Prostate cancer is a significant health concern, ranking as the second leading cause of cancer-related death among men in the United States.
Studies reveal that the incidence of prostate cancer is twice as high in Black men compared to white men. What’s even more alarming is that Black men are disproportionately diagnosed at later stages of the disease, leading to lower survival rates.
This disparity is deeply troubling and warrants a broader conversation about equitable healthcare access—a discussion we must have in the near future.
For now, let’s focus on how to make informed healthcare decisions regarding prostate cancer. This topic is personal for me—not only am I a Black man, but my father is also a prostate cancer survivor. That puts me at a greater risk of getting prostate cancer. Yep, I have skin in the game with these recommendations I’m about to share with you.
The Controversy of Prostate Cancer Screening
Screening for prostate cancer—primarily using the PSA (Prostate-Specific Antigen) test—has been one of the most debated topics in healthcare since its introduction in the 1990s. Key questions remain: Who should be screened? When should screening begin? Should we rely on PSA testing, Digital Rectal Exam (DRE), or both?
Although we’ve learned a lot over the years, the conversation around prostate cancer screening remains complex. Notably:
- DRE’s Limitations: Research shows that DRE has limited value in detecting early-stage prostate cancer.
- PSA Testing Concerns: While PSA testing is associated with early detection, it doesn’t necessarily lower mortality rates. It also carries risks of overdiagnosis, leading to unnecessary procedures and complications.
For Black men or individuals with a family history of prostate cancer, these general findings may not apply in the same way. In these cases, early screening—even starting in your 40s—could be life-saving.
Understanding PSA Testing
One important thing to understand is that an elevated PSA level doesn’t always indicate prostate cancer. PSA levels can rise due to other conditions, such as benign prostatic hyperplasia (BPH), which is a non-cancerous enlargement of the prostate. This lack of specificity has led to recommendations emphasizing the importance of shared decision-making between patients and their physicians.
In 2008, guidelines began focusing on the need for a collaborative approach to PSA screening. This means having an open conversation with your doctor about the risks, benefits, and your personal health history. Together, you can decide if PSA testing is right for you.
The Role of Shared Decision-Making
Shared decision-making is where you have a conversation with your physician to learn about the risks and benefits of getting PSA testing. It's a collaboration in the decision about if and when to screen for prostate cancer. It involves:
- Assessing Risks: Your physician will evaluate your personal and family health history.
- Discussing Benefits: You’ll understand how screening could lead to early detection.
- Addressing Concerns: Your doctor will explain the potential risks, such as false positives or overdiagnosis.
- Empowering Your Choice: Ultimately, the decision to screen is yours, supported by your physician’s expertise.
This approach ensures that the decision to undergo prostate cancer screening aligns with your values, priorities, and health status.
Building a Relationship with Your Physician
If you’re considering prostate cancer screening, one critical step is finding a physician you trust. Your doctor is your partner in navigating the complexities of screening and ensuring you receive personalized, compassionate care.
At Coupet Quality Clinic, we believe in fostering strong patient-physician relationships built on trust and open communication. This connection is vital for making healthcare decisions that align with your needs.
The Bottom Line
If you’re at risk of prostate cancer, don’t let the noise and confusion surrounding screening deter you. The most important step you can take is simple: talk to your physician. That one conversation could save your life.
I’m Dr. Coupet, the people’s doctor, and I’m here to advocate for your health. Remember, informed decisions start with informed conversations. Take charge of your health today.