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On a Mission: BIDMC Doctor Educates African-American Men about Prostate Cancer

By Heather Maloney
Beth Israel Deaconess Medical Center Staff

When you walk into Dr. J. Jacques Carter's office, every surface is piled high with brochures, papers and reports, much of it about prostate cancer. While this may seem normal for a busy oncologist, Dr. Carter is a primary care physician who has dedicated much of the last ten years to educating black men about their risk for this potentially deadly disease.

"Although prostate cancer is highly treatable if it's detected early, there's a huge disparity for African American men," Carter says. "And this disparity does not exist for any other cancer."

According to the Prostate Cancer Foundation, African American men are 61% more likely to develop prostate cancer compared with Caucasian men and are nearly 2.5 times as likely to die from the disease. African Americans also develop prostate cancer earlier in life, and get a more aggressive form of the disease.

"Unfortunately, men in general don't go to a doctor until they're sick," Carter says. "And, like many diseases, early detection makes a big difference."

That difference is especially important when it comes to black men.

"These guys get diagnosed late," Carter says. "One way we can close the gap is to get these men screened. We need to make them aware that it's a big health issue."

There is some debate in the medical community around whether men should be screened for prostate cancer at all, but Dr. Carter stresses that this shouldn't apply to African American men because of their significant risk. He recommends screening for all black men, as well as caucasian men with a family history of prostate cancer, beginning at age 40.

"We believe strongly that black men need to be screened because of their high risk," Dr. Carter says.

To help get the message across, Dr. Carter has immersed himself in a number of local efforts to encourage men to get the screenings they need before it's too late. He's involved with the annual Massachusetts Prostate Cancer Symposium, which draws several hundred attendees, and he's the medical advisor for the Prostate Health Education Network (PHEN), which helps educate black men about the importance of prostate cancer screening.

But one of his most significant roles is serving as Medical Director of the Prostate Cancer Screening and Education Program at the Dana-Farber Cancer Institute, a position he has held for the last four years. The program's Family Resource Center Van, staffed by Dr. Carter, provides education and free screenings throughout New England.

"We screened and educated more than 600 men last year," Carter says. "We do education programs at organizations and companies. Last fall, we screened 50 men in one session."

At each screening, Dr. Carter, along with staff and volunteers, performs DREs (digital rectal exams) and blood testing for prostate specific antigens (PSA), both of which can indicate the presence of cancer, all at no charge. They send each patient a letter with their test results, and a patient advocate contacts any patients who have abnormal test results and do not have a primary care doctor. These patients are referred to local physicians, often at BIDMC, for additional testing and treatment.

But it's not just the uninsured who take advantage of the screenings. While access to good, affordable healthcare is an issue for some, Dr. Carter has found that even when it is available, many men won't take advantage of it.

"When we go out to private companies, we find that these are mostly educated guys in their 50s," Carter says. "They don't get any kind of routine preventive healthcare and don't go to doctors, even though they have insurance."

Which takes us back to Dr. Carter's original point: men don't go to a doctor until they're sick.

"Motivation is a big factor for them; they're concerned that a diagnosis of prostate cancer will make them less of a man," he says. "I'm hoping to change that."

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted December 2009

Contact Information

Prostate Cancer Program
Cancer Center at Beth Israel Deaconess Medical Center
Carl J. Shapiro Clinical Center
330 Brookline Avenue
Boston, MA 02215
Phone: 617-667-7777
Fax: 617-667-7292