V Foundation grantee Adam Murphy, M.D., offers an expert opinion

Health Matters: Dexter Scott King Dying From Prostate Cancer Shook Our Community. Here’s What You Need To Know About It.

WE’VE TAPPED A BLACK MALE MEDICAL EXPERT TO LEARN MORE ABOUT PROSTATE CANCER INCLUDING ITS TREATMENT AND SYMPTOMS.

On January 22, 2024, it was announced that Dexter Scott King, the youngest son of Martin Luther King Jr and Coretta Scott King, had died after battling prostate cancer.

The King Center in Atlanta, which Dexter King served as chairperson, said the 62-year-old son of the civil rights leader died on Monday at his California home after battling prostate cancer. A statement from King’s family shared that he passed away Sunday in California after a battle with prostate cancer. “He transitioned peacefully in his sleep at home with me in Malibu,” his wife, Leah Weber King, said in a statement from the King Center for Nonviolent Social Change. “He gave it everything and battled this terrible disease until the end. As with all the challenges in his life, he faced this hurdle with bravery and might,” she added.

While King’s recent passing due to prostate cancer has deeply saddened many, it’s sparked essential conversations about the impact of this disease in our community. Other cases, like Defense Secretary Lloyd Austin’s ongoing treatment for the disease, have also generated interest, but what is less discussed is the impact it has on Black men. Black men get prostate cancer at a younger age and tend to have a more advanced stage when it is found. They are also more than twice as likely to die from prostate cancer than other men. We recently spoke with Dr. Adam Murphy, M.D., V Foundation Clinical Scholar at the Robert H. Lurie Comprehensive Cancer Center, about his research on prostate cancer’s impact on Black men and preventative measures they can take.

ESSENCE: Can you share several signs of prostate cancer that people should be aware of?

Dr. Murphy: There aren’t a ton of signs of prostate cancer when it’s curable. If you have signs, it usually is a problem because it’s often advanced. When it’s advanced, it’s things like where it spreads to the bone, causes bone pain or to the liver, and causes jaundice or systemic symptoms like weight loss and loss of appetite. Sometimes, it’s new blood clots, urinary obstruction, or pelvic pain. We typically try not to have people look for signs of prostate cancer and screen regularly so that they can detect it early. It can be pretty aggressive when it’s advanced, but early prostate cancer is usually asymptomatic and curable.

How does prostate cancer come about?

Prostate cancer is like other cancers, but it’s usually due to the accumulation of mutations in the DNA of the prostate gland. The prostate gland has an epithelial part where the gland cells make PSA and prostate-specific antigens; those epithelial cells or stem cells that regenerate the gland cells are the source of cancer.

Why are more Black men at risk for prostate cancer?

It seems like the combination of genetics and environment. In Nigeria, the rates of prostate cancer are pretty low. When people immigrate to the United States or the United Kingdom and are exposed to the Western lifestyle, their rates go up pretty fast to mimic what the rates are for African Americans. The rates in Nigeria are lower than the rates of white Americans and Hispanics in the United States. So I think part of it is the environment of the United States interacting with the genetics that we have in our body to make that risk higher.

When should men start the screening process just to be proactive and preventative?

There are a lot of different guidelines that say different answers. There are five that regulate how we think of this. Three of them say different age ranges. Some say 40 years old; some say 45 or 55. We believe the best answer is that you start at age 40 to get an early baseline PSA level. That early baseline PSA level is a predictor of who will have prostate cancer or not if you can find if you’re above the median for your age range, which is 0.7. At that age, those people should be followed more closely because 90% of the people who will ever die of prostate cancer will be in that group, who are above the median. People who are below the other 50% of folks will be unlikely to develop or die of prostate cancer, and those people can probably push their screening off to age 50.

What are some common misconceptions about prostate cancer?

I think it’s a very curable cancer early on, but people get scared. They believe it’s a death sentence. If you catch it early, 97% of people live ten more years when it’s caught early, versus 25% when it’s caught at later stages. One common misconception is it’s a death sentence. Another one is that you have to do the rectal exam. Often, I see patients who are very scared of the rectal exam and avoid screening altogether. If you refuse to do the rectal exam, doing the blood work is at least a big deal. The blood and prostate-specific antigen tests are acceptable as long as they are done in the same hospital or lab.

Aside from doing the screening, what other preventable measures can be taken?

The way that the guidelines are written down is that patients should talk to their doctors about their preferences in a shared decision-making approach for how they’d like to chat about prostate cancer and whether they want to be screened for it or not. Other measures to prevent cancer are considering your diet and knowing your family history.

What are some treatment options?

The National Comprehensive Cancer Network has these risk groups, and the American Osteopathic Association has these risk groups about how aggressive the cancer is and the treatment options for that kind of grouping for the stage you’re at. So, from low risk to what’s called favorable intermediate-risk prostate cancer. You typically have radiation therapies, but radiation is a broad category. There’s radical prostatectomy, which is the surgery to remove the prostate gland and the seminal vesicles. The preferred treatment for at least the first two risk groups (very low and low risk) is something called active surveillance, where we are deferring treatments so that you don’t have to get treated upfront, so you can maintain all your kind of healthy functions. The surgery radiation can affect erectile function or potency. It can affect urinary incontinence or leaking urine. Some people will have other things happen, like bleeding in the urine or rectal irritation, diarrhea, and rectal bleeding, with radiation. So you get the side effects from the active treatments, surgery, and radiation. That active surveillance kind of helps you because not all prostate cancers are going to progress. Some of them will not progress for years and, on average, progress with about five years in.

Share about your funded research through the V Foundation and the importance of research in the diverse and health equity space as well.

The V Foundation! I was in the first round of the Stuart Scott Memorial Cancer Research Fund research grant for the V Foundation. It was for three years, and it helped me do the first-ever validation of the prostate health index for Black men specifically. We started to recognize that when you look at things like area under the curve, which is talking about measuring the accuracy of these tests, you needed to dig a lot deeper and look at things like sensitivities, how the proportion of the people with the disease and you actually detect the sensitivity and the negative predictive value, which is, if you have a negative test, what’s the likelihood that you actually don’t have the disease? Now, with an asset called the Stockholm three tests, I’ve done that work with prostate MRI. My most recent data shows that they all work differently, in Black patients. And in part because the prevalence of prostate cancer is higher in Black men.

Is it too early to tell about success stories or any type of progress right now?

No, the threshold had to be lowered for Black men. That’s a success story because I think people need to not use the same thresholds. And I think it does a disservice to Black men. MRI is very useful in helping us improve the accuracy of detecting prostate cancer that’s significant. But a negative MRI, meaning that you don’t see anything on the MRI, does not mean you don’t have significant prostate cancer if you’re Black. That’s something else I just found out because of our new funding. We’re aiming to make prostate biopsies safer for Black patients.