Prostate Cancer A Threat to Black Men

Prostate cancer is very common in men, with nearly 250,000 new cases reported every year according to the American Cancer Society.

Studies have shown that Black men are more likely to develop the disease than any other racial group and more likely to die from the illness.

“Black men are taught to tough it out if given the choice,” said Dr. James Reed, internal medicine physician at Novant Health Mint Hill Family Medicine, “particularly if they have no symptoms. If they don’t have symptoms, they don’t want things like [screenings] done. But it’s still important because you can have prostate cancer with no symptoms. And that's something I think people forget.”

Many organizations work to raise awareness and encourage more men to undergo exams earlier.

In North Carolina, there are prostate cancer hotspots for Black men. In 2010, they were Iredell, Lenoir, and Brunswick counties, according to the North Carolina Central Cancer Registry.

“If you look at all the counties across North Carolina, there are significant hotspots of life-threatening prostate cancer all over our state, and particularly in Black men,” said Dr. Andrew Armstrong, medical oncologist at Duke Cancer Center. “And if you look at the map of where life-threatening prostate cancer is, it’s not isolated to east, north, west or south. It’s all over.”

Prostate cancer occurs in a walnut-shaped gland found in males that produces seminal fluid to nourish and transport sperm. In some cases, the cancer is mild and requires little to no treatment, while others can be aggressive and cause severe symptoms, such as difficult, frequent, painful or painful urination, or pain in the back, hips, or pelvis that doesn’t go away.

Black men are 1.6 more times likely to be diagnosed at an advanced stage of prostate cancer and are more likely to die from the condition. It is unclear why the occurence is higher in Black men, but genetics could play a role.

“There are reasons that we know and there are reasons that we don't know,” Reed said. “Black men may have some genetic predisposition. It does run in families. There is a genetic component to it. Black men do have a higher incidence of prostate cancer. Unfortunately, their prostate cancer is also more aggressive than typical prostate cancers.”

A 2020 study, taken over the span of seven years, found the disease spread faster in Black men than in white men who had mild symptoms. In the study, nearly 60% of Black men had disease progression compared to 48% in white men.

Some men are hesitant about going prostate checks because of the digital rectum exam, but cancer can be detected through early screenings and treated through surgery before the disease metastasizes throughout the body.

“[Patients] tell me how much they hate it and I say, you’re doing it once a year,” Reed said. “I’m doing it 10 times a day. It’s uncomfortable, it’s just something that’s a necessary evil.”

Doctors recommend all men think about getting tested and their risk of prostate cancer around age 45. At age 50, they should begin to screen annually because as they age, they are more at risk of developing the disease.

“The goal of screening is to pick up the cancer when it can be cured,” Armstrong said. “And through early detection, screening, imaging, most men fortunately, can be cured of prostate cancer. So that of the men diagnosed with prostate cancer nowadays, about six out of seven men are actually cured with surgery and radiation, with or without hormonal therapy, and do not require lifelong treatments. They become survivors.”

More education and awareness are needed on prostate cancer within the Black community.

“I think that a lot of that goes with having a primary care physician. That's what I do,” Reed said. “So, the people that come and see me, it’s going to happen, or you’re going to at least have that discussion one way or another. But if you just use the emergency room, you don’t see a doctor regularly, those are the people that have fallen through the cracks.”

Aaliyah Bowden, who covers health at The Post, is a Report for America corps member.