Painting A Portrait of Prostate Cancer

[Note: This article is the first of a two-part series on prostate cancer and it contains mature health subject matter.]

By Terrance Afer-Anderson

PART ONE:

In 2007 and 2008, in my role as a Health Educator for the Norfolk Department of Public Health, I served as the Marketing and Public Relations Committee Chair for the American Cancer Society of South Hampton Roads’ Annual African-American Men’s Health Forum. Its major focus was to increase awareness of the stunning prostate cancer disparity impacting Black men.

The Office of Minority Health of the U.S. Department of Health and Human Services reports that, from 2017 to 2021, African-American males were 1.7 times more likely to have new cases of prostate cancer than non-Hispanic white males. It further notes that, from 2018 to 2022, African-American males were 2.1 times more likely to die from prostate cancer than non-Hispanic white males.

To put that in perspective, I had no idea when beginning that important advocacy and awareness work with ACS that, in 2009, I would myself be diagnosed with prostate cancer. Neither was I aware that, after having a procedure in 2010 to assail and eradicate the disease, that it would return with vengeance some 14 years later, in the Fall of 2023, as metastatic disease, nor that it would rear its ugly head yet again with a second metastatic recurrence in late Spring of this year.

To the uninformed, metastatic disease means that cancer has spread beyond its original site, in my case, outside of the prostate gland. I won’t go into specifics but will note that I have ever defined myself as a prostate cancer survivor-warrior.

Much of that inspired approach is due to the encouragement of Charlie W. Hill, a co-founder and towering president of the Hampton Roads Prostate Health Forum, established in 2007.  Charlie was also working as a community volunteer with ACS at that time and became a blessed, cherished mentor when I was first diagnosed and navigating the disease.

◆◆◆

But what is the prostate gland? What is its purpose? How big is it? Is it an essential organ?

The origin of the word prostate is in the Ancient Greece, meaning “stands before.” That’s wholly appropriate because the prostate gland is located below, positioned in front of, the bladder. The rectum is itself behind the prostate. I’ll come back to that in just a minute.

The gland is typically described as about the size of a walnut and it weighs about 1 ounce. The National Institutes of Health National Library of Medicine notes, “The prostate’s most important function is the production of a fluid that, together with sperm cells from the testicles and fluids from other glands, makes up semen. The muscles of the prostate also ensure that the semen is forcefully pressed into the urethra and then expelled outwards during ejaculation.”

Advertisement

That small gland has wrought havoc among many African-American men and their families. So, my own diagnosis has not only made me a fighter, but an impassioned advocate, ever committed to spreading the word about the ravages of prostate cancer in the nation’s Black communities, in earnest painting a portrait of the various parameters of the disease. There are several elements in which we should take note.

The onset of prostate cancer is often asymptomatic. You may not have any symptoms at all. When symptoms do occur, it could be indicative of later stage disease. Yet, through routine care, prostate cancer is most often diagnosed early, a benefit frequently escaping Black men.

The Mayo Clinic references the following potential symptoms of prostate cancer. “blood in the urine, which might make the urine look pink, red or cola-colored; blood in the semen; needing to urinate more often; trouble getting started when trying to urinate; waking up to urinate more often at night.”

Mayo further notes that, the “signs and symptoms of advanced prostate cancer can include: accidental leaking of urine; back pain; bone pain; difficulty getting an erection (erectile dysfunction); feeling very tired; losing weight without trying; weakness in the arms or legs.”

So how does one get screened for prostate cancer? Let’s first take a look at PSA, an acronym for prostate-specific antigen, the protein produced by cells of the prostate gland. The cells can either be normal or malignant, cancerous.

The Centers for Disease Control and Prevention, the CDC, a critical federal agency currently under fire by the Trump administration, notes, “The levels of PSA in the blood can be higher in men who have prostate cancer.” One of the primary screening tools to assess if someone might be a candidate for prostate cancer is the PSA, a blood test to discern the level of prostate-specific antigen in the blood.

The CDC also adds, “The PSA level may also be elevated in other conditions that affect the prostate.” The agency identifies these as: “certain medical procedures, certain medications, an enlarged prostate, a prostate infection.”

Though many urologists and oncologists are stepping away from performing a procedure having traditionally been done in association with the PSA test, it was for many years considered an important companion, tactile screening. It is the dreaded DRE, the digital rectal exam.

I’ll begin the second half of this Painting a Portrait of Prostate Cancer series opening up – a purposefully witty choice of words – with some insight on the DRE.

Advertisement