Black man, check yourself! by Ian Hughes

BLACK men are twice as likely to be struck by prostate cancer than White men, but thousands are still oblivious to the symptoms, experts have warned.

The latest figures show one in four Black men contract the disease in the UK every year, and research by the Proton Therapy Center, a cancer treatment clinic based in Prague, found more than a third (35%) of those aged 50 and over—the age group most at risk—have no idea how to identify common prostate cancer warning signs.

Dr Jiri Kubes, Medical Director at Proton Therapy Center, said there is no scientific explanation why there is such a high risk among Black men: “There is no clear evidence as to why Black men carry such a high risk of prostate cancer, but there is strong evidence that awareness is dangerously low.

“You have to be vigilant with prostate cancer, as it doesn’t usually immediately reveal itself. In most men, it is there without them even knowing, and they often only become alerted when symptoms worsen.

“Men with even the slightest of concerns shouldn’t hesitate to see their doctor. This is an especially important message for Black men, who are more at risk of the disease starting and progressing.”

Prostate cancer is Britain’s second most common form of the disease, behind breast cancer – claiming more than 11,000 lives in 2016 – but there is currently no national screening programme in the UK.

The warning signs

Dr Kubes added: “Male cancers have traditionally received less attention than those more common in women, although this is quickly changing.  While there is an increasing emphasis on tackling male strands of the disease, all men—and black men especially—need to be aware of the warning signs.

“These include: an increased need to urinate or thoughts of urinating more frequently; pain during sex; chronic fatigue; sudden weight loss, and feelings of nausea.  Sufferers may also have difficulty urinating standing up, or maintaining a steady stream, and pain in the crotch, thighs or lower back.”

The chances of getting prostate cancer increases with age, and the NHS advises all men aged 45 or over to get checked out – especially if there is family history of the disease, eg. father or brother, or if a man is overweight or obese.

What is the prostate?

The prostate gland sits underneath the bladder and surrounds the urethra. Its main job is to produce a thick white fluid that helps to create semen.  While prostate cancer often starts slowly – and may never cause a problem – it can spread quickly via the bloodstream. Figures from Cancer Research UK show a quarter of all those diagnosed with the disease each year will die as a result. 

Tests for prostate cancer include a digital rectal examination and a PSA test, which measures the levels of prostate specific antigen in the blood. 

A micrograph showing prostatic acinar adenocarcinoma – which is the most common form of prostate cancer.

There is currently no screening programme for prostate cancer in the UK because it has not been proved that the benefits would outweigh the risks, according to the NHS.   Routinely screening all men to check their prostate-specific antigen (PSA) levels is a controversial subject in the international medical community for several reasons.

The problem with tests

Firstly, PSA tests are unreliable, and can suggest prostate cancer when no cancer exists  – known as a false-positive result. This means that many men often have invasive and sometimes painful biopsies for no reason.  Also, up to 15 per cent of men with prostate cancer have normal PSA levels  – a false-negative result – so many cases may be missed.

The NHS says more research is needed to determine whether a screening programme would provide men with more benefit than harm.

Heather Blake, Director of Support and Influencing at Prostate Cancer UK, said: “Early diagnosis of prostate cancer is vital to saving men’s lives. To ensure no man slips through the net, we urgently need a test which can be used as part of a routine national screening programme, particularly as men will often have no symptoms until the latter stages of the disease.

“Unfortunately, due to a number of factors, the current PSA blood test has the potential to cause more harm than benefit if used on its own for a screening programme, which is why investing in research to find a more suitable testing method is the top priority of our research strategy.

Recommendations

“In the meantime, we recommend that men over 50 – and men over 45 if they are Black or have a family history of the disease – discuss the pros and cons of the PSA test with their GP, so that they can decide if it’s right for them.  

“Until there is a better test, a man’s awareness of his risk is his best defence against prostate cancer.” 

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