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Monday, December 9, 2013
Prostate CA Screening & African American Men
I am a caucasian woman who is dating an African American man. He is 50 years old with a family history of prostate cancer. Recently I found out that he`s never been screened for prostate cancer and has no intention of doing so. When I tried to bring it up he said, "We just don`t do THAT." I asked, "Who are `we` and what exactly is it that you don`t do?" to which he responded, "Brothers. We don`t do that..." and he wouldn`t say anything else. I don`t get it. Can you help me to understand his concerns. Is there anything I can say or do to help him understand why it`s important that he be screened?
Yes there are some African American males who feel that prostate screening particularly the DRE (digital rectal exam) is somehow demeaning, esmasculating, and for some strange reason, an assault on their manhood. When I've been presented with attitudes as this, I tell the person that
(1) the DRE gives the doctor a sense of any irregularities on the surface of the prostate
(2) it's the person undergoing the exam who needs to assess their feelings of identity particularly when the exam is done in private and lasts all of 3-5 seconds and their are no sexual connotations present unless the examinee imagines them
(3) if left unchecked and a person does contract prostate cancer and its left to grow unchecked, sexual performance and manhood will indeed be affected but more importantly the individual may be fighting just to live
(4) if keeping up appearances of masculinity are more important than making sure that one's health is monitored, then if a radical prostatomy is needed, impotence and incontience are probable outcomes that may last longer than a simple exam.
Finally, there are individuals who should consider undergoing a PSA test, which measures prostate antigens in the blood but the DRE is often used in conjuction with the PSA to get a comprehensive picture of what's going on with the prostate gland. Finally, finally, the person should speak with his physican to get the most up-to-date information on prostate screening and treatments.
I hope this helps.
David B Miller, PhD, MPH, MSW
Associate Professor of Social Sciences
Mandel School of Applied Social Sciences
Case Western Reserve University