By Yaw A. Nyame, MD, MS, MBA, associate professor, University of Washington School of Medicine, Seattle, as told to Keri Wiginton
Despite advances in prostate cancer prevention and treatment, Black men still face higher risks. They’re more likely to get prostate cancer, often at younger ages. They tend to have more aggressive disease. And, unfortunately, they’re still more likely to die from it than men of other races.
These gaps exist across the entire care process, from screening to treatment. They stem from a mix of complex factors, including limited access to health care, economic inequality, systemic racism, and other social determinants of health.
But here’s the good news:
For metastatic prostate cancer (when the cancer spreads to other parts of your body), newer treatments like immunotherapy work just as well or better for Black men as they do for men of other backgrounds. The key is making sure everyone has access to what we consider the “standard of care.”
People too often blame health disparities on biology, but prostate cancer behaves similarly across racial groups. What I mean by that is treatment response doesn’t seem to differ very much by race, even though there are some biological differences between the prostate cancers of Black men and those of other races.
Certain genes are passed down through families, but race itself is a social construct. And while we shouldn’t ignore the role biology plays in cancer, these differences don’t explain racial disparities at a population level: Social and environmental factors drive the inequities we see. By addressing these external barriers, we give Black men a chance to achieve the same positive results as everyone else.
As a doctor focused on addressing disparities in prostate cancer care, here are some insights to help you take charge of your health or support a loved one facing this journey.
Take an Active Role in Your Treatment
This isn’t a passive process where doctors make all the decisions. You’re an essential part of your care team. So, before your appointment, take some time to learn about the standard of care for advanced, metastatic prostate cancer. This is one instance where the internet can be very helpful.
Prepare by making a list of questions. If you’re in a support group, see if other men want to share their experiences or suggest topics to bring up.
One of the things I’ve seen time and time again is how valuable peer support is to people with prostate cancer, and research shows that Black men often want more chances to connect with others facing similar experiences.
Organizations like Zero Cancer or the Prostate Health Education Network offer peer mentors who can provide guidance and understanding.
You’ll also find reliable information from trusted resources like the:
- American Cancer Society
- Fred Hutch Cancer Center
- Prostate Cancer Foundation
- National Comprehensive Cancer Network (NCCN)
The NCCN Guidelines are what most prostate cancer doctors follow, and they have an advanced-stage prostate cancer patient guide you can download. It lays out the basics of prostate cancer, along with treatment that’s generally recommended for your stage.
Advocate for Screening and Genetic Testing
The prostate-specific antigen (PSA) test is a simple blood test. It’s one of the best ways to catch prostate cancer early, when it’s easier to treat. But too many Black men aren’t getting screened in time, leading to higher rates of advanced prostate cancer in this community.
If you’re dealing with metastatic prostate cancer, you can be a powerful advocate by encouraging others around you to get screened.
Genetic testing is another valuable, often underused tool in the Black community. There’s understandable fear and mistrust around these kinds of tests, but knowing your genetic risk, regardless of race, can offer critical information for your family and could impact your treatment plan.
Your doctor can connect you with a genetic counselor who’ll walk you through the pros and cons of genetic testing. They’ll help you understand why testing might be important for you and how it could guide a more personalized approach to your treatment.
Consider Getting a Second Opinion
When someone comes to our cancer center, we explain what the standard of care is, and we make sure they get it. We also talk about treatment goals. Do you want to live as long as possible? Focus on quality of life? Manage side effects? Explore complementary treatments?
Your doctor should take the time to get to know what’s personally and culturally important to you. And if you don’t feel that they’re truly listening and giving you quality care, I’m here to tell you it’s completely OK to get a second opinion.
An easy way to find a trusted doctor for a second opinion is through prostate cancer advocacy groups, which often have patient support programs. Check out organizations like
- Zero Prostate Cancer
- The Prostate Cancer Foundation
- The Prostate Health Education Network
You can also reach out to prostate cancer specialists at centers like the Fred Hutch Cancer Center, where I work. Even if you don’t get your care here, we can point you toward treatment options or guide you in finding a specialist in prostate cancer.
Clinical Trials and High-Quality Care
Many people think clinical trials just compare a new treatment to a sugar pill, but that’s not what these trials are about. They’re actually a form of high-quality care, whether or not you receive the study drug.
In the worst-case scenario, you’ll still receive top-notch care with the current standard treatments you’d get outside the trial. But in the best-case scenario, you’ll get that same quality care along with access to a groundbreaking treatment.
For advanced prostate cancer, clinical trials can offer options that may boost your quality of life, help you live longer, and give hope beyond traditional treatments. Your doctor can tell you more about how to join one, but you’ll also find information through prostate cancer advocacy groups or by visiting ClinicalTrials.gov.
Get Involved in Research to Advance Equity
There’s often a power imbalance in health care, and we want to change that.
Efforts across the country are working to empower Black patients to advocate for themselves and receive the care they deserve. One example is the American Cancer Society's IMPACT Initiative (Improving Mortality from Prostate Cancer Together).
Groups like the Black & African-Descent Collaborative For Prostate Cancer Action (BacPac) were created specifically for Black prostate cancer patients and serve as supportive communities.
By getting involved, you’re not only advocating for yourself, but you can help create a more equal health care system. So, I encourage you to explore these resources and stay informed about the wonderful things that exist out there that are trying to make a real difference in this space.
Show Sources
Photo Credit: shapecharge/Getty Images
SOURCES:
Yaw A. Nyame, MD, MS, MBA, associate professor, Department of Urology, University of Washington School of Medicine, Fred Hutch Cancer Center, Seattle.
National Comprehensive Cancer Network: “Advanced-Stage Prostate Cancer.”
