In recent shows we have dealt with issues like maternal mortality, school exclusions, police brutality and deaths in custody and youth homicides in general. Something they all have common is that they all disproportionately affect Afrikan people (https://www.mixcloud.com/AfrikaSpeaks/). (1)
Prostrate cancer can also be added to the list. It is the most common cancer in men in the UK, but:
“Although it affects all men, black men are 2-3 times more likely to develop this cancer than their white counterparts. The death rate is twice as high. Furthermore, black men are more likely to develop prostate cancer at a younger age.” (2)
A staggering 17% of men don’t even know they have a prostrate. (3) Additional concern is found in research that reveals that this high risk group are only largely oblivious to the symptoms (which can include any or some of: an increased need to urinate or thoughts of urinating more frequently, pain during sex, chronic fatigue, sudden weight loss, feelings of nausea, difficulty urinating standing up or maintaining a steady stream, and pain in the crotch, thighs or lower back), but also uninformed about how to identify common warning signs. What makes this more worrying is that the early stages can be relatively symptom free. (4)
In spite of the fact that prostrate cancer is the second most common form of the disease in the country, behind breast cancer, there is currently no national screening programme because the National Health Service (NHS) have yet to identify proof that that the benefits outweigh the risks. (5)
Further afield, we find the situation replicated around the world. Afrikan men in the USA have “substantially higher prostate cancer incidence and mortality rates than the general population.” (6) Additional studies indicate that “the Caribbean population have the highest rates in the world (26.3 per 100,000) closely followed by sub-Saharan Africans (10 per 100,000), whereas Asians have the lowest (2.5 per 100,000).” (7)
None of the studies so far have conclusively identified the reason for the disproportionality and although some reports have highlighted some genetic and biological factors (e.g. high testosterone levels), the sample sizes have been too small to be generalisable. (8)
Aside from the preponderance of prostrate cancer among Afrikan men, other factors can also exacerbate the outcome, including “distrust, fear and disconnect with the health care system.” In fact, some studies reveal that doctors are more likely to recommend a watch-and-wait approach over surgery or radiation therapy for Afrikan men, compared to European men. There is also some evidence that some Afrikan men are also inclined to watch-and-wait due to reservations about the side-effects of treatment. (9) Another study relates such reservations to the association with “various perspectives of sexuality, masculinity and identity.”:
“In healthy men, the discourses for masculinity and being a man is strongly linked to being sexually active and taking care of one’s family. Inability to fulfil these roles threatens this idea of masculinity resulting in men staying away from anything that might suggest that loss. In the studies conducted in Africa and specifically on men from African backgrounds, there was a real fear that men would lose their partners to others if they failed to keep up their sexual relations.” (10)
The methods for diagnosing prostrate cancer have also been cited as a barrier to identifying the illness. As well as the PSA (prostate specific antigen) blood test, which is not always conclusive, there is the digital rectal examination, which in spite of being the only way of feeling the prostrate, is viewed warily. (11)
Further to whatever the influence of genetics and biology may be, Afrikan-centered Holistic Health practitioner, Dr. Llaila O Afrika, asserts some lifestyles causes of prostrate problems, namely “abuse.” He elaborates:
“The are many types of abuse for example sexual activity irrespective and regardless of the male cycle and too frequent ejaculation. Additionally, tight pants, synthetic and underwear cause thermal fatigue and do not allow the temperature of testicles to be regulated. Also hormonal fluctuations caused by synthetic foods, immunosuppressive drugs (i.e. asprin, white sugar), alcohol, vinegar, salt, smoking and general dis-ease.” (12)
