Black men are two to three times more likely to die of prostate cancer than white men, and doctors are powerless to explain why or reduce the risks.
Calling the figures “a disgraceful tragedy,” on Tuesday the American Cancer Society and 100 Black Men of America urged a national attack on prostate cancer - hoping to emulate activists who successfully raised millions of research dollars to fight breast cancer and AIDS.
At the top of the agenda is increasing federal research. The government spent about $80 million on prostate cancer research last year, one-twelfth what is spent on AIDS research and about one-sixth of breast cancer research and prevention funding - even though all three diseases kill about the same number of Americans yearly.
“This country hasn’t even paid lip service to prostate cancer,” said Jay Hedlund of the National Prostate Cancer Coalition, calling not for reduced spending on other diseases but for equalizing money. “They are going to have to do much better, and we are going to be very aggressive.”
The Clinton administration plans to seek across-the-board increases in medical research spending for 1999, but he gave Tuesday’s prostate cancer call a chilly reception.
“We don’t believe in pitting one disease against another,” said Health and Human Services spokesman Victor Zonana.
About 184,500 American men will be diagnosed with prostate cancer this year, and almost 42,000 will die, the American Cancer Society estimates.
Black Americans have the highest risk. For every 100,000 black men, an estimated 234 will get prostate cancer this year, compared with 135 of every 100,000 white men. Black men are two to three times more likely to die of the disease. The cancer risk increases as men age and is rare under 50 - but blacks are more likely to get prostate cancer at younger ages.
Scientists can’t explain the racial disparity, although theories range from genetics to health care access and distrust of the mostly white medical establishment.
But part of the quandary is that so little is known about prostate cancer, said Dr. Charles McDonald of Brown University, president-elect of the cancer society.
Prostate cancer can grow so slowly that it will never threaten some patients, but doctors can’t tell in advance. Doctors don’t know which therapies are most effective - a key question because certain treatments cause serious side effects - nor how to reduce the risk of getting prostate cancer.
Even prostate screening is controversial. The cancer society recommends offering men over 50 a blood test called PSA that can detect early cancer, as long as they first are told about the uncertainties of treatment and that PSA can be wrong. But the National Medical Association, a black physicians group, says all black men should get PSA testing and education starting at age 40, said Dr. Isaac Powell of Wayne State University.