It’s especially important that Black men over 40 discuss this with their doctor
African American men are 65 percent more likely than Caucasian men to be diagnosed with prostate cancer during their lifetimes. Additionally, African American men are 2½ times more likely to die from prostate cancer than Caucasian men. Prostate cancer tends to appear sooner in African American men, and the type of prostate cancer in African American men tends to be more aggressive, meaning it can spread beyond the prostate to other areas of the body.
We are not sure why African American men fall victim to prostate cancer more so than others, but emerging research suggests factors including genetics, socio-economic status, nutritional status, lifestyle/social habits (including smoking), and access to medical care make a big difference in the long-term survival of men with prostate cancer.
The US Preventive Services Taskforce (USPSTF) has made prostate cancer screening recommendations, starting at age 50. Unfortunately, these recommendations are controversial, and some physicians don’t believe they take into account the higher risks and death rates seen in African American men with prostate cancer.
What can men do right now?
Have a discussion with your doctor at your next visit. If you are over the age of 30 and have not had a general medical examination in two years, make an appointment today.
At all general medical examinations in men over the age of 30, a digital rectal exam should be performed. Be sure to specifically ask your doctor about a digital rectal exam. If an
enlargedprostate is detected, additional testing or examinations may be done.
Remember, benign prostate hypertrophy (enlargement), as we discussed last week, is common with age and not cancerous. If your prostate is enlarged, or if tests come back suspicious, and if you are African American with a positive family history of prostate cancer, your physician may recommend that blood test screenings start at age 40-45 rather than age 50.
Keep in mind that the common blood screening test, called a Prostate Specific Antigen Test (PSA test), can also provide false positives. Be sure to discuss this with your doctor and have a plan on what to do if the test comes back positive.
Prostate cancer can be successfully treated with either medicines and/or surgery. The most important thing to know about prostate cancer is that when it is located in the prostate, the prognosis is excellent. If the prostate cancer has spread beyond the prostate to other parts of the body, the prognosis is much worse, so detecting prostate cancer early, especially in African American men, is most important.
Make sure you talk to and encourage all the African American men you know over the age of 40 to talk to their doctor and
ask if prostate cancer screening is appropriate for them. You could very well save a life.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.
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I had a high psa for 15 years or so and over that time had 5 biopsies. My psa was about 25. I then had a turp for enlarged prostate but in all the biopsies and then the turp, there was not sign of cancer. My story in 4 part detail is here:
Stan’s story