Prostate Cancer in African Americans - For women to speak to their loved ones

Prostate Cancer in African Americans

1 in 7

African American men will develop prostate cancer in his lifetime.

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Help Us Discover

Prostate cancer is the most commonly diagnosed non-skin cancer in U.S. men.

About

30,000

African American men are diagnosed yearly with prostate cancer.

(2019)

THE GOOD NEWS IS...

The earlier prostate cancer is discovered and treated, the more likely a man is to

recover and remain cancer free.

What is the Prostate?

What is Prostate Cancer?

The prostate is about the same size and shape as a walnut, and it’s divided into two lobes similar to the two halves of a walnut. It‘s located below the bladder and in front of the rectum. It surrounds part of the urethra in this area and urine passes through it. The prostate produces the milky fluid that transports the sperm formed in the testicles to the urethra within the penis.

Cancer is a disease that begins in cells, which are the building blocks that make up all tissue and organs of the body, including the prostate. Normal cells grow, divide, and die on a regular schedule. Sometimes something goes wrong with this process and the cells don’t die as they should and instead, create a growth or tumor.

Tumors can be benign, meaning not cancer, or malignant, meaning cancer.

Most prostate cancer grows very slowly with many men never knowing they have the disease. However, some prostate cancers are aggressive and will spread beyond the prostate to other parts of the body such as the bones, lymph nodes, and lungs.

African American Men

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Develop prostate cancer almost twice as often as Caucasian men.

Are 50% more likely to lose their lives to the disease.

What are the Symptoms?

When a prostate tumor begins to grow, it usually does not cause symptoms. As it spreads, it eventually puts pressure on areas such as the urethra (the canal that carries off the urine from the bladder, and in the male, serves also as a passageway for semen) and may block the flow of urine from the bladder and cause other urinary problems. These are usually the first symptoms of prostate cancer. If untreated, it can spread to nearby lymph nodes, bones, or other organs and may cause aches and pains in the pelvis, hips, ribs, back, and other bones. That’s why screenings and yearly checkups are critically important in catching cancer early, before it spreads outside the prostate.

Frequent urination (especially at night)

Pain or burning urination

Weak urinary stream or inability to urinate

Pain when ejaculating

Blood in urine or cloudy appearance

Pain in the lower back, pelvis, or upper thighs

Interruption of urinary system (starting and stopping)

What are the Risk Factors?

What Can We Do?

All men are at risk of developing prostate cancer and certain factors have been identified to increase a man’s chances of developing the disease.

Being educated about prostate cancer and possible prevention strategies is important to reducing risk and improving overall health.

• Almost all prostate cancer occurs in men 50 and over

Help them get tested

• A frican American men are 1.7 times more likely to be diagnosed with prostate cancer and 2.3 times more likely to die from the disease

Encourage your loved ones to speak to their doctor.

• C lose relative with prostate cancer – father, brother, or son

Spread the word Share this information with a friend.

Maintain a healthy lifestyle

• Eating large amounts of animal fat

Be active, eat nutritious meals, maintain a healthy weight.

• E xposure to chemicals like Agent Orange and other pesticides

Participate in clinical trials

• Certain genetic mutations such as BRCA1 and BRCA2

Change the course of medical research.

Help Us Discove Not all diseases are created equal. Minorities have higher rates of certain diseases.

It is an unfortunate fact that minorities suffer disproportionately from some diseases. In fact, many diseases affect African Americans more than people from other groups. For example: • A frican Americans are more likely to die at early ages from all causes.

• A frican Americans are twice as likely as non-Hispanic white adults to be diagnosed with diabetes. They are also more likely to have kidney disease, to be hospitalized, and to die from diabetes.

• A frican Americans have higher rates of high blood pressure.

Men are more likely to die from heart disease.

• A frican Americans are more likely than white adults to have a stroke.

Men are 60 percent more likely to die from it. Survivors are more likely to become disabled and have difficulty with daily activities.

• A frican Americans have higher rates of certain cancers. African Americans are more likely to have stomach cancer. Men have higher rates of lung and prostate cancer. African Americans are twice as likely to die from prostate cancer. Breast cancer is more common in African American women under 45, and they are more likely than other women to die from this disease.

