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Prostate cancer discriminates.  It does not affect all men equally, and at highest risk are men with a family history of prostate cancer and men of African descent.

In some ways, black men are hardest hit of all:  If you are a black man, you are not only more than twice as likely to get prostate cancer, but to develop it at a younger age – maybe years before you start thinking of getting your prostate checked.  You’re more likely to have aggressive cancer that needs to be treated, and your cancer is more likely to develop in a harder-to-reach part of the prostate that can be missed in a biopsy.  Your cancer may even involve different genes, such as NKX3-1 (see side story).

Lethal Cancer Genes and Black Men

There are plenty of genes that are equal-opportunity offenders in prostate cancer.  “These are genes that cause aggressive disease that kills men of all races,” says molecular biologist and medical oncologist Jonathan Simons, M.D., CEO of the Prostate Cancer Foundation.  But some of them – particularly NKX3-1, which PCF-funded scientists Kosj Yamoah, M.D., Ph.D., and Edward Schaeffer, M.D., Ph.D., are studying – target black men in particular.   Even the genes that cause aggressive prostate cancer in men of all races “are activated earlier, and are disproportionately burdensome in African American men.”

Just as “people with red hair, blue eyes, and freckles are more likely to develop cystic fibrosis, and women of Ashkenazi Jewish heritage are more likely to have the BRCA1 gene that triggers breast and ovarian cancer, black men are more likely to develop aggressive prostate cancer, and to die of it,” Simons told the Congressional Black Caucus in 2018.  “In addition to the NKX3-1 gene, a handful of other genes need to be studied.”

In the meantime, black men need to be aware of their higher risk, and to get checked for prostate cancer regularly – because, to repeat a very important point, when the disease is caught early and treated, it is almost always curable.

The good news is that when prostate cancer is caught and treated early, it is almost always curable.  Also, there has never been more hope for controlling and even curing cancer that has spread outside the prostate.

But you can’t get cured if you don’t get diagnosed, and you can’t get diagnosed if you don’t get checked.  Maybe, like many men, you just need that nudge: somebody telling you to go to the doctor for a five-minute bit of routine maintenance, a simple blood test, that could save your life.

Here’s your nudgeHarry Lennix, who stars in the NBC series, “The Blacklist,” is helping the PCF spread the word about early testing – starting with this public service announcement, filmed on the set, in the FBI Counterterrorism Division’s office, where Lennix plays Assistant Director Harold Cooper.   “I’m trying to extend lives and save lives of men, especially black men,” he says.

Lennix is stepping up to fill an important need:  “Nobody, to my knowledge, has been the face of this disease in this community, and I wonder why.  Is there some sort of stigma attached to it?  Or maybe nobody thought to ask, and nobody volunteered.  It’s a small thing I could do to help.  I hope that my being a voice, putting a face to it will encourage men to get their PSA and yearly physical in general.”

Lennix notes that although the black community has been relatively skeptical about the medical industry, and despite well-documented, nationwide racial disparities in medical care,  “I hope awareness, shining the light on the issue, will help things to improve.  I don’t think there’s any downside in getting tested and doing those things we can.  I hope we can find parity as we develop treatments and cures for the diseases that affect us in particular.  Being afraid of being politically correct – not wanting to draw attention to our blackness, those issues that affect the black community – has hurt us a lot.  But this is a matter of life and death.

“The cure is to identify the problem, be honest about the prognosis and diagnosis, and then go about trying to fix it.”

The problem is that the men at highest risk of lethal prostate cancer may be those least likely to go to the doctor and get screened, or get symptoms checked out.   Lennix can relate:  “I get it.  I wish it would go away, too.  But wishful thinking is not a remedy; ignoring doesn’t make it go away.  Today, with the PSA test, you get a blood draw, it’s pretty quick.”  Prostate cancer screening is “not what it used to be,” the dreaded rectal exam.

Nobody wants to go to the doctor, he continues, but just do it:  “We have to put on our big boy pants.  If we care about the people who love us, help them to care for us by taking care of ourselves.”  Lennix, who once studied to be a Catholic priest, believes in being “our brother’s keeper.  It’s an old idea, a Biblical idea,” that of helping one another and sharing someone’s burden.   He remembers hearing his high school principal saying, “Help me (to) help you help me.”   In other words:  “’I know you want to help me, and the way you can help me is to let me tell you what I need, rather than guess and speculate.’  I know what’s good for me, and that is to be healthy, and to maintain a good life for as long as I can.  My purpose in wanting to live long and be healthy is to be of benefit to other people.  If that’s the case – for men, and black men in particular – if we want to be here, and we should, because we know our absence creates all kinds of problems in the community, we have to participate in this life of ours.

“If we give a damn about the people that we love, then we have to be here for them.  And if by going to get a test once a year, get our blood drawn, if that can help – by all means, we have an obligation to do it, and it need not be feared.”  Lennix started getting screened for prostate cancer at age 40, and so did his two brothers.  Although prostate cancer does not run in his family, cancer does, and this also raises the risk of prostate cancer – because some of the same faulty genes that can cause one kind of cancer may cause prostate cancer, as well.

Lennix says he doesn’t know how many people have seen his public service announcement.   “But if one guy hears it and goes in to see the doctor, then mission accomplished.  I hope it’s very many more than that, because we’re trying to save lives.  I want men to know that there is no reason to fear this.  There’s every reason to be proactive and get tested and cured.  Prostate cancer is highly curable when it’s caught early.”

Lethal Cancer Genes and Black Men

There are plenty of genes that are equal-opportunity offenders in prostate cancer.  “These are genes that cause aggressive disease that kills men of all races,” says molecular biologist and medical oncologist Jonathan Simons, M.D., CEO of the Prostate Cancer Foundation.  But some of them – particularly NKX3-1, which PCF-funded scientists Kosj Yamoah, M.D., Ph.D., and Edward Schaeffer, M.D., Ph.D., are studying – target black men in particular.   Even the genes that cause aggressive prostate cancer in men of all races “are activated earlier, and are disproportionately burdensome in African American men.”

Just as “people with red hair, blue eyes, and freckles are more likely to develop cystic fibrosis, and women of Ashkenazi Jewish heritage are more likely to have the BRCA1 gene that triggers breast and ovarian cancer, black men are more likely to develop aggressive prostate cancer, and to die of it,” Simons told the Congressional Black Caucus in 2018.  “In addition to the NKX3-1 gene, a handful of other genes need to be studied.”

In the meantime, black men need to be aware of their higher risk, and to get checked for prostate cancer regularly – because, to repeat a very important point, when the disease is caught early and treated, it is almost always curable.
Janet Farrar Worthington
Janet Farrar Worthington is an award-winning science writer and has written and edited numerous health publications and contributed to several other medical books. In addition to writing on medicine, Janet also writes about her family, her former life on a farm in Virginia, her desire to own more chickens, and whichever dog is eyeing the dinner dish.