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James Miller Jr. at a prostate cancer prevention event. Courtesy photo of Miller.<\/p>\n\t\t\t\t\tOverview:<\/p>\n
Black men in America are at a higher risk of prostate cancer diagnosis, with one in eight developing the disease compared to one in 12 white men. They are also diagnosed at later stages, often when treatment options are limited, and are twice as likely to die from the disease compared to white men. The most effective screening tool is a prostate-specific antigen (PSA) test, which is a simple blood draw, and the American Cancer Society recommends African American men start screening at 45, five years earlier than everyone else.<\/p>\n
James Miller Jr.\u2019s dream of being a homeowner had finally come true \u2014 which meant a trip to\u00a0 Home Depot for supplies. As he walked the aisles of the home improvement store, his phone rang. It was his doctor with news no one wants to hear: Miller had stage four metastatic prostate cancer.\u00a0<\/p>\n
His first question: \u201cHow much time do I have?\u201d\u00a0<\/p>\n
Maybe seven years, the doctor said. He was 57.<\/p>\n
Miller\u2019s story isn\u2019t unique \u2014 it\u2019s an epidemic hiding in plain sight. Black men face the highest rate of prostate cancer diagnosis of any racial or ethnic group in America. They\u2019re diagnosed at later stages, often when treatment options narrow. They\u2019re twice as likely to die from the disease compared to white men. These deaths are largely preventable. Yet in California, where Miller lives, no legislation specifically addresses prostate cancer screening or prevention.<\/p>\n
Advocates say that\u2019s unacceptable \u2014 and it\u2019s costing Black men their lives.<\/p>\n
What Every Black Man Needs to Know<\/p>\n
The prostate is a walnut-sized gland that sits below the bladder, responsible for creating ejaculation fluid, explains Dr. Brent Rose, associate professor of radiation oncology at UC San Diego. One of the biggest problems with prostate cancer is most men don\u2019t have symptoms until it\u2019s advanced.<\/p>\n
The most effective screening tool is a prostate-specific antigen (PSA) test \u2014 a simple blood draw, far more accurate than a digital rectal exam. Rose says many men avoid screening because they dread the rectal exam, but that test is no longer the standard recommendation.<\/p>\n
The statistics are sobering: One in eight Black men will develop prostate cancer, compared to one in 12 white men. Black men are also diagnosed younger. That\u2019s why the American Cancer Society recommends African American men start screening at 45 \u2014 five years earlier than everyone else.<\/p>\n
James Miller Jr. at a prostate cancer prevention event. Courtesy photo of Miller.<\/p>\n
\u201cWhy is it more common in Black men? The answer is, we don\u2019t know,\u201d Rose says. \u201cThere are two separate hypotheses. One is that it\u2019s genetic. And the other is related to social determinants of health,\u201d \u2014 factors such as racism, poverty, and disparities in health care access.<\/p>\n
The pain crept into Miller\u2019s lower back and hips first. Then came the frequent trips to the restroom.\u00a0Just getting older, he thought. When he dropped 20 pounds in a few months, he chalked it up to his diet finally working. But then came chest pain. Finally, he went to the emergency room.<\/p>\n
That\u2019s when Miller learned those were the symptoms of late-stage prostate cancer. The once sturdy, get-it-done airport security screener was now riddled with cancer \u2014\u00a0hips, lymph nodes, thigh bones, ribs, and even on his skull.<\/p>\n
\u201cIt was like a recording in my head. Oh my God, I\u2019m gonna die,\u201d the Riverside, California, resident says. \u201cHow did I get this? Is this karma? Did I deserve this?\u201d<\/p>\n
Miller admits he left Home Depot that day and went straight home and got drunk. Devastated, he started Googling, searching for any hope of surviving more than seven years. Depression quickly set in. After decades of neglecting his health and grinding through stressful jobs, Miller wondered if there was more he could\u2019ve done.<\/p>\n
\u201cMost Black men, you figure, \u2018I\u2019m still breathing, I\u2019m still walking around, I\u2019m fine.\u2019 We\u2019re taught from when you\u2019re a little boy, you grind it out, suck it up,\u201d Miller says. \u201cBut we have the highest rates of prostate cancer.\u201d<\/p>\n
According to the Centers for Disease Control and Prevention, between 2003 and 2022, Black men had the highest rate of localized, regional, and distant prostate cancer. Meaning whether it spread to other lymph nodes or parts of the body, Black men were the most likely to be diagnosed with the disease.<\/p>\n
\u201cBlack men are more likely to die from prostate cancer if they get it, on average, but not because the cancer itself is all that different,\u201d Rose says. \u201cIt\u2019s more likely that Black men tend to have more barriers to care. So getting diagnosed a little bit later or maybe not getting the optimal treatment.\u201d<\/p>\n
Secrecy Is Killing Black Men<\/p>\n
Melvin Parker watched his wife fight breast cancer. After a lumpectomy on her left breast, twice a day radiation for one week, and four rounds of chemotherapy \u2014 in December 2022, she rang the bell.\u00a0<\/p>\n
And then six weeks later, Parker got his own diagnosis: prostate cancer.<\/p>\n
The 53-year-old Frisco, Texas, resident had no idea the disease ran in his family. His father had prostate cancer. Parker\u2019s brother had it too, but only revealed his diagnosis after he finished treatment. Both brothers were diagnosed the same year.<\/p>\n
\u201cComing from a family where my dad is very old school, very traditional, very private \u2014 we don\u2019t share,\u201d Parker says. \u201cI\u2019m probably the most transparent of the family when it comes to health.\u201d<\/p>\n
During a routine Veterans Affairs Department check-up, physicians noticed Parker\u2019s PSA levels were high. Initially, they gave him tips on how to lower them. But a few months later, another test showed the levels were still high.\u00a0<\/p>\n
\u201cI was terrified. I was absolutely floored,\u201d he says. \u201cIs this my slow death? Is this the beginning of the end?\u201d<\/p>\n
Parker isn\u2019t sure at what stage his cancer was diagnosed. The\u00a0American Cancer Society states that<\/a>\u00a0prostate cancer stage matters, but doctors now look beyond it to consider risk factors \u2014\u00a0such as how aggressively it will grow and spread.<\/p>\n According to his doctors, the cancer had been growing in Parker\u2019s body for a couple of years before detection. A month after his diagnosis, he underwent prostate cancer removal surgery. Six months post-op, the results were in.\u00a0<\/p>\n Today, Parker is cancer-free.<\/p>\n