Prostate cancer is the most commonly diagnosed cancer among Latino men, with 17,000 diagnoses and 2,000 deaths annually.
While issues like a lack of access to consistent health care as well as language and cultural barriers contribute to those numbers, modern prostate cancer care approaches have evolved to make screening and treatment more successful than ever.
UI Health’s Dr. Luis Rivera says prostate cancer does not always offer warning signs, so screening is important for catching it, but that trouble urinating and blood in the urine or semen are definitely worth talking to a doctor about. Rivera also notes that the digital rectal exam that many men would prefer to avoid is no longer the default screening method for prostate cancer – and that the approach to treating prostate cancer has shifted over the years, too.
“There's an approach called ‘watchful waiting’ where somebody is considered average or low risk, you might just monitor, with serial PSA testing,” Rivera said. “Also there’s shared decision making. So you discuss with the patient, if we proceed with the biopsy, even a biopsy can have significant side effects and what we call comorbidities. They can have erectile dysfunction, trouble urinating after just the biopsy … some patients may also just opt out of going forward with the either biopsy or a prostatectomy, which is the removal of the prostate.”
Frank Medina, a University of Chicago Medicine medical student and member of Latinos United for Cancer Education Research and Outreach, said the state of health care access for Latinos is leading to worse outcomes for Latino men with prostate cancer.
“They’re less likely to develop or test positive for prostate cancer but more likely to die from prostate cancer. It's about 2.9% lifetime risk of dying from prostate cancer among Latino men,” said Medina. “But if you look at health care coverage of Latino men specifically in the United States, about 30% of Latino men don’t have steady access to care or have a primary care physician.”
Medina says that simply opening a dialogue with men who might be reluctant to get screened for prostate cancer is helpful to creating better outcomes.
“We all know about machismo among Latino men about being strong and not asking for help from people,” Medina said. “It’s important to talk about homophobia and also to preconceived notions people might have where ‘Hey, if I'm going to go check my prostate out, someone’s going to give me a digital rectal exam’…but it’s about having a conversation.”
But those who do receive a diagnosis of prostate cancer have plenty of reason for optimism, says Dr. Hiten Patel, assistant professor of urology at the Northwestern University School of Medicine.
“We actually have very good treatments for prostate cancer for both localized and even if it’s spread … The standard options would be surgery or radiation and both of these therapies are highly curative for men who have localized prostate cancer,” Patel said. “If there’s prostate cancer that spread outside the prostate, then we also use hormonal therapy. And hormonal therapy is not a chemotherapy, but it’s something that suppresses men’s testosterone and it keeps prostate cancer cells from growing prostate cancer feeds on testosterone. So if you have a prostate cancer that spread, that’s often the best way to keep it under control.”
And the outlook is continuing to improve with time, Patel says.
“In the last five to 10 years, we actually have [developed] newer agents that help improve men’s life and improve their survival,” Patel said.