The charity Prostrate Cancer UK has taken steps to meet the challenge head on, initially by an awareness raising campaign called ‘Stronger Knowing More’ fronted by WBA world heavyweight champion David Haye, Olympic gold medallist Linford Christie, writer and musician Benjamin Zephaniah, ex-England footballer Viv Anderson, actor and Red Dwarf/Death In Paradise star Danny John-Jules, and capricious MP Chuka Umunna. Another campaign lead is prostrate cancer survivor Errol McKellar. (13) There is some logic to the approach as there are some very high profile Afrikan men that have survived prostrate cancer including Ben Carson, Sydney Poitier, Quincy Jones, Louis Farrakhan, Colin Powell and Harry Belafonte. (14) Indeed, Nation of Islam leader Min. Louis Farrakhan has set up his own prostrate cancer foundation. (15)
But Bro. Errol’s story is instructive. In 2010 he took a PSA after a chance sighting of a prostrate cancer leaflet at his doctor’s surgery, while there for an entirely different matter. Additional tests would reveal that he had 92% prostate cancer. His treatment included an operation and three months of radiotherapy. He has now been given the all clear but he is continually dealing with some of the serious side effects from his treatment, including bladder control and erectile dysfunction. (16)
Undeterred, Errol has become an award-winning campaigner raising awareness about the disease. When he worked as a mechanic, he helped save the lives of almost 50 of his customers who would not otherwise have been aware they had prostate cancer. (17) He has since set up The Errol McKellar Foundation is currently that focuses primarily on giving presentations and talks around the UK to raise awareness of important men’s health issues and especially prostate cancer. (18)
When confronted with all the risk factors, some of which can be down to just family association, the underlying message must be towards a healthier, preventative lifestyle. Llaila Afrika suggests as a remedy for prostrate problems:
“A cleansing diet of fruits could be beneficial. Additionally, herbs such as parsley, uva ursi, ginger, juniper berry, gravel root, echinacea, red clover, yucca, goldenseal, juniper oil capsules, Aminos such as Glutamic Acid, Alanine, Glycine and Histidine are used to treat this dis-ease. Also infections in this area are best remedied with cranberry juice, juniper berry oil, vitamin E, vinegar and water. Again, a wholistic natural foods diet coupled with a healthy mind and spirit are recommended for optimum results.” (19)
Given that, according to the Public Health Outcomes Framework, Afrikan people are the most like out of all groups to be overweight or obese (20) as well as being two to four times more likely to develop Type 2 diabetes than white people, a healthier lifestyle is replete with challenges. (21) Yet coupled with poor health outcomes for Afrikans globally is the realisation that “Racism Is Literally Bad For Your Health,” physically and mentally. (22) Therefore, it might make sense for our own holistic well-being, and our families and children in particular, to include fighting racism in our overall health strategy.
(1) Emma Kasprzak (12/04/19) Why are black mothers at more risk of dying? https://www.bbc.co.uk/news/uk-england-47115305; Office of the Children’s Commissioner School Exclusions Inquiry (2012) “They never give up on you”. p. 9 https://www.childrenscommissioner.gov.uk/wp-content/uploads/2017/07/They-never-give-up-on-you-final-report.pdf; Kevin Rawlinson (01/08/17) Met using force against disproportionately large number of black people. https://www.theguardian.com/uk-news/2017/aug/01/met-police-using-force-against-disproportionately-large-number-of-black-people; Institute of Race Relations (1991) Deadly Silence: Black Deaths in Custody. Institute of Race Relations.; BBC News (08/03/19) Killed in 2019: The UK’s first 100 victims. https://www.bbc.co.uk/news/uk-47476217.
(2) Professor Frank Chinegwundoh MBE (12/06/18) Time to talk about the prostate cancer risk in black men and what we can do about it. https://www.england.nhs.uk/blog/time-to-talk-about-the-prostate-cancer-risk-in-black-men-and-what-we-can-do-about-it/
(3) Linford Christie (16/0417) Black men must face the truth about prostate cancer. https://www.theguardian.com/commentisfree/2017/apr/16/black-men-truth-prostate-cancer
(4) The Voice Online (02/04/19) Thousands Of Black Men Unaware Of Prostate Cancer Signs. https://www.voice-online.co.uk/article/thousands-black-men-unaware-prostate-cancer-signs.
(5) Ibid.
