Irecently had a PSA test, a blood test that can detect the early signs of prostate cancer. It came back negative and I felt relieved. It led me, however, to discuss with my GP the merits and validity of the test, especially for African and Caribbean men.
The report Hear Me Now launched by David Lammy in parliament earlier this year highlights the issue of prostate cancer and black men. It provides analysis along with case studies and a number of key recommendations for GPs, primary care professionals and commissioners. There is now a growing body of evidence of inequality and disparity between black men and the rest of the population that shows they are more likely to get cancer at a younger age.
One of the report’s key recommendations is the importance of early detection and screening at primary care level. A number of case studies and personal testimonies at the event highlighted black men who either suspected or believed they had cancer symptoms, but often were fobbed off by GPs for being too young or confusing them with other symptoms. For some of these men, it was years before their concerns were acknowledged. This was too late for some while others had to undergo major surgery to save their lives.
Sadly a number of GPs may either feel threatened, or don’t care to listen to black men when they are trying to articulate their health needs. These men may feel embarrassed or fearful of having a consultation with a doctor. I am sure these experiences could equally apply to Asian, Kurdish, Turkish, Chinese, Irish and white working class men.
Men generally have a love/hate relationship with primary care. The charity Men’s Health Forum has highlighted the lack of responsiveness of healthcare professionals while building the confidence of men to access services. The macho culture that we are all susceptible to from an early age means, as men, we are in denial when it comes to awareness of our bodies and showing our emotions and vulnerabilities.
Although the government talks about the case for parity of esteem between physical and mental health, this still feels like an academic exercise for black and minority ethnic communities. A report by Cancer Black Care and Black Mental Health UK, Improving Cancer Screening Access for London’s African Caribbean Communities Living with a Diagnosis of Mental Illness, shows that people living with severe and enduring mental illness fail to access screening services. Current cancer strategies and policies still have a colour blind approachm, despite the glaring evidence of ethnic inequality and mortality rates. We need a major public health programme that works closely with faith and community based organisations, commissioned by Public Health England, clinical commissioning groups and local authorities. We need to develop new innovative approaches to tackle the taboo of cancer and the misinformation circulated in local communities.
We also need to look at the training of primary care professionals, especially GPs And we must encourage more young people from black and minority ethnic backgrounds to enter the medical profession. It still feels like a rarity today after 65 years of the NHS to find black British GPs or consultants.
More research is required to develop a new perspective on cancer survival rates. Of course we must be mindful that agency and choice for black people in not taking responsibility for their health cannot be excused. .
We also need to support the work of leading black clinicians and organisations. The organisation Cancer Equality has run Ethnic Minority Cancer Awareness Month each July for a number of years to educate and inform communities. However, this is not valued in the NHS calendar of events.
I just hope all the millions generated by Prostate Cancer UK and the Movember campaign will provide the necessary funding and support for all men, with the support of women, to tackle cancer and give survivorship a new meaning.