When it comes to African-American men and prostate cancer, the news is not good. Black men have the highest incidence rate for prostate cancer in the United States and are more than twice as likely as White men to die of the disease, according to the National Cancer Institute. While genetics and DNA may play a factor, health experts also believe that lack of access to quality health care leads to Black men not being routinely tested for prostate cancer.
BET.com sat down with Dr. Chiledum Ahaghotu, associate professor and chief urologist at Howard University Hospital, to talk about what Black men need to know about prostate cancer and the importance of early detection.
How concerned should Black men when it comes to prostate cancer?
Prostate cancer is the cancer most diagnosed among men in the U.S. and African-American men are 60 percent more likely to die because of it. That’s a two-fold chance. Also, African-American men are more likely to be diagnosed at a late stage of the disease than any other racial group in the country.
Why is this the case?
A lot of smart people are trying to figure that out, but we do have a few factors associated with that. Just the biology of the disease in Black men, genetic factors, associated with our race. But there are also outside factors, too, such as lack of access to health care and differences in how Black men seek health care and how we utilize that care when we do have access to it. Also, smoking has been found to increase the death rate associated with prostate cancer.
Now why [do] we have prostate cancer? We aren’t 100 percent sure why. But here’s what we know: Western diets that consist of red meat and pork increase the risk of developing prostate cancer. We know that obesity may be linked to prostate cancer, too. So exercise and weight moderating may make a difference.
There has been a lot of conflicting talk since the U.S. Preventative Task Force came out earlier this year against routine testing for prostate cancer if men are not showing symptoms. In your opinion, how do you feel about these recommendations?
The U.S. Preventative Task Force’s recommendations are based on a flawed method of testing when you look at African-Americans and prostate cancer. It was based on two large studies that only had 2-3 percent of Blacks in each clinical trial. And those numbers are extremely low to make conclusions and apply them to a population that wasn’t adequately represented.
And so what we are left with is a need for them to come up with guidelines specifically for high-risk populations and people with family histories. And the pushback that they have given us is that it isn’t necessary because there were no significant differences in mortality in Black men who were screened and not screened.
Many believe there is an underlying agenda, and if our government accepts this set of recommendations, they could influence what Medicaid and Medicare covers, not to mention commercial insurance companies.
And yes, I admit that the Prostate-Specific Antigen (PSA) Test has its limitations, but it’s really the only one we have.
And so what are your recommendations for Black men and PSA tests?
For men of African descent, the National Medical Association recommends an informed decision process should occur once you have reached 40 years old. You must have a conversation with your doctor, and if you decide to get screened, the recommendation is to begin for 40 with a PSA or a digital rectum exam and then do that annually until about the age of 70.
And here are two important things to keep in mind: In the early stages of prostate cancer, there are no symptoms, and once there are symptoms, most likely the disease has already spread, and then there really is no cure. And also, the decision to get screened doesn’t mean you have to get treatment. You can watch and wait.
Know your family history! You’d be surprised how many people are not having this conversation. And this information is not just about understanding your risk, but also getting valuable information from people who have gone through it.
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(Photo: Courtesy of ABC)