(6) Cancer Treatment Centers of America (CTCA) (28/09/17) Study finds black men with prostate cancer are less likely to get proper treatment https://www.cancercenter.com/community/blog/2017/09/study-finds-black-men-with-prostate-cancer-are-less-likely-to-get-proper-treatment
(7) Abeyna LC Jones and Frank Chinegwundoh (2014) Update on prostate cancer in black men within the UK ecancer 8 455. https://ecancer.org/journal/8/full/455-update-on-prostate-cancer-in-black-men-within-the-uk.php
(8) Ibid.
(9) CTCA. Op. cit.
(10) Mavis Machirori, Christine Patch & Alison Metcalfe | Noy Kay (Reviewing Editor) (2018) Study of the relationship between Black men, culture and prostate cancer beliefs, Cogent Medicine, 5:1, DOI: 10.1080/2331205X.2018.1442636. https://www.cogentoa.com/article/10.1080/2331205X.2018.1442636
(11) Chinegwundoh. Op. cit.
(12) Llaila O Afrika (1998) Afrikan Holisitc Health. A&B Publishers Group. p. 37.
(13) Sharon Thiruchelvam (06/12/17) Marketing a life-saving message for men. https://www.raconteur.net/healthcare/marketing-a-life-saving-message-for-men
(14) Avia Ustanny (28/01/07) The secret that kills: Focus on prostate cancer. http://old.jamaica-gleaner.com/gleaner/20070128/news/news7.html
(15) Ralph Blum (06/12/11) Calling All 40 Year Old Black Men. https://pcri.org/insights-blog/2017/7/27/calling-all-40-year-old-black-men
(16) The Errol McKellar Foundation (2018) The Errol McKellar story. http://theerrolmckellarfoundation.com/errol-mckellar/errol-s-story
(17) Ibid.
(18) The Errol McKellar Foundation (2018) About us. http://theerrolmckellarfoundation.com/foundation/about-us
(19) Afrika. p. 179
(20) Public Health Outcomes Framework (22/08/18) Overweight adults. https://www.ethnicity-facts-figures.service.gov.uk/health/preventing-illness/overweight-adults/latest#by-ethnicity
(21) Diabetes UK (27/02/19) Number of people with diabetes reaches 4.7 million. https://www.diabetes.org.uk/about_us/news/new-stats-people-living-with-diabetes
(22) Michel Martin (28/10/17) Racism Is Literally Bad For Your Health. https://www.npr.org/2017/10/28/560444290/racism-is-literally-bad-for-your-health?t=1560710645308; Laia Becares (15/01/15) How racism harms health. http://blog.policy.manchester.ac.uk/featured/2015/01/how-racism-harms-health/
we ask the question:
Do we take prostate cancer seriously enough?
1) Do you know where your prostrate is, or are you among the 17%?
2) Would a national screening programme raise awareness? Would Afrikan men participate?
3) Are some men put off by the diagnostic methods and the potential side-effects of treatment?
4) Do we need a community-based campaign to tackle the issue?
5) Will fighting racism improve our health?
Our Special Guest:
Bro. Errol McKellar: is the award-winning founder of the The Errol McKellar Foundation and gives inspirational presentations and talks around the UK to raise awareness of important men’s health issues and especially prostate cancer. A retired mechanic, Bro. Errol is a prostrate cancer survivor, who after being treated for the disease helped save the lives of almost 50 of his customers who would not otherwise have been aware they had prostate cancer. He’s also been a youth team coach and scout with Leyton Orient and several other London clubs for almost 30 years and worked with many future stars including David Beckham, Ashley Cole and Sol Campbell. Bro. Errol was awarded the 2016 Points of Light Award for Volunteering and the 2018 NHS Heroes Award – Hero Volunteer. http://theerrolmckellarfoundation.com/
Additional information about the health inequalities around prostrate cancer, including the Hear Me Now reports are available from BME Cancer Communities (http://bmecancer.com/index.php/hear-me-now/download-reports).