‘Talking About It Matters’: Black Men and Prostate Cancer

In this episode of the Listen to Black Doctors podcast, a survivor, a physician, and a fashion designer discuss why Black men should speak openly about prostate cancer.

This special edition of Listen to Black Doctors focuses on prostate cancer, PSA levels, and what those numbers actually indicate. It is an important conversation for men, especially Black men, and for the people who care about them. Host Jeremie Rivers is joined by Reggie Hicks, a prostate cancer survivor and executive producer of the documentary If You Are My Brothers; Dr. Michael H. Forde, whose work centers on public health, equity, and prostate cancer awareness for Black men; and Frederick Anderson, fashion designer and founder of the Blue Jacket Fashion Show, a fundraiser for ZERO Prostate Cancer. Together, they share personal experiences, explain PSA testing, and stress why the dialogue must continue. As Rivers puts it, “Our health is worth talking about.”

Dr. Forde explains why prostate health is something people need to become comfortable discussing: “There is a history of Black men being at higher risk of prostate cancer, so that’s why it’s important to have those discussions earlier, especially when it comes to screening.”

The guests then each explain why the issue matters to them personally.

“I think it’s a conversation that men tend not to have,” Hicks says, recalling that he was diagnosed with prostate cancer while filming If You Are My Brothers. “It’s a conversation that is important to us being healthy, but also to our family members, our friends … I just had my first granddaughter and I’m blessed to be here … I’m here going on 15 years later because it was caught early.”

Anderson points to the numbers. According to ZERO Prostate Cancer, Black men face a higher lifetime risk of prostate cancer, with about 1 in 6 expected to be diagnosed. “It’s avoidable, and that’s why I’m in the conversation,” said the designer, who has dressed Beyoncé, Janet Jackson, Charlize Theron, and others. “It’s up to us, brother to brother, to open that conversation and to keep ourselves alive and inform ourselves.”

Dr. Forde has seen how stigma can keep people from discussing prostate health. “I have had some family members and colleagues who have experienced prostate cancer. And seeing them go through some of the uncertainties (and navigating) in a way they may not have been experienced with before, made me realize that there’s some kind of gap in our community as men when it comes to speaking on things like prostate cancer.” For that reason, he says, “We have to keep pushing this conversation forward.”

“I’ve sat down with families in my own community who found out too late. It’s not the diagnosis itself that haunts you, it’s knowing that it did not have to end that way.”Dr. Michael H. Forde

What is a PSA?

The PSA test is the most common screening tool for prostate cancer. “PSA stands for prostate-specific antigen,” says Dr. Forde. “Typically, prostate cancer screening relies on this PSA test to measure the protein levels in the blood.”

A small blood sample taken from the arm is used to check PSA levels. If the numbers are high, the doctor says, that could point to cancer, infection, or an enlarged prostate.

Dr. Forde also explains the typical PSA ranges: “If it’s less than 1 nanogram per milliliter (ng/mL), that’s considered low risk, very normal. Generally, 1 to 3 ng/mL is what’s considered safe for most men. Four to 10 ng/mL, that’s when you get borderline or elevated. And then above 10 ng/mL, that’s considered high.”

When should you get your PSA levels checked?

ZERO Prostate Cancer recommends beginning prostate cancer screening between ages 40 and 45.

“If you have any cancer history in your family, not just prostate cancer, you should probably get screened at 40 or 45,” Anderson says, adding that “You have to request a PSA, it is not part of regular bloodwork.”

After the first PSA test, the important thing is to work with a doctor to monitor changes over time. “They need to follow the numbers. It’s not about the first number,” Anderson explains. “They watch it to see what’s happening. Is it changing? Is it going up? Is it going down? That takes communication, persistence, and us going in and saying, hey, I want to know what’s going on with my body.”

How can Black men get more comfortable talking about prostate health?

It can be easy to avoid the subject, especially when it feels so personal. “Don’t be scared,” Hicks says. “As my wife says, ‘Life over libido.’ Your family, your friends, everybody wants to have you around.”

Hicks had his wife with him through his diagnosis and says communication became essential. “I think we just went on faith and understanding that we were going through this journey together,” he shares. “Men, we tend to want to internalize it. It’s hard for a lot of men to bring their significant others into the equation … You really need to sit down, talk, and make the decision together. Because it will turn out so much better at the end of the day.”

Anderson created the Blue Jacket Fashion Show to help open up discussion around prostate cancer. “We want to make sure there are places for men to go to get the information and understand how this affects them,” he says.

“Knowledge is power. We as the Black community, I know we are apprehensive to go and trust in others because we’ve been betrayed so many times, so we have to lean on each other. It’s important to have conversations together, and together we can solve the disparities in prostate cancer survival and treatment. Because the earlier you find it, the better you’re going to do.”Frederick Anderson, founder of the Blue Jacket Fashion Show

Starting the conversation is the first step.

“This is where it starts … The more we talk about it, the more we address it, the less it can seem stigmatized and taboo for people,” says Dr. Forde. “One thing I want listeners to take after this conversation is to keep it simple: screening age 40 to 45, knowing your family history … One sentence, one number said out loud today can be the thing that starts this whole process moving in the right direction for somebody.”

“Healing starts with knowing,” the doctor adds. “You cannot advocate for your health if you don’t have the information to advocate with. You cannot fix what you refuse to find out. So whatever fear, whatever pressure to appear strong has kept you or someone you love from having this conversation, let today be the day that changes.”

Listen to the full conversation by tuning in to this episode of Listen to Black Doctors.