Issue: October 2023
Fact checked byHeather Biele

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September 01, 2023
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Star saxophonist, patient advocate James Casey dies of colon cancer at age 40

Issue: October 2023
Fact checked byHeather Biele
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James Casey, acclaimed saxophonist for the Trey Anastasio Band, died Aug. 28 at age 40 after a 2-year battle with colon cancer.

Earlier this year, Casey shared his diagnosis and cancer battle at the “Colorectal Cancer in Young Black Americans” webinar event, presented by the Association for Black Gastroenterologists and Hepatologists (ABGH).

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James Casey, acclaimed saxophonist for the Trey Anastasio Band, died Aug. 28 at age 40 after a 2-year battle with colon cancer.
Image: James Casey
Renee Williams

“We are deeply saddened to hear of his passing,” Renee Williams, MD, MHPE, professor at NYU Grossman School of Medicine and vice president and co-founder of ABGH, told Healio. “While expected, it’s still heartbreaking. I saw James in March during an advocacy panel and looking at him then, you would never know he was suffering from stage 4 colon cancer.”

In fall 2021, Casey experienced increasingly severe pain in the right side of his abdomen, prompting a visit to the emergency room, where he was admitted and received a CT scan.

After initially being sent home with a diagnosis of colitis, Casey was back in the same ER within 3 days and rushed into emergency surgery, where they discovered a stage 3 tumor in his colon.

“James went to the ER two times with abdominal pain and was sent home before his third visit which led to his diagnosis” Williams said. “The second time the doctors thought he was drug seeking; he knew this because he overheard the physicians speaking.”

Despite surgical removal of the tumor and subsequent chemotherapy, the cancer had already reached his lymph nodes and progressed to stage 4.

Casey’s initial misdiagnosis and dismissal in the ER underscore the disparities in access to screening and care Black patients face on a daily basis.

Valerie Antoine-Gustave

“This is not an uncommon story, especially for people of color,” Valerie Antoine-Gustave, MD, MPH, a clinical instructor in the department of medicine at NYU Grossman School of Medicine, told attendees during ABGH’s event. “[James Casey’s] story highlights some of the challenges we face when presenting our symptoms, when we are saying what is happening with us.”

Persisting health inequities

Despite a gradual decline in CRC diagnoses in the U.S., data from the American Cancer Society show Black patients remain 20% more likely to develop CRC, 40% more likely to die from CRC and significantly more likely to be diagnosed at a later stage.

“Black patients often have to hurdle many systemic barriers when seeking care for GI symptoms,” Ugo Iroku, MD, MHS, co-founder of ABGH, previously told Healio. “The most common feedback we receive as providers stems from patients not having their health complaints taken seriously, leading to prolonged suffering, delayed referral for specialist care and delays in diagnosis or treatment.”

Williams, who also serves as the director of the Saul J. Farber Program in health equity in the department of medicine at NYU, added: “Health inequities are closely tied to the social and structural determinants of health. As physicians, we need to factor this into our care to improve patient outcomes and promote equity.”

While combatting these disparities at a social and structural level will take time, Williams recommends providers start small by talking to individual patients: Get a baseline understanding of their health literacy about CRC screening and emphasize that colonoscopy is “just one method” for screening.

“The best test is the test that gets done,” she said. “Engage in shared decision-making and address your patients’ concerns around cost or any other issues that may be important to them. Give them space and time to make a decision and continue to highlight that this is a highly preventable and treatable disease if caught early.”

A lasting legacy

Before his death, Casey continued to release music and serve as an advocate for patients with CRC. The proceeds from his 2022 holiday album, “A Little Something for Everyone,” went to the Colorectal Cancer Alliance and Eastern Virginia Medical School’s HOPES Clinic to raise awareness and fund CRC screening for uninsured patients. And in March — Colorectal Cancer Awareness Month — he released his full-length solo album, “The Kaua’i Project,” which details his personal journey with CRC.

“Even though he was diagnosed with stage 3 and eventually stage 4 colon cancer, James was a huge advocate for colon cancer screening,” Williams said. “He gave his time to discuss his diagnosis and journey with this terrible disease. As he was traveling, he was also getting treatment with chemotherapy and dealing with those side effects. But he still showed up.”

When asked why he continued sharing his story, even as his disease grew more taxing, he explained to Williams that he did not want someone else to go through what he did.

“We have to respect his legacy and unwavering commitment,” she said.

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