to sign up. I just took the contract to my parents to sign and pay whatever needed to be paid. It was never easy but I did it.

So how and when did the idea to establish your own modelling academy or agency come about?

I always had the passion for teaching young girls and boys about the modelling industry since I was at a very young age. I just never had the courage or platform to start. But it always burned inside of me. My daughter started off at eModels Bloemfontein and was part of Jeanre Neethling’s models for a few years before I started the eModels Heidedal branch. Later I set up my own YEZ Models Academy. I always knew I had the talent of being a model. But it never happened that I could accomplish my dreams. God opened a door for me to help and be a mentor for models. He trusted me with the lives of His beautiful children.

Modelling is probably one of the toughest industries for one to make it. What inspires you to do what you do?

What inspires me in the modelling industry is the desire to see absolute change in my models. I love to work with models that take the industry seriously. Models that want to give their all. It gives my heart joy to see people growing and when I have been part of their growth in life. It make me happy to see models take what I teach them about the industry and make something out of it. The modelling industry is not only about being a pretty face and the skinniest or tallest model there can be. But we as YEZ Models believe in training all models to the best of their ability and for them to be career-driven individuals. So to see change and happy faces keeps me going and I love what I’m doing with my whole heart.

It must be satisfying to launch the careers of aspiring models who might become big names in the future. What is it like to watch them grow?

It’s an absolute pleasure to see growth in my models. It’s sometimes so emotional and brings tears to my eyes. I work hard with my models. Strange enough they all become like your own children. You give your all to educate them – sometimes sleepless nights to make things happen. But to see them grow makes me want to push harder, even if it’s one child or model at a time.

You have had a number of youngsters, including your own daughter, under your wings for some time. Has anyone scored a big contract yet?

Yes, my daughter Tatum got a contract at an international agency in Cape Town, which is a totally blessing to us. We work hard to develop our models to be ready for the modelling world. Some of my models did Top Models SA recently. Two senior models are also signed with big agencies in Johannesburg and Cape Town, which is a big step towards becoming greater. One of the keys to success is to grab the opportunities and make the best of them.

How do you scout for potential models and what do you look for in potential models?

We are looking for committed and hardworking models. You must have a passion for the industry. Any size or height can be part of us. Everyone has a place in the industry.

What do you hope the future looks like for your agency as well as the models you groom and represent?

I am hoping for a great future. I trust that our training and platform will give positive opportunities to all our models. We work hard and strive for success.

As you push to become a major player in the modelling industry, what are the values you stand by that have helped you so far?

Pray and never stop praying. In my best or worst days, I keep on praying. It is also important for me to respect the next person or their decisions; to do everything I do with passion and love; to appreciate what I have; to trust and believe for better to come; and, most importantly, to run my own race.

With many new modelling agencies opening up in the Free State and South Africa, how important has it become for potential models to do their research when seeking representation?

It is very important to do research on modelling academies, schools or agencies. You as a model must know what the modelling agency stands for and if you want to associate yourself with such a brand. It’s important what image the modelling agency has and gives to the society.

Modelling is a career that is probably still little understood. What advice would you give to parents about modelling?

A lot comes with being a model. It’s really not all about being on the runway. It has a lot to it. Models learn a lot from us as modelling academies or agencies. Modelling gives a child great confidence.

Last but not least, can you provide us with one beauty tip and product that you swear by?

Beauty tips (laughs)! I’m a make-up artist and love to dress up. Every girl or woman needs a good mascara. It may seem like a pointless idea but those seconds you spend in front of the mirror curling your lashes will make a huge impact. It will make you look wide awake, even if you’re not. You also need to throw on a hat! I honestly feel that a hat is every girl’s secret weapon. Find a cute one that flatters your face shape and the bonus is that you’ll be able to skip washing or styling your hair that day.