By Kai Li
September is Prostate Cancer Awareness month, a perfect occasion to focus on prostate cancer risk factors and prevention. This is particularly urgent for Black men, who are 1.7 times more likely to develop prostate cancer and more than twice as likely to die from it than all other racial or ethnic groups. Among Black men in Maryland, 1 in 7 is expected to be diagnosed with prostate cancer, and it is the second leading cause of cancer death.
Racial disparities in the incident rates and mortality may exist because of persistent structural inequities, such as the lack of access to specialists, poor doctor-patient encounters that lead to distrust, treatment delays, and communities with higher environmental toxin exposures. Despite these inequities, I have seen in my own practice how following these tips, such as knowing your risk factors, monitoring for symptoms and being proactive, can help you take control of your prostate health.
1. Know your risk factors:
Risk factors include family history, older age, ethnicity, and unhealthy lifestyles. One of the major risk factors for prostate cancer is obesity. Black men have a higher rate of obesity at 37.1 percent compared with White men at 32.4 percent. Black men can reduce obesity by adopting healthy diets and lifestyles such as eating a low-fat diet including more fruits and vegetables, maintaining a healthy weight, and being physically active most days.
2. Stay up to date with your primary care for early detection:
Common symptoms include difficulty with urinating, and pain in the lower back, belly, hip, or pelvis. Early detection allows for more treatment options. Prostate cancer has a 99 percent five-year survival rate when diagnosed in stage one. If detection occurs at a later stage, the five-year survival rate drops to 31 percent.
Mr. Ellis Ivey, one of my patients, a 62-year-old Black man from District Heights, Md., has been a Kaiser Permanente member for more than 30 years. Ivey has stayed on top of making routine check-ups and blood work thanks to Kaiser Permanente’s reminders for screenings, appointments, and vaccinations based on genetic factors. During one of the routine appointments, his blood test resulted in a high prostate specific antigen (PSA) count. After my in-office prostate biopsy confirmed that Mr. Ivey had prostate cancer, I quickly performed a robotic-assisted laparoscopic radical prostatectomy surgery in August 2021. Today, Mr. Ivey is feeling great, and his cancer is in remission.
“From my view, Kaiser Permanente is the best thing that’s ever happened to me,” said Mr. Ivey. “If it weren’t for Kaiser Permanente, I wouldn’t be doing so well. My nurses, primary care physician, and other doctors take good care of me. They always remind me of tests and procedures I need quickly. I am grateful for my care with Kaiser Permanente and Dr. Li.”
3. Know your treatment options to advocate for your own health care:
Treatment for prostate cancer is determined by the stage of cancer as measured by the Gleason score, which is a grade from 1 to 5 based on how abnormal the cells appear. Other factors include your PSA, clinical exam, age, and overall health. The main proven treatment options include active surveillance, radiation therapy, and surgery. You should know your treatment options so you can discuss them with your health care provider. Active surveillance involves closely monitoring patients that allows them to avoid or postpone treatments that may cause side effects. This option may be recommended for slow-growing cancer that’s confined to the prostate. Should definitive local treatment be necessary, the two treatment choices are surgery or radiation. While these options have equivalent cancer control outcomes, they differ in recovery, side effects, and complication profiles.
Many of my patients benefit from conducting their own research before making decisions about prostate treatments. Kaiser Permanente offers prostate cancer health tools to help patients make wise health choices or take action to improve their health.
Like Mr. Ivey, you can take control of your prostate health and maybe even save your own life with routine screenings, early detection and knowing your treatment options should a problem arise. By partnering with your primary care doctor and using online health tools, you can advocate for your health.
Kai Li, MD is a urologist with Kaiser Permanente, a leading health care provider in the country.