Prostate cancer disproportionately impacts Black men, often leading to more aggressive forms of the disease and later diagnoses. Black men are also twice as likely to die from prostate cancer as white Americans. This disparity makes early detection and advanced treatment options critical for improving outcomes. BlackDoctor.org spoke with Dr. Arpeet Shah, a urologist at Advocate South Suburban Hospital, to discuss the importance of early screenings for Black men and the benefits of innovative treatments.
Understanding Prostate Cancer in Black Men
Prostate cancer affects Black men at higher rates than their white counterparts, with cases often being more aggressive and diagnosed later. According to Dr. Shah, this increased risk means that Black men need to be particularly vigilant about screening and early detection.
“I tell my African American patients to begin screening earlier—around age 40—compared to Caucasian men, who typically start around 50. Screening is simple; it involves a blood test and physical exam. The screening should continue until around 70 to 75, depending on shared decision-making between the patient and their doctor. The goal is to catch prostate cancer early, so we can treat it more effectively and potentially less invasively,” Dr. Shah advises.
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Early Detection: Key to Better Outcomes
Prostate cancer is often referred to as a “silent” disease because it typically doesn’t show symptoms until it has reached an advanced stage. Many men believe that they don’t need to worry about prostate cancer until they experience symptoms. However, Dr. Shah stresses that this misconception can lead to late diagnoses, where treatment becomes more difficult, and the chances of a cure decrease.
“Prostate cancer doesn’t usually cause symptoms until it spreads, which is why screenings like the PSA blood test are crucial. If prostate cancer is caught early, it can be treated and often cured. Once it spreads beyond the prostate, we can control it but not cure it. So, regular screenings are essential, regardless of symptoms,” Dr. Shah says.
New Hope: HIFU Therapy
While traditional treatments for prostate cancer, such as surgery or radiation, have been effective, they often come with significant side effects. For patients with localized, significant cancer, newer therapies like High-Intensity Focused Ultrasound (HIFU) offer a more targeted approach.
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Unlike traditional methods that treat the entire prostate gland, HIFU focuses on the cancerous portion, leaving the healthy tissue intact. This form of focal therapy minimizes common side effects such as urinary incontinence and erectile dysfunction, which are more frequent in traditional treatments like radical prostatectomy.
“The benefits of HIFU are significant—it’s an outpatient procedure, done without any incisions. We place the ultrasound probe into the patient’s rectum while they are asleep, using ultrasound energy to destroy the cancerous area. Patients also recover faster,” Dr. Shah adds.
Who Can Benefit from HIFU Therapy?
Not every patient with prostate cancer is a candidate for HIFU therapy. It’s most effective for men with localized cancer confined to one area of the prostate. According to Dr. Shah, about 40 percent of prostate cancers in the U.S. can be managed with active surveillance—meaning the cancer is monitored rather than immediately treated.
“Whether a prostate cancer is suitable for active surveillance depends on several factors, including the patient’s age, health conditions, and how aggressive the cancer appears under a microscope. Some cancers are so slow-growing that treatment could cause more harm than good, but these patients must be closely monitored in case the cancer changes,” Dr. Shah notes.
However, for those with more significant or localized cancer, HIFU can be a game-changer.
Black Men and Prostate Cancer Treatment
Recent studies suggest that Black American men may respond better to some late-stage prostate cancer treatments. A 2019 study presented at the ASCO (American Society of Clinical Oncology) conference found that Black men showed improved outcomes when treated with newer hormonal therapies for metastatic prostate cancer compared to white men. While the reasons behind this are still being researched, this finding offers hope as new treatments emerge.
For early-stage prostate cancer, however, the best strategy remains early detection and prompt treatment when necessary.
Overcoming Hesitancy Toward Screening
Despite the importance of early detection, many men hesitate to get screened for prostate cancer. Whether due to fear, misconceptions, or a reluctance to visit the doctor, this hesitancy can have serious consequences. Dr. Shah encourages men to overcome these fears, emphasizing that the screening process is simple and the benefits of early detection far outweigh any discomfort.
“For those hesitant about screening, I’d say it’s normal to feel apprehensive, but the screening itself is very simple—a blood test that can be done alongside other routine tests. An abnormal result doesn’t mean you have cancer, just that further testing is needed. Most prostate cancers detected early are treatable or even curable, so early screening is vital,” he shares.
Prostate cancer is a significant health concern for Black men, but early detection and advanced treatment options like HIFU provide hope for better outcomes. By starting screenings early and staying informed about innovative therapies, you can take control of your prostate health and improve your chances of living a cancer-free life.
