During a recent trip to the SUNY Downstate Health Sciences University, I contemplated the news about the loss of a dear friend’s mother to cancer the previous day. This vibrant woman’s death reminded me why I joined Downstate: to mitigate the ravages of cancer within underserved populations.
Later that day, text messages shared the news that Dexter Scott King, the youngest son of Dr. Martin Luther King Jr., had succumbed to prostate cancer at age 62. His passing also reinforced my concerns about longstanding disparities in prostate cancer and its disproportionate toll on marginalized communities.
Defense Secretary Lloyd Austin’s apology for keeping his prostate cancer diagnosis private further underscored the urgency of addressing the issue. His candid acknowledgment of the impact, especially in the Black community, reminds us of the deeply personal and often silenced nature of such a diagnosis.
Austin’s continuing saga about his recovery from treatment elevates public discourse about prostate cancer, particularly in communities where awareness and access to screening remain inadequate. It is a stark reminder for all men, regardless of background, to prioritize regular screenings as part of proactive healthcare.
Under these circumstances, I am compelled to redouble my advocacy and outreach to ensure that those lost to cancer or facing cancer diagnoses fuel a collective commitment to equity and access to healthcare.
In 2024, an estimated 299,000 men in the United States will receive a diagnosis of prostate cancer; approximately 35,000 will lose the battle. It is the most frequently identified cancer and the second leading cause of cancer-related deaths among men. Black men are at a 70 percent higher risk than their white counterparts.
In Brooklyn, prostate cancer has the highest incidence and mortality rates among men, with Black men experiencing predominantly adverse outcomes. A recent article in the Journal of Clinical Oncology, “Racism Does Not Cause Prostate Cancer, It Causes Prostate Cancer Death,” highlights the complex “intersectionality” of discrimination and its impact on marginalized groups. Coined by law professor Kimberlé Crenshaw in 1989, the term intersectionality highlights how different forms of discrimination connect to affect marginalized individuals’ or groups’ experiences.
As a healthcare provider, I often contemplate whether disparities in prostate cancer stem from inherent biological differences or societal influences, recognizing that both factors are likely to play a role. Prostate cancer diagnoses primarily affect Black men, as well as rural, Hispanic, American Indian, and Alaskan native communities.
Dexter King’s death and Lloyd Austin’s diagnosis are important reminders about confronting healthcare inequities head-on. While specifics about King’s cancer are unknown, his loss emphasizes the importance of encouraging at-risk individuals to engage in discussions about screening with their healthcare providers.
My journey is deeply rooted in loss: My father passed away from complications of prostate cancer during my senior year of high school, igniting a sincere desire to prevent other families from similar suffering. As a urologist, I am committed to mitigating the burden of prostate cancer, a condition that can be effectively managed when detected early.
Achieving true health equity demands a concerted effort on both global and local levels. Addressing disparities in one demographic group can have ripple effects, with a positive impact on overall population health. I often wonder whether my father would have lived to witness my high school graduation had he possessed greater awareness and access to screening.
As part of a demographic at heightened risk and as someone committed to preventing untimely loss, my appeal is clear, yet potentially life-altering: Encourage your family members who are at risk, including fathers and brothers, to undergo screening. By taking proactive steps together, we can begin dismantling the cycle of disproportionate suffering that has afflicted Black men for far too many years.
Brian Keith McNeil, MD, MBA, FACS, is the associate dean for clinical affairs and vice chair, Department of Urology, SUNY Downstate Health Sciences University.