By LINCOLN DEPRADINE
Prostate cancer, which severely impacts people of African descent, is curable and Black men must get themselves tested early for the possible presence of the disease, according to medical doctors Aisha Lofters and Neil Fleshner.
“Please get your loved ones tested,” Fleshner, a veteran uro-oncologist in the Division of Urology at the University Health Network, told participants at a conference hosted by The Walnut Foundation (TWF).
Dr. Lofters, in her conference address, described prostate cancer as “highly curable”, adding that available treatments are greatly effective.
Dr. Fleshner, in concurring, said many men who are diagnosed with prostate cancer receive treatment “and are cured, and I think that’s a great first message. It’s very treatable”.
Prostate cancer, he added, “is one where if you detect it early, in many cases, you can either – if not cure the man – you can certainly extend his life quite considerably, and I think that’s an important message”.
Fleshner and Lofters, a scientist at Women’s College Hospital and an associate professor at the University of Toronto, were among an expert panel of speakers at the annual conference of TWF, a health group with a mission to “advancing men’s health and wellness within the Black community, with a focus on prostate health”.
The conference, which examined why Black men are “disproportionately affected by prostate cancer”, was sponsored by Movember Canada, which supports and funds men’s health projects – including mental health and suicide prevention, prostate cancer and testicular cancer – “to help men live happier, healthier, longer lives”.
Research indicates that men of African background – those born on the continent and also males living in Diaspora communities, including Canada and the Caribbean – are at least “two times more likely to die from prostate cancer than other populations”.
Altogether, it’s said that “one in six Black men will be diagnosed with prostate cancer”.
Jamaican Dr. Belinda Morrison, who addressed the conference via an audio-video link from her homeland, said not only has prostate cancer been the “leading cancer” in Jamaica for the last 50 years, but it’s also claiming the most cancer-related deaths in the Caribbean, which has “one of the highest mortality rates of cancer in the world”.
“For the most part, for most islands, prostate cancer is number one,” said Dr. Morrison, a urologist and researcher, who did part of her medical training in Toronto.
“Persons who identify as being Black, generally, have a more aggressive form of prostate cancer and they appear to present at a younger age. This disease, in our population, is affecting younger and middle-aged men.”
Morrison, a senior lecturer at the University of the West Indies and also program director of the residency training program in urology at UWI, said males in the Caribbean often only undergo medical screening when an illness has become “metastatic” and has spread to various body parts.
“If you go to a public health clinic, it’s more likely that you’ll see a woman sitting there than a man. Men don’t generally go to the doctor until they feel very ill,” said Morrison, whose mentors while training in Toronto included Fleshner, a clinical scientist and prostate cancer doctor for about 30 years.
Fleshner said about 60 per cent of prostate cancers is explained by genetics. “It is very much a genetic disease,” he said.
Research, said Fleshner, only recently uncovered what appears to be a correlation between prostate cancer and a specific gene in Black men.
“We may have discovered a gene that is disproportionately represented in the Black community that may explain this risk of prostate cancer,” he said, adding that the information is “hot off the press” but also “very preliminary”.
Fleshner encouraged people to find out about their family’s medical history, saying “it’s important to know who in your family had what cancers and usually at what ages. That’s an important piece of information that we need as researchers. What we hope to do is, ultimately, that your kids or grandkids will know their genetic risks not just for prostate cancer; it will be for things like heart disease and stroke and for those individuals, we’ll tailor what diseases they need to check for and at what ages. That’s the way the whole field is going to go”.
Lofters and Dr. Jackie Bender reported on their combined research work on the prostate experience – including treatment, follow and support – of Black men in Ontario, Quebec, Alberta and Nova Scotia.
“Most of the participants have been from the Caribbean. We are having a much harder time recruiting men of West African background,” said Lofters.
“There’s very little research that has been done in the Black community in Canada, in general, regarding health and regarding prostate cancer.”
Lofters underscored the importance of research, saying data garnered could help in finding new medical cures and treatments and in influencing public policies, including government spending.
Bender, an assistant professor at the University of Toronto’s Dalla Lana School of Public Health, said a “Peer Navigation” program that she designed and developed more than 10 years ago, and on which she has collaborated with The Walnut Foundation, is being used to assist Black men, who “face very unique challenges to high-quality care after prostate cancer”.
“Navigation is an intervention that helps improve access to treatment and services to improve healthcare outcomes,” said Bender, who also works at the Princess Margaret Cancer Centre.
“We have interviewed Black men with prostate cancer and their family members across Canada, and one of the things we’re learning from them is that what they would really like is to connect with someone else – another guy, or another caregiver – who has gone through the prostate cancer experience, to really hear what it’s like and to learn what they can do to sort of cope with the symptoms and side-effects and have a healthy recovery.”
Bender emphasized that the “Peer Navigation” can help to “overcome barriers”, and is an “effective intervention for any health issue to help people navigate the healthcare system”.
She said that upcoming initiatives include the hosting of a workshop to “engage more Black men and their families in research”.
