(CNN) — Nate Battle avoided doctors until 2014, when his insurance company started promoting preventative health exams. Battle, 49, a Black man, claimed he arranged an appointment assuming it would be regular and innocuous. But a PSA test led to subsequent tests that indicated Battle had severe prostate cancer.
Battle told CNN he had his prostate removed and is grateful the disease was found early.
Battle remembered, “At my follow-up appointment, the doctor said, ‘You had another six months before things were going to get really bad for you.’” “That was scary to hear.”
The advocacy group ZERO Prostate Cancer estimates that 1 in 6 Black men will acquire prostate cancer. Black men are twice as likely to die from cancer than White men, according to the American Cancer Society.
Health experts like Battle warn Black men to obtain prostate cancer tests due to the racial imbalance.
Dexter King, the youngest son of Rev. Martin Luther King Jr., died of prostate cancer in recent weeks, highlighting the prevalence among Black males. US Defense Secretary Lloyd Austin had a prostatectomy in December to treat prostate cancer detected that month.
Doctors and health advocates attribute the death disparity to a lack of quality health care in many Black communities, mistrust and avoidance of the health care system, and stigma surrounding the disease, which prevents Black men from discussing their diagnosis.
These variables can also prevent screening, warn experts. According to the American Cancer Society, “having a father or brother with prostate cancer more than doubles a man's risk of developing this disease,” yet early diagnosis makes treatment easier.
Dr. Otis Brawley, Johns Hopkins University professor of oncology and epidemiology, said Black men have higher death rates because marginalized Black and brown communities often have doctors with less training and fewer resources for high-quality care. Low-income people frequently avoid health checks due to expense, he said.
Brawley claimed that if stage II Black and White males are treated equally, they have the same outcome and prognosis. “If you remove insurance, social, and racism issues and give everyone equal care, you get equal outcomes.”
Brawley said the digital rectal examination, in which a doctor inserts a gloved finger into a man's rectum to feel the prostate for abnormalities, is similarly stigmatized.
Brawley claimed many Black patients had declined the treatment.
Brawley helped start the Schaufeld Program for Prostate Cancer in Black Men at Johns Hopkins in 2021, which visits Baltimore and Washington, D.C. barbershops to educate Black men about prostate cancer and screening.
“A lot of men in their 30s and 40s don’t know what the prostate is, or where it is,” Brawley added. “We want them to know [screening] is available and that we respect their choice.”
Courtney Bugler, president and CEO of ZERO Prostate Cancer, said she has met with Black men who were unaware of their family history of prostate cancer because no one ever mentioned it.
"We find that men are not always interacting with their health care providers and don't realize they are at risk for the disease, so they don't know to be more vigilant," she added.
ZERO Prostate Cancer has conducted over two decades of awareness campaigns. Bugler said the group is also pushing Congress to adopt the PSA Screening for High-Risk Insured Men Act. Health insurance providers would have to provide prostate-specific antigen testing for Black males or men 55–69 with a family history of prostate cancer without co-pays, deductibles, or co-insurance.
Bugler said ZERO Prostate Cancer advises Black men to discuss prostate cancer screening risks and advantages with their doctors at 40. She also encourages them to share survival stories.
Battle denied going to the doctor for years, even knowing his family had males with the condition. Black males may not undergo prostate cancer screenings due to toxic masculinity and intransigence, he added.
“It’s ingrained in us that we are strong,” Battle remarked.
Battle stated this thinking is leading to Black prostate cancer mortality.
“It’s about putting your pride aside,” Battle remarked. “Is your pride more important than your life?”