Prostate Health and Movember: Suggestions for men of African descent

Barely four years into retirement, the death of a dear friend from prostate cancer changed my orientation to male reproductive health. This November’s health post is in honour of my friend, and, in recognition of Movember – men’s health awareness month

Until the death of my friend, my approach to prostate care was folded into a more general regimen of healthy diet, supplements, exercise, washing my hands before (and after) urinating, and, carefully managing my consumption of assorted, but focused, traditional bitter herbal teas and bark distillations that Jamaicans call ‘bush herbs’. At 50 my attention turned to observing possible signs of benign prostatic hyperplasia (BPH) described by Phyllis Balch, including: increased night-time urination, feeling that the bladder does not fully empty after urination, difficulty urinating, burning sensation when urinating or ejaculating, decreased power of urinary flow, blood in the urine, pelvic pain and chronic lower back pain.

I became more in tuned to my body, built my team of allopathic and alternative health practitioners, consulted health guides such as Phyllis Balch’s encyclopedic Prescriptions for Nutritional Healing and went for periodic examinations. There are two basic tests before the more complex and invasive procedure of biopsy: digital-rectal examination and prostate-specific antigen (PSA) tests. Of course, if one researches carefully enough, the PSA, depending on the researcher, is reported to have false-negatives and false-positives ranging from 10% to 80%; thus, it is far from a sure-fire diagnostic as noted by the creator of the test, Richard Amblin. Cautious as I am of anything industrially scaled, including tests, I take nothing for granted, not least in a society where life itself has become classified and commodified as 70 to 90 years worth of creating, defining, controlling and profiting from various ‘diseases’. My position is ‘know thy body’ and become informed because whatever decisions are made, it is thine and thine alone.  While it is empowering to be as informed as possible, and, to discuss with one’s medical support all tests and treatment, it is imperative that in regard to prostate health that men do not avoid digital-rectal examination in favour of the easy PSA test. Men should no more fear exposing themselves to debates in medicine than to a digital-rectal exam.

On the matter or ‘race’ and prostate cancer, researchers offer differing opinions. The Canadian Cancer Society suggests that Canadian men of African descent from Caribbean and African backgrounds have double the risk of prostate cancer versus other men (see here and here). A 2024 Canadian observational prostate cancer study published in JAMA gave a more nuanced picture, however. The researchers observed that among its sample, men who self-identified as of African descent were more likely to be diagnosed with prostate cancer at an early age. BUT, they noted, ‘Black’ men “…experience comparable prostate cancer outcomes compared with men of other races”. This is clearly a complex story with ‘bad’ and ‘good’ news. Yet, there is a world of difference between early and disproportionate diagnosis versus comparable outcomes.

 To address early diagnosis despite comparable outcomes, men of African descent should explore the factors leading to early diagnosis. While attention to the fundamentals is obvious – diet, exercise and periodic high-quality screening – we, as ‘Black’ men, should also closely observe the inner world of our emotions, psyche and spirit. Contrary to the materialist ideology of the West, these aspects of existence are not only intricately connected to our bodies, they are also epigenetically informed by the historical experiences of anti-Black racism and anti-Black misandry. The placebo effect shows perfectly well how powerful our thoughts are, and, the challenge is to harness the power of the mind with intention, and, concrete and consistent practices. I think it worth noting that, as Jungians say, ‘you are not what happened to you’ – or to your ancestors for that matter. As Bruce Lipton, the ‘father’ of epigenetics observes, we are not our genes. While the stories we are told and tell ourselves about genes and the intergenerational transmission of effects are real, we can change the narrative, the story itself and, therefore, how we experience reality.

 A small part of the way to changing the narrative is the way that we as ‘Black’ men talk to each other and educate our son’s about prostate health. In my view narrative is not destiny, it is a roadmap. A part of dialoguing with each other, therefore, is the awareness that there are simple concrete things we can do to sustain prostate/reproductive health in addition to regular or periodic check-ups, exercise, diet and supplements and emotional regulation. For example, I have advised my friends that this 5-minute basic yoga routine is, I believe, an ounce of prevention worth pounds of cure (and suffering). Youtube is awash with other basic, intermediate and advanced Qi Gong, Tai Chi and hatha yoga prostate routines. What you will notice in just about all of the videos is the encouragement to be present, to focus. Alternatively, doing 50 - 100 Kegels per day will work wonders. They can be done while sitting, urinating, and, if your pelvic floor is really strong, while walking. Prostate health is not only a click away, it is first and foremost a decision. 

 From the passing of my friend, I have learned that the stories we tell ourselves have lives of their own. With disciplined awareness, taking control of our perceptions and taking concrete action, ‘Black’ men can rescript the prostate cancer narrative.

 As always, I encourage consulting your health care provider(s) on diagnoses, exercise, diet and supplements.

 Happy Movember!