Too Many Black Men Are Dying From Prostate Cancer
— Improving access to screening can reduce racial disparities and save lives
Dr. Weeks’ Comment: Are you concerned that you have bad genes and you may get cancer? Consider this: cancer is caused by epigenetic factors far more than by genetic factors. Only 5-10% of cancers are caused by bad genes. The rest of cancers is caused by what you expose your genes to from your environment and choices of food and drink.
“This year, more than 1 million Americans and more than 10 million people worldwide are expected to be diagnosed with cancer, a disease commonly believed to be preventable. Only 5–10% of all cancer cases can be attributed to genetic defects, whereas the remaining 90–95% have their roots in the environment and lifestyle.”
Cancer is a Preventable Disease that Requires Major Lifestyle Changes
journal Pharmaceutical Research Sept 2008
We learned in medical school “Genes load the gun, but epigenetics pull the trigger.” So what is “epigenetics” and how can you lower your cancer risk?
Epigenetics is the study of how your environment -including the food and drink and air you consume – changes the way your genes produce either health or illness. So your cancer risk is indeed increased if your parents or other family members had cancer, but not sinply because of genetics. Think with me for a minute: what other influences where you and your family members all exposed to? If you did not eat organic and non-GMO food, you were exposed to more to carcinogenic (cancer causing) herbicides and pesticides than your neighbor who ate organically. If you cooked with commercially processed, rancid canola, soy or corn oil, you were intoxicated with dangerous levels of glyphosate and oxidizing oils which suffocate your cells creating an ideal condition for the opportunistic (not so aggressive) cancer to thrive.
This article below deals with the catastrophically higher risk of lethal prostate cancer in black men
“I am well aware that Black men in the U.S. have the highest mortality rate for prostate cancer and are twice as likely to die from it than white men.”
and wisely calls for better screening. However, in addition, I teach my patients to improve the quality of their epigenetics in three crucial ways: 1) by enhancing active transport of oxygen to their tissues including the prostate (cancer can’t grow in well oxygenated tissues) 2) detoxifying on a cellular level to optimize cell membrane functions and 3) optimizing overall nutrition with organic, non-GMO finely ground seed drinks because seeds are the treasure chest of Nature concentrating as they do, nutrients 20-30X more than the plant’s fruit and vegetable. Also, stop all dairy as dairy increases prostate risk in black men .
So get your PSA screening (insist on the “% free PSA” also) and get your hs-CRP blood test to measure your degree of inflammation (because inflammation drives all cancers) and why not stack the cards in favor of health by optimizing your epigenetics.
ARTICLE by Jonathan Henderson, MD October 3, 2021
Prostate cancer remains the second highest cancer-related cause of death in men in the U.S., and there has been a worrisome trend of rising metastatic disease at diagnosis. These facts make it increasingly important that the urological community and the patients we serve turn our attention to ways to overcome these challenges.
The Role of Screening
As a urologist practicing in Shreveport, a majority-minority city in Louisiana — the state with the highest incidence of prostate cancer — I am well aware that Black men in the U.S. have the highest mortality rate for prostate cancer and are twice as likely to die from it than white men. Consequently, Black men are more likely to be saved by screening.
Prostate-specific antigen (PSA) screening may be more controversial today than decades ago, as more questions have arisen about the balance of benefits versus potential harms of unnecessary treatment. However, there is one aspect of this disease on which the entire healthcare community agrees: for both the diagnosis and treatment of prostate cancer, patient-physician shared decision-making should be optimized. Providers must have the ability to counsel patients on evidence-based best practices, taking into account the individual’s risk factors and personal preferences.
Unfortunately, policy changes over the past few years have made access to screening increasingly challenging. This is an issue that must be addressed at a Congressional level.
Consider a recent study on PSA screening in men ages 40 and older released at the 2021 Genitourinary Cancers Symposium. The data suggest that the 2012 decision by the U.S. Preventive Services Task Force (USPSTF) to de-prioritize PSA testing has resulted in a higher proportion of men diagnosed with metastatic prostate cancer in later stages than before the USPSTF policy. This decision was faulty from the beginning, as it was loosely based on an erroneous interpretation of previous data and undermines the benefits of PSA tests.
There is a direct relationship between PSA screening and diagnosing prostate cancer at an earlier stage. Despite multiple studies identifying this upward shift of prostate cancer metastatic at diagnosis, the USPSTF still devalues PSA testing by giving it a C grade, suggesting that the balance of benefits and harms is close and that the extent of the net benefit is small. In contrast, a rating of a B or higher would carry the recommendation to providers to offer or provide the service. The USPSTF’s current C rating is inappropriate because it not only negates a physician’s expertise and knowledge of a patient’s health history, but it also undermines recent breakthroughs in molecular and genomic testing that facilitate personalized precision healthcare delivery. Furthermore, as many insurers and providers use USPSTF ratings as one factor in planning treatment, men cannot be confident their insurance company will cover the cost of their PSA test.
This unacceptable circumstance diminishes the value of adequate access to PSA screening at a time when the number of deaths due to prostate cancer has been increasing. Many lives may not have been lost had people’s cancer been detected earlier.
Removing Barriers to Screening
The current rating highlights the essential role government regulators must play in removing barriers to screenings for those at high risk of developing prostate cancer, including Black men; those with a family history of prostate cancer; and professionals and servicemen who may have suffered exposure to cancer-causing toxins.
So, what can be done? Congress — though often ineffective at passing meaningful piecemeal healthcare legislation — can begin by reforming the process USPSTF uses to issue recommendations and guidance. Congress should hold this powerful, yet unelected agency to the same standards as other bureaus. The USPSTF Transparency and Accountability Act, introduced in every Congress since 2015, has sought to improve the accountability and processes of this unelected body.
Waiving cost-sharing — including deductibles, copayments, and coinsurances — for at-risk patients will help more men, including those affected by regional, economic, and racial disparities, to secure earlier diagnoses and better treatment options. Some states are introducing legislation to require insurers to cover prostate cancer screening, as state action has become increasingly commonplace due to congressional inaction on various issues. But the problem of prostate cancer in the U.S. is bigger than any one state’s legislature, and it has gotten worse, especially regarding prevention.
If elected officials in Congress are committed to reducing racial disparities in prostate cancer deaths, expanding access to healthcare, and protecting generations of American men, re-introducing and passing the USPSTF Transparency and Accountability Act is one of the simplest and most impactful actions they can take. As public policy catches up to the medical realities of prostate cancer, the work to educate and update primary care providers on the importance of PSA screening will remain essential.
Jonathan Henderson, MD, is president of the Large Urology Group Practice Association (LUGPA).