What American Men Need to Know About the Prostate Cancer “Double Whammy”

Rarely in my career as a urologist have I been more concerned about men proactively protecting themselves from prostate cancer.

The reason to be proactive is fairly well known. Prostate cancer is the second-leading cause of cancer death in men. It trails only lung cancer.

Far less well known, and the reason I’m concerned, is something I call the “prostate cancer double whammy.”

Even before Covid-19 changed our world, urologists were already alarmed at data showing that the rate of advanced prostate cancer rose in men 50 and older in the years following a federal government task force recommendation against the PSA test. That test measures the prostate specific antigen (PSA) level in blood.

Fast-forward to the pandemic. A few months into nationwide lockdowns, America’s Covid-19 expert, Dr. Tony Fauci, warned in a speech to cancer doctors about the reduced number of Americans seeking regular cancer screenings. Fewer regular screenings for prostate, breast, and other cancers could result in an estimate 10,000 additional cancer deaths over the next several years.

Screenings criticized, followed by pandemic

Even before Covid-19 changed our world, urologists were already alarmed at data showing that the rate of advanced prostate cancer rose in men 50 and older in the years following a federal government task force recommendation against the PSA test. That test measures the prostate specific antigen (PSA) level in blood.

Fast-forward to the pandemic. A few months into nationwide lockdowns, America’s Covid-19 expert, Dr. Tony Fauci, warned in a speech to cancer doctors about the reduced number of Americans seeking regular cancer screenings. Fewer regular screenings for prostate, breast, and other cancers could result in an estimate 10,000 additional cancer deaths over the next several years.

The latest evidence of this prostate cancer prevention one-two punch continues to be daunting.

Aggressive cases double

The Centers for Disease Control and Prevention (CDC) said in a recent report the proportion of aggressive (metastatic) prostate cancer cases doubled between 2003 and 2017, going from four to eight percent.

The spike can be attributed to the U.S. Preventive Services Task Force recommendation in 2012 against the routine use of screening with the PSA test.

There is no doubt American men would benefit if PSA testing would come back to where it was before the Task Force intervened.

Additionally, in late January 2021, the American Cancer Society issued a Cancer Can’t Wait open letter, noting the dramatic drop-off in pandemic-era screenings, foreshadowing a staggering rate of preventable deaths.

So, here is the key takeaway for men and those who love them: If we do the screenings and find prostate cancer early, we have a high chance of cure. If we put our heads in the sand, some people will come to the doctor with cancer that is too far advanced to cure.

Situation compounded for African American men

Black men are fifty percent more likely than white men to get prostate cancer, and twice as likely to die from the disease.

The pandemic has raised awareness of the disparities in minority access to quality healthcare. Having a conversation with a doctor about prostate cancer and getting tested is an opportunity for Black men to bridge the healthcare access gap.

There’s no better time than the present for Black men to take the PSA test. After all, April is National Minority Health Month.