The recent revelation regarding Defense Secretary Lloyd Austin’s undisclosed prostate cancer treatment has sparked a critical dialogue around prostate cancer, a disease that disproportionately affects black men. This controversy underscores the urgency of addressing prostate cancer and the need to spread awareness about its impact on black men.
Prostate cancer is the second leading cause of cancer death in men in the US. However, according to the American Cancer Society, black men are more likely to develop prostate cancer than other racial groups. Studies show that we are 76% more likely to be diagnosed with prostate cancer, and sadly, we’re also more than twice as likely to die from it. There are tons of theories about why black men are more prone to prostate cancer. These include:
- Age: the risk rises as you age, and most cases are diagnosed in men over 50.
- Genetics: studies have shown that prostate cancer in Black men has a different genetic profile. It’s a more aggressive cancer and, at diagnosis, they present with a higher stage of cancer.
- Stress: the stress of enduring racism and a racist system may play a part in developing the disease beyond genetic factors
- Lack of Access: for many reasons, there is a lack of access to quality healthcare
The Rise of Prostate Cancer Diagnosis
More men are being diagnosed with advanced prostate cancer which is less likely to respond to treatments. Prostate cancer rose by 3% yearly from 2014 to 2019 after two decades of decline. This increase is concerning because prostate cancer that has spread to distant sites beyond the organ is extremely difficult to treat. There is no durable cure for those with metastatic prostate cancer. Some theorize that the rise of deadly prostate cancer may be partly linked to recommendations against prostate-specific antigen, or PSA, screening for healthy men.
The PSA Screening Dilemma
The debate regarding the efficacy of PSA screening has been ongoing. In 1994, the Food and Drug Administration approved the use of measurements of the PSA to be used as part of a screening test for prostate cancer. Then in 2008, the U.S. Preventive Services Task Force (USPSTF) recommended against PSA screening for men ages 75 and older. The concern was that doctors were diagnosing and treating too many men whose prostate might progress so slowly that the men would die of something else before it became a problem.
Then in 2018, the USPSTF took the guidance further, saying that men ages 55 to 69 should make an individual choice about screening after talking with their doctors. This decision was made because so many men were being either misdiagnosed or receiving harsh treatments that could have been delayed due to the slow-moving nature of prostate cancer. Some believe the rise in cases of deadly prostate cancer may be partly linked to these recommendations against PSA screening.
Delving into Crucial Conversations with Your Physician
- The risks of screening: Elevated PSA levels don’t always signal cancer but they require a biopsy to be sure, which carries the risk of infection. If cancer is detected, patients must weigh the risks of treatment, which may include radiation and surgery, sometimes resulting in incontinence and impotence.
- Whether to choose treatment if cancer is detected, there’s evidence that “active surveillance,” which involves repeated PSA testing and close monitoring, can help men diagnosed with cancer avoid harsh treatment or at least delay it.
Types and Timings of Screening
- Digital Rectal Examination: The doctor will insert a gloved lubricated finger into your rectum and feel the prostate gland for enlargement, lumps, tenderness, or hard spots.
- Prostate-specific antigen: PSA is a protein made by your prostate. The doctor will test to check the amount of this protein in your blood. A high PSA level doesn’t necessarily mean you have prostate cancer.
The general guidelines recommend starting at age 55, however, you may need PSA screening between the ages of 40 and 54 if you: have at least one first-degree relative (father or brother) who has prostate cancer, have at least two extended family members who have had prostate cancer, or are black.
Symptoms of Prostate Cancer
The symptoms are different for each person, but if you have any of the symptoms below, be sure to see your doctor immediately.
- Pain in the back, hips, or pelvis that doesn’t go away
- Difficulty starting urination
- Urinating often, especially at night
- Blood in the urine or semen
- Weak or interrupted flow of urine
Empowering Action: Taking the Lead on Prostate Cancer
The urgency of addressing prostate cancer in the black community cannot be overstated. Engaging in early and informed screening, holding discussions with healthcare providers, and actively participating in clinical trials are essential steps toward combating this pervasive health threat.
Let us confront prostate cancer head-on and work collectively to bridge the gaps in research and healthcare access for black men.
Remember! Your health is your most valuable asset
For further information and support, please visit Prostate Cancer Foundation
The Health & Wellness Committee