Courtesy of U.S. Department of Health and Human Services Office of Minority Health.

The fastest and safest way to determine whether new treatments work for these and other diseases is through clinical research. Yet it’s often difficult to find volunteers – especially minorities – willing to participate in clinical trials. There is a shortage of participants in clinical research – and minority participation is even lower than that of the general population.

It’s important to include all types of people in clinical studies.

Human beings are very much alike. Only one-tenth of one percent of our genes varies from one person to the next.

But even with these tiny differences, there are still people with different appearances and different health conditions.

Illnesses affect each of us differently – as individuals, as families, as racial and ethnic groups, and as communities. Because of these differences, it’s important to study different groups of people in order to understand which treatments work best for them. The best way to know that a particular medicine is right for someone is to test it in similar people.

What are Clinical Trials and Studies?

A clinical trial is any test or study that involves people. Every clinical trial is designed to answer specific questions about possible ways to prevent, diagnose, or treat a disease or injury.

At Yale, there are hundreds of clinical studies under way for a wide variety of conditions and diseases, including prostate cancer. Some trials involve people with a particular illness or condition to help establish the safety, dosage, and side effects of a new medicine or treatment. All these research studies are an important and necessary step in the process of making sure new treatments are safe and effective for all populations.

r | Be part of Clinical Research at Yal Frequently asked questions and common myths.

How do I know a clinical trial is right for me?

Every clinical trial includes guidelines about eligibility to participate, such as age, gender, and previous treatment or medical history. Some of the ways to determine whether a clinical trial is right for you include: • C omparing the reason why you’re interested in participating to the question the trial hopes to answer. You should think about whether the trial has the potential to fulfill your hopes and expectations. You should also weigh the potential risks and benefits of participating in the trial.

• I nforming yourself about the questions the trial is trying to answer by doing your own research on reputable websites and in the library, and by asking questions. You may also want to talk to your family, friends, or personal physician.

What if I have an illness like cancer? Should I participate in a clinical trial?

A clinical trial may offer a new or experimental treatment that may not otherwise be available to you. In some cases this therapy may be more effective than the standard treatment for a particular illness, although there’s no way of knowing this outcome in advance. Clinical trials are a treatment option for many people with cancer. Depending on the questions the research is trying to answer, each clinical trial has guidelines on who may or may not join the trial. These guidelines help ensure your safety and the accuracy of the study’s results. If you have cancer or another illness, you should discuss with your doctor whether participation in a clinical trial is right for you.

The researchers can do whatever they want. I’m just a guinea pig.

Like all health care providers, the study team conducting research must follow rules and laws that protect your safety. Many of these rules are mandated by the federal government. Every clinical trial in the United States is approved and monitored by a committee whose job is to ensure your safety. At Yale, these committees are part of the Human Research Protection Program, which ensures that Yale studies are conducted ethically. All trials also follow a study plan that states exactly what researchers will do during the study.

When I’m sick, I use remedies that have been in my family for years. I don’t need to spend a lot of time and money seeing a doctor.

Many people depend on home remedies to help them feel better when they’re sick. Others have had positive experiences with natural or herbal remedies. But if you rely solely on home or natural remedies, you could be missing out on proven medical treatments that have helped millions of people. We know those treatments work and that they are safe because they’ve been tested in clinical trials.

My faith will see me through when I’m sick.

Research shows that faith plays an important role in healing disease.

There are also many medical treatments available to keep you healthy and extend your life. We can develop new ones only by carefully testing them to make sure they are safe and effective. That’s why clinical trials are important to your health and the health of your family.

How should I prepare to meet the doctor to discuss participating in a clinical trial?

•W rite down any questions you may have ahead of time.

• A sk a friend or relative to come along for support and to hear the responses to your questions.

• R ecord the discussion so you can listen to it again later.

le.

Prostate

An estimate castration-resis Patient-centered care and cutting-edge therapy.

Cancer affects each patient differently. At Smilow Cancer Hospital at Yale New Haven, each patient receives a personalized treatment plan based on their individual cancer diagnosis and therapy options. This results in the development of a unique, comprehensive treatment plan for each patient that can include surgery, medical oncology, radiation oncology, a combination of treatments, or conservative monitoring.

