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SUMMIT HIGHLIGHTS PROSTATE CARE INEQUITIES

By LAURA HEATON

UPI Consumer Health Correspondent





WASHINGTON, Sept. 23 (UPI) -- Prostate-cancer survivors, community leaders, policymakers, doctors and medical researchers convened Thursday to bring attention to a glaring disparity in the rates of prostate cancer in African-Americans.



"We understand that prostate cancer completely, unfairly, and inappropriately strikes African-American men," Sen. John Kerry, D-Mass., said at the second annual African-American Prostate Cancer Disparity Summit on Capitol Hill. Kerry has spoken publicly about his own battle with the disease.



African-American men have a 60 percent higher incidence rate and a 150 percent higher mortality rate from prostate cancer, compared to all other groups. In 2006 more than 232,000 men will be diagnosed with prostate cancer, and more than 30,000 men will die from it, according to the Prostate Cancer Foundation.



The two-day event, which coincides with National Prostate Cancer Awareness month, is hosted by the Prostate Health Education Network. Founded by cancer survivor Thomas A. Farrington, PHEN aims to confront the disparity of African-American men dying from prostate cancer at more than two times the rate of any other race.



Prostate cancer is "a major problem that has gone on for years, and now it is systemic and epidemic," Dr. V. Diane Woods of California's Loma Linda University told United Press International. There are both genetic and behavioral factors that contribute to this disparity, she added.



Panelists detailed some of the current research into the genetic reasons for prostate-cancer disparities. Most of the dialogue, however, focused on the societal and behavioral factors that contribute to the unfavorable statistics.



The main barriers to effective prostate healthcare among the African-American community are a distrust of the healthcare system, a fear of rectal exams and diagnosis, a lack of knowledge of cancer cures and routine exams and concerns about treatment, said Dr. Isaac Powell of Detroit's Wayne State University.



"These are the factors we can influence," Powell said.



But as the statistics suggest and participants at the Summit acknowledged, a significant portion of the U.S. population remains uninformed.



"We have a healthcare system that knows that if you detect early you can save lives, and a healthcare system that knows that if you make a variety of treatments available you can save lives. We're not doing it," Kerry said.



Prostate-cancer screening typically consists of two procedures: A PSA screening measures the level of prostate-specific antigen in a patient's blood. Through a digital rectal exam, a doctor can check for any noticeable abnormality in the prostate.



"Right now, our biggest weapon is early detection," said Everett Dodson, director of prostate-cancer screenings at Howard University Cancer Center in Washington, the only African-American cancer center in the country. Dodson will manage a series of free screenings in conjunction with the summit this weekend.



Remarks made by panelists reflect the controversy that exists within the medical community regarding prostate-cancer screening. Some people are concerned about false positives and about creating premature alarm, Dodson explained. Furthermore, results from the tests might lead a man to undergo intrusive treatment, even when he might have a very slowly progressing cancer that doesn't yet need to be treated.



Some at the conference suggested a doctor's failure to discuss screening with an African-American patient could reflect systemic racism.



Dr. Timothy Gilligan from the Cleveland Clinic Taussig Cancer Center responded that "the ethical question in medicine about whether or not to intervene in the lives of apparently healthy people" was more of an issue.



Gilligan recommends doctors educate men about aspects of the screening so that individuals can make their own decisions.



While acknowledging the controversy over the importance of screening, Woods pointed out that doctors ultimately decide what issues to discuss with their patients. These decisions, she said, can be based on the doctor's perceptions of a patient.



"A white male doctor could be operating on the myth that his black male patient doesn't care about preventative health" and will therefore not discuss options that he might offer to his white male patients, she said.



These cultural misperceptions are also a result of scant information available in the medical field about African-American men, Woods said. She cited findings by the National Institute of Health, which showed that in 2004 only 4 percent of human research subjects were black males.



The initial screening is an important first step, but clinics and institutions must also concentrate efforts on providing adequate follow-up care, said Dr. Lucile Adams-Campbell, director of Howard University Cancer Center.



"Once you get men into the system I guarantee that you'll be dealing with hypertension, diabetes, obesity, stroke -- you name the tune -- and you'll be saving lives."



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