Since only Black men are dying from prostate cancer earlier and at twice the rate over every other racial group, medical professionals might as well now throw out what many health officials believe is the best test for detecting prostate cancer in Black men.
The debate rages on in the medical community under the recent recommendation that doctors stop offering the PSA blood test. It comes as a big surprise to local family practitioner Sanaa Ligons.
The Prostate Specific Antigen test is always one of the first tests she orders for her over-50 male patients.
Dr. Ligons at the Whitney Young Family Health Clinic in San Bernardino, said that she understands that the test that may not be so critical for other racial groups. Even so, she said that Black males should not only continue PSA testing, but start earlier than the current recommendations.
“In some populations, maybe the Hispanic and Caucasian population, where it’s not so frequent or so bad, it’s okay not to [PSA] screen, but for African American males, I think we should be screening earlier,” Dr. Ligons said.
At the Whitney Young Clinic, African American men over age 50 can routinely expect to get the essentially painless PSA test, an important protein marker that determines if a man has prostate cancer. If they’re over the recommended age, she automatically orders the lab.
The other alternative–the dreaded Digital Rectal Exam–is often a deal breaker for Black males.
Dr. Ligons said the clinic doesn’t use DREs anymore, just the PSA because it is more reliable to detect the cancer.
When men get their annual PSA, it’s easier to spot the trend over time. If the protein marker rises, it’s one indicator that he may have the beginning stages of the cancer. With that earlier indicator comes a better chance of survival.
But she said patients must also watch for other symptoms. Urination shows the first signs of trouble if the patient sees a slower or weak urine stream, which could indicate prostate enlargement or cancer. Those symptoms could be benign, meaning not cancerous, but no one should take the chance by avoiding the test.
Black men are most likely to get and die from prostate cancer, but she said that they are still not getting better about walking into her office, and asking for their PSA tests.
“Nope; not at all. They don’t come in and request it,” she said.
Recommendations on prostate screening come by way of the U.S. Preventive Services Task Force, and is being criticized for calling to curb PSA testing, particularly since Black men comprise those most at risk of dying from the cancer. However, they reportedly only made up about 4% of the Task Force’s case study.
Essentially, medical advocates argue that throwing out the PSA test would be a killer for more Black men.
Men’s Health Network (MHN) and the Veterans Health Council also stand strongly opposed to the decision to curb testing, claiming that Vietnam-era veterans were also more at risk from over-exposure to Agent Orange.
The group blasted the Task Force for not consulting with the National Cancer Institute, or its studies showing that PSA screening was attributed to a 45-70% decline in death rate, as presented at the annual African American Prostate Cancer Disparity Summit last year.
“The recommendation against PSA testing puts men’s lives in jeopardy as they will be discouraged from getting screened for prostate cancer. This especially affects African-American men, men exposed to Agent Orange, and men with a family history, all of whom are at greatest risk of developing prostate cancer and dying from the disease. In the U.S. alone, 30,000 men die from prostate cancer annually, a staggering number. Early detection is key and PSA testing is the best available tool, reducing prostate cancer mortality by 40% since its inception,” commented Ana Fadich, MPH, CHES, Director of Programs and Health Promotion at MHN.
For information on screening, call Whitney Young Family Health Clinic at (909) 386-7600