Reverend Elvin Clayton (left) Pastor, Walter’s Memorial AME Zion Church, Bridgeport, CT and Cultural Ambassador to the Yale Clinical Research Program

Reverend Dr. Leroy O. Perry, Jr. (right) Pastor, St. Stephens AME Zion Church, Branford, CT and Cultural Ambassador to the Yale Clinical Research Program

We are making a difference.

Yale is committed to developing treatments to lower the toll of chronic disease and have joined together with the African Methodist Episcopal (AME) Zion Church to ensure that clinical studies meet the community’s needs. The AME Zion Church is one of the nation’s oldest African American denominations. Our AME Zion Church representatives serve as Cultural Ambassadors to Yale’s research programs acting as expert resources, advising Yale investigators how best to raise awareness about clinical research. Together, with Yale, we are educating the community about how disease affects us and the importance of participating in clinical research. We are dedicated to finding new ways of treating disease in all types of people.

Our group is currently focused on prostate cancer awareness, treatment, and clinical research options and through a partnership with Yale School of Medicine and Merck Pharmaceuticals, the AME Zion Church Cultural Ambassadors host a series of health events on the disease.

Please attend the events to learn more about Prostate Cancer and current clinical trials. Remember you have an important role to play in your health and in helping us discover the medicines of tomorrow.

Smilow Cancer Hospital, both on our main campus in New Haven and in our 14 Care Centers throughout the state, treats more cancer patients than any other hospital in Connecticut by bringing together some of the nation’s best minds to develop new methods to prevent, diagnose, and treat cancer. With a steadfast focus on patient- and family-centered care and through expert oncologists working with a variety of specialties and health care providers; state-of-the-art technology; and access to novel treatment options, including innovative clinical trials, we are committed to making sure that each patient has an outstanding and positive cancer care experience.

Your treatment options: Our Prostate and Urologic Cancers Program offers innovative therapies including clinical trials for the treatment of advanced and metastatic urologic cancers and cutting-edge surgical techniques. For your type of cancer, the care team will discuss your treatment options with you and those close to you.

Your options will depend on several things: • T he stage of your cancer, which tells you if it has spread and if so, how far.

• Y our overall health.

• C hance of the cancer coming back.

• S ide effects you might have from the treatment.

•W hat chance the treatment has of reducing or removing the disease.

• H ow long the treatment might help extend your life.

• H ow much the treatment might help reduce your symptoms.

Cancer Treatment at Yale.

ed 10% to 50% of prostate cancers become metastatic stant prostate cancer within three years of initial diagnosis.

What is metastatic castration-resistant prostate cancer?

Metastatic prostate cancer is cancer that has spread beyond the prostate. Because male hormones (such as testosterone) stimulate prostate cancer growth, men with metastatic prostate cancer usually get hormone therapy as their first treatment.

The goal of this treatment is to lower the body’s levels of male hormones and thus shrink the cancer. If the hormone treatment does not work, the cancer progresses, and this is known as Metastatic Castration-Resistant prostate cancer.

Additional treatments are needed to help stop the disease. If you have this type of prostate cancer, you may be able to take part in a clinical trial.

Yale Cancer Center is currently screening patients with your type of cancer for two studies that use the study drug Pembrolizumab, which is a treatment that aims to stimulate your immune system to fight the cancer.

Pembrolizumab, also known as KEYTRUDA®, has been approved by the Food and Drug Administration (FDA) for patients with certain types of cancer; however, it has not been approved for your type of prostate cancer.

The purpose of these studies is to: • Test the safety of the study drug, pembrolizumab, in combination with a standard of care treatment.

• S ee how well your body handles pembrolizumab compared to placebo in combination with a standard of care treatment.

• See how well pembrolizumab compared to placebo works in combination with a standard of care treatment.

• See if pembrolizumab helps patients live longer and have a better quality of life.

There is a difference between the two studies. In study 1 (Keynote 921), patients will receive pembrolizumab or placebo with a chemotherapy plus a steroid. In study 2 (Keynote 641), patients will receive pembrolizumab or placebo in combination with a hormone drug.

