Mid-Michigan effort helps minority men beat prostate cancer

By WANDA REESE
Capital News Service
LANSING– In December of 1994, at his wife’s insistence, Lonnie Johnson went in for his annual physical – which was overdue. When the exam was over, his life was changed forever. The Lansing man was told he had prostate cancer. His reaction-shock—then anger.
“I talked with four urologists,” Johnson said. “Three of the four recommended surgery, one radiation, which I know now would have been a waste of my time and life.”
But the good news is that Johnson has lived to tell his story. He’s a survivor. Many men, particularly men of color, are not as fortunate.
Prostate cancer is a malignant growth or tumor in the prostate gland. According to the American Cancer Society, it is the second most common form of cancer in men over 50, behind skin cancer; exceeded only by lung cancer. One of the problems with the disease is its insidious nature. Usually, there are no symptoms, making early detection key to survival.
While awareness of the importance of early detection has been a critical component of media campaigns directed at white males, men of color, particularly African-Americans, have not shared in the benefits of the campaigns.
In fact, statistical snapshots show that African-American men have the highest rate of prostate cancer in the world, and the lowest rate of survival. But in Mid-Michigan one highly successful campaign is leading the state–and perhaps the nation–in breaking ground and setting standards for screening black men.
According to PSA Rising Magazine, a prostate cancer newsletter, African-American men are two to three times more likely to die of prostate cancer than white men. Only 60 percent diagnosed with the disease survive for five years, compared with 81 percent of white men.
Statistics from the Michigan Department of Community Health show that prostate cancer occurs in African-American men in Michigan 1.7 times more than in white males, and that they’re 2.3 times more likely to die of the disease than white men. During 1997, Michigan ranked 15th highest in the nation in prostate cancer mortality overall.
A 1997 study conducted by the David Walker Research Institute at Michigan State University concluded that black men show a more aggressive and advanced stage of cancer at a younger age.
The Walker study also showed a significant increase in screening rates among African-American men as a result of strong community programs and focused public health initiatives that specifically target minority populations.
When Lonnie Johnson’s cancer was diagnosed, he was angry that so little information was available regarding prevention, diagnosis and treatment options.
Part of the reason that black men didn’t know about prostate cancer, Johnson said, was that the information disseminated simply didn’t address black men.
The specially created coalition in the Lansing area is successfully changing that situation. The Lansing Area Black Male Cancer Project has created a community-awareness campaign that has significantly increased the number of African-American men screened for prostate cancer.
“The greatest challenge lies in convincing African-American men that a digital rectal examination is necessary, along with a blood test, to determine the size of the prostate,” said George Rowan, chairman of the Prostate Cancer Awareness Committee at Ingham Regional Medical Center, and director of the Walker Institute.
Rowan said a major stumbling block to any awareness campaign involving African-American men, is the issue of trust.
“The DRE requires a physician to insert a finger in the rectum, and many men feel that this borders on homosexual behavior and won’t submit to the exam.” Equally challenging, Rowan said, is the distrust many black men have for the medical establishment.
Annual screening is recommended for men 50 to 75 years old. African-Americans are of particularly high risk-especially if there is a family history of the disease. There are two recommended tests:
• The digital rectal exam (DRE)- screens gland size/for lumps.
• Prostate-specific antigen test (PSA) – measures a specific protein in the blood.
Both the committee and project are made up of medical experts, scholars and community and church leaders. Rowan said the first step was a focused and aggressive initiative designed to get the word out, saturate the community with information, craft a promotion that specially targeted black men, and provide location, opportunity and the means to be tested.
The success of the Mid-Michigan effort has provided a model for the rest of the state. Statistics from a survey conducted for the Coalition of Prominent Michigan Hospitals by the polling firm EPIC-MRA, showed that overall 24 percent, or more than 306,000 Michigan men over 50 have not been screened for prostate cancer. For men of color, the survey showed slightly higher rates of screening. Specifically, the survey of 1,865 men found:
• 76 percent of African-American men over 50 tested, compared to 74 percent of white men over 50.
• The Lansing area had the highest percentage of screenings for prostate cancer – 80 percent.
• Lowest rates of screening occurred in Southwest Michigan – 64 percent.
Statewide, more than 6,500 new cases of prostate cancer are expected in Michigan in 2002. Last year 7,000 men were diagnosed; 1,100 were expected to die.
Rowan said the success of any grass-roots effort is largely dependent on the ability to convey to its recipients a sense of trust and common ground. The Lansing project, armed with valuable groundwork information, used this crucial tool to its advantage in the community.
Ground forces were dispatched to every corner of the community to make black families throughout the metropolitan area aware of the critical need for black men to not only be knowledgeable of how deadly the disease is, and its silent nature, but also the importance of being tested.
“Our success is also due to the positive experiences of the men who have been screened in our program. Word of mouth is a powerful message, even more so than I imagined,” Rowan said.
The success of the grass-roots campaign has also brought an increase in resources, contributed by Ingham Regional Medical Center.
The committee, through its affiliation with the hospital, then designed a media campaign that included specially targeted messages aimed at the African-American community. In addition, news coverage opportunities of the screening events was initiated to promote community awareness.
© 2002, Capital News Service, Michigan State University School of Journalism