ACS Issues Action Proposal on Prostate Cancer in African-Americans

The American Cancer Society (ACS) has issued a “National Blueprint for Action,” describing a multifaceted set of proposals aimed at overcoming the disproportionate incidence of prostate cancer in African-American men.

According to the society, African-American men have the highest rate of prostate cancer in the world, and they are twice as likely to die from this cancer as white men. The reasons for these differences are unknown. The society estimates that 184,500 new cases of prostate cancer will be diagnosed in American men in 1998, blacks and whites combined, making it the leading cause of cancer in the nation.

Charles McDonald, md, president-elect of the American Cancer Society, said that the proposed plan was the product of a national meeting held in Houston in November 1997, involving more than 260 lay and medical leaders dealing with these issues. Representatives from numerous African-American, medical, and government organizations collaborated on the meeting’s agenda and helped develop the action steps. Many have already pledged to assist in its implementation.

“This is an overarching proposal,” said Dr. McDonald. “One which might replace the helter-skelter separate organization approach.”

Five Critical Challenges

According to Dr. McDonald, the proposed plan included many action steps that were organized into four main categories: research, education, support for patients and families, and public policy. He emphasized five critical challenges:

The urgent need to increase research on prostate cancer, especially in African-American men; specific areas in need of research include the cause of prostate cancer, risk factors, potential prevention, and new effective treatments.

• The necessity to involve African-Americans in research design, the implementation of clinical research, the development of education initiatives, and as patient participants in clinical research trials.
• The mandate for effective lay and professional education regarding prostate cancer, especially for primary-care health providers.
• The challenge of strengthening the capacity of grassroots organizations, particularly in the African-American community, to effectively engage in advocacy and in education and patient support initiatives.
• The importance of developing more community-based support programs for African-American patients and their families.

John R. Kelly, phD, vice-chairman of the American Cancer Society’s board of directors explained that the American Cancer Society was prompted to call for the Houston leadership meeting to develop an action course because of the “alarming burden of disease in African-American men.”

Need for a “Compelling National Movement”

Dr. Kelly, who currently chairs the society’s scientific research committee, said that the American Cancer Society, in addition to its determination to expand its own programs in prostate cancer, sees the society’s role as a catalyst for collaborative action with national groups and with smaller groups at the local level.

“We have to attack this problem very much like we did with breast cancer,” said Dr. McDonald. “We very much need a compelling national movement. Fifteen years ago a woman with breast cancer suffered the loss of her breast, but research gave us the clinical tools to allow today for lumpectomy as an option to total mastectomy. I’m convinced we can find similar answers for the prostate cancer questions we currently face,” he added.

Thomas Dortch, president of 100 Black Men of America, agreed that the action proposals must be moved forward by individual organizations and collectively as partners. He has pledged to ask other African-American organizations to join the collaboration and plans to develop a “curriculum” on prostate cancer for meetings of 100 Black Men of America.

Dr. Kelly said that the American Cancer Society will distribute the action proposal to health policy-makers, professional societies, and other organizations as a national call to action.“Prostate cancer is a major priority of the American Cancer Society,” said Dr. Kelly. “We currently fund $8 million in research support and mount a nationwide patient and family support program called ‘Man to Man.’”

“But prostate cancer, particularly among African-Americans is a disgraceful tragedy which needs a holistic approach to knowledge, awareness, and advocacy. This proposal of actions is the beginning of just such an approach,” he said.