Will I receive a placebo?

A placebo is often used in clinical trials to evaluate the effectiveness of the medication being studied. A placebo drug is a pill, liquid, or powder that is designed to look like the medication being tested, however, it does not contain any medication.

Speak to your study doctor about the possibility of you receiving a placebo.

Note that patients participating in the following clinical trials will be treated with at least one medication, even if a placebo is also used.

HIC #2000025624, is officially known as, “A Phase 3, randomized, double-blind study of Pembrolizumab (MK-3475) plus Docetaxel plus Prednisone versus placebo plus Docetaxel plus Prednisone in participants with chemotherapy-naïve Metastatic Castration-Resistant Prostate Cancer (mCRPC) who have progressed on a Next Generation Hormonal Agent (NHA) (KEYNOTE-921),” can be found on clinicaltrials.gov by searching NCT03834506.

HIC #2000026116, is officially known as, “A Phase 3, randomized, double-blind trial of Pembrolizumab (MK-3475) plus Enzalutamide versus placebo plus Enzalutamide in participants with Metastatic Castration-Resistant Prostate Cancer (mCRPC) (KEYNOTE-641),” can be found on clinicaltrials.gov by searching NCT03834493.

To learn more about these studies, contact the study Doctor at (203) 737-8367.

Fred – Prostate Cancer Survivor Dedicated to tomorrow’s faith

My PSA had been high for awhile so in 2002 my doctor recommended I see a urologist. A biopsy was performed and at the age of 54, I was diagnosed with prostate cancer. Without my routine physicals, I probably wouldn’t be alive today.

We were able to catch the cancer early, and that made all the difference.

“Without my routine physicals I probably wouldn’t be alive today. We were able to catch the cancer early, and that made all the difference.” - Fred

My urologist told me that surgery would be the best treatment for me since I was still young and healthy. I didn’t even realize that I had other options at the time. However, the thought of having surgery caused me to pause and seek out more information.

This information led me to Yale Cancer Center. They reviewed different treatment options with me and decided that radiation therapy would be just as effective without the need for surgery. After discussing the treatment plan with my urologist, Thomas Martin, MD, Assistant Professor of Clinical Urology, I decided radiation seed implants were the most appropriate treatment for me.

Staying informed and being aware of your options is so important during treatment.

Attending support groups at Smilow Cancer Hospital taught me what questions to ask my doctors and about new treatments available. I attend all of the patient events offered through Smilow and Yale Cancer Center and the survivorship programs because they provide important information that is relevant to my care. I knew nothing about cancer coming into this experience and have emerged informed and ready to help others.

I tell all the guys I grew up with to get their blood work done and to keep track of their PSA. No one ever talked about cancer when I was growing up. Now it is in the media all the time. I’ve learned that you can’t force people to seek help or become informed; you can only do your best to share what you have learned and raise awareness. It’s up to you to keep track of your own health and write your own story.

It’s disheartening to see that I am usually the only African American, male or female, at the cancer support groups. We tend to have the most aggressive forms of cancer and yet no one attends these support groups. I hope that by sharing my story I can encourage all people to seek help and ask questions. I can’t understand why someone wouldn’t want to take advantage of this. This is information that could save your life.

Volunteering is something that I can do to give back. I’m part of the Big Brothers Program and volunteer at the Emergency Room in New Haven. I chose to work in the ER because I know they need me there. I’ve taken an interest in medicine and love meeting and talking with people that need my advice or help. I’ll tell anyone anything they want to know about my experience if it will help them in some way.

I still am able to run, which is very important to me. I completed a 12-mile road race and still try to run six miles or so every other day. It’s not easy, but I am here, I am alive and still sharing my story with anyone that will listen. After overcoming something like this, I feel as though I can live forever. There is always some doubt and despair, but you learn to know yourself and what you are capable of. With hope and faith by your side, you are able to realize the reality of your life and face it head on.

Read Fred’s full story at www.yalecancercenter.org/patient/care/stories/Fred

Help Us Discover Be Part of Clinical Research at Yale.

To find out about ongoing trials, visit: YaleStudies.org or call 1-877-978-8343