Your Family's History With Cancer Is Worth Knowing
- Singer Charlie Wilson discovered that prostate cancer ran in his family only after his own diagnosis, underscoring how family history can double a man’s risk and often leads to earlier onset; experts note that 5–10% of prostate cancers are hereditary.
- Wilson, now in remission, credits early detection, family support, and faith for his recovery, and now uses his platform to raise awareness — especially among African American men who are disproportionately affected and less likely to discuss screening with their doctors.
- The prostate cancer treatment plan is based on whether the cancer is considered low, intermediate, or high risk. Your doctor assesses the risk level after reviewing your test results.
- Prostate cancer treatment may include surgery, radiation, and/or hormonal therapy. Each treatment method comes with potential side effects such as sexual dysfunction and urinary incontinence.
- Surgery is not needed for all men diagnosed with prostate cancer. In some cases, active surveillance is a preferred option for older men or those at low risk of the disease spreading.
- Prostate cancer screening guidelines urge Black men to begin screening at 40 years old, which is 10 to 15 years earlier than for men at average risk. The National Cancer Institute says among Black men, “death rates are higher” or “more than twice” that of white men, sparking increased efforts to boost early detection for this demographic.
“My dad was ill when I found out,” Wilson told EBONY Magazine. “I was quite surprised when he told me that he had it, but he had never shared that information with anyone in our family.”
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Wilson, the former lead singer of The Gap Band — known for other early 1980s classics like “Outstanding” and “Yearning for Your Love” — has also enjoyed a successful solo career and collaborated with artists ranging from Bruno Mars to Snoop Dogg.
‘I Thank God It Was Detected Early’
The thirteen-time Grammy winner learned he had prostate cancer in 2008, and at the time, he knew little about a disease that affects one in eight men and one in six African‑American men.
“I thank God that it was detected early. My wife and I did a lot of research to determine the best treatment for me,” Wilson said.
The American Cancer Society (ACS) reports that Black men have the highest prostate cancer death rates of any group — two to four times higher than other men.
Additional research published in Cancer reinforces this disparity: “Black men are disproportionally affected by prostate cancer; they have the highest prostate cancer incidence in the United States (183.4 new cases per 100,000).”
In 2024, the Prostate Cancer Foundation (PCF) issued screening recommendations specifically for Black men, stating, “Among Black men who elect screening, baseline PSA testing should occur between ages 40–45. Depending on the PSA value and health status, annual screening should be strongly considered.”
The New England Journal of Medicine also highlights the elevated risk Black men face. A multidisciplinary team — including primary care physicians, urologists, oncologists, translational scientists, and patient advocates — reviewed 287 studies to develop screening guidelines tailored to Black men. They found:
- Prostate cancer tends to develop 3–9 years earlier in Black men.
- PSA screening discussions should begin in the early 40s.
- Baseline PSA testing between ages 40 and 45 is recommended.
- Continued screening until age 70, adjusted for PSA levels and overall health, could reduce mortality by roughly 30% without significantly increasing overdiagnosis.
The ACS notes that unconscious bias, treatment inequities, and limited access to high‑quality care drive much of the disparity. Even when stage at diagnosis and socioeconomic status are equal, Black patients have lower survival rates across nearly every cancer type. The largest factor is unequal access to preventive care, timely diagnosis, and effective treatment.
Inequities in Care For Black Patients
Addressing these inequities requires collective responsibility. The cancer community must work together to dismantle systemic barriers that prevent minority communities from receiving quality care, participating in preventive screenings, and enrolling in clinical trials.
Wilson relied heavily on his family and faith throughout treatment. “My family was positive from the outset. Our faith is strong, and prayer is our daily ritual,” he explained.
His diagnosis also motivated him to speak out.
“When I found out the number of African‑American men who die from this disease because they don’t discuss it with their doctors, I knew I had to share my story. I became a spokesman for the Prostate Cancer Foundation and did workshops around the country. I still speak about prostate cancer at my concerts,” Wilson added.
Expert Resources on Prostate Cancer Treatment
- Advanced Prostate Cancer: Treatment For Metastatic Lesions To The Bone
- Boxing Champ Leon Spinks’ Prostate Cancer Has Spread — What Are the Treatment Options?
- Brachytherapy Streamlines Prostate Cancer Care – It Cuts Back Treatment Time Without Diminishing Results
- Chemotherapy for Prostate Cancer: Adding Power To Your Treatment Plan
- Don’t Be Ashamed – The VA Has Treatment To Help Deal With Incontinence After Prostate Cancer Surgery
What Factors Go Into Treatment Choices?
For many patients, the differences between treatment options — such as surgery, radiation, or hormone therapy — can be subtle. But those nuances matter, especially when side effects impact daily life.
Dr. James Ryan Mark, a urologic oncologist at Fox Chase, urges patients to carefully weigh the benefits and trade-offs of each treatment option.
“In certain cases, the differences in treatment options can be relatively minor,” Dr. Mark explains.
WATCH: Balancing Treatment and Quality of Life: What Men Should Know About Prostate Cancer Care
One common combination for aggressive prostate cancer is radiation therapy paired with androgen deprivation therapy (ADT), also called hormone therapy, which suppresses testosterone to slow cancer growth. While this approach can significantly improve recurrence rates and survival, it’s not without cost — especially for older patients.
Dr. Mark says adding those treatments to radiation significantly improves recurrence rates and survival, “but not all men sustain that big of an improvement, and particularly if you’re older, taking out your testosterone can really affect your muscle strength and vitality.”
For some, preserving strength and energy may outweigh a modest increase in cancer control.
“As patients are getting [older], to some, that is more important than maybe a 10% [increase] in their case of prostate cancer control,” he adds.
Dr. Mark also cautions against rigid treatment protocols that don’t account for individual needs. He encourages patients to ask their care team questions and explore different treatments, specifically asking about possible outcomes and the side effects they bring.
“Sometimes, it almost seems dogmatic in the way the treatments are delivered,” he says. “It’s always good to ask what the benefit of each aspect of the treatment is and what can be given in a different way.”
Dr. Vivek Narayan, a medical oncologist at the University of Pennsylvania, is part of a growing movement in oncology that embraces combination therapy as the backbone of metastatic prostate cancer treatment. This approach pairs traditional hormone therapy (also called androgen deprivation therapy or ADT) with FDA-approved oral agents like abiraterone, enzalutamide, apalutamide, and darolutamide — each designed to disrupt the testosterone-driven growth of cancer cells further.
WATCH: A Message Of Hope For Men Fighting Advanced Prostate Cancer
These therapies not only slow disease progression but also offer patients a chance at living longer, fuller lives — even with an advanced diagnosis.
Dr. Narayan highlights the progress in advanced prostate cancer care, noting that the disease is increasingly manageable and patients now have greater potential for improved quality of life. Still, patients must be carefully monitored.
“Even with metastatic prostate cancer, it’s not always the cancer that causes the biggest problems. We’ve got to keep an eye on overall health, because that matters just as much.” Dr. Narayan notes.
This shift in perspective is critical — not just for patients, but for caregivers and clinicians alike. It reframes the diagnosis from a terminal sentence to a chronic condition that can be managed with precision and care.
The outlook for prostate cancer care is promising, driven by treatment breakthroughs and the rise of personalized medicine. Dr. Narayan’s work at Penn Medicine, along with cancer research centers across the country, continues to push the boundaries of what’s possible, offering patients not just treatment but a renewed sense of hope.
Prostate Cancer Screening and Warning Signs
When you do get screened for prostate cancer, your doctor will run a few tests.
One of the tests is the PSA test, a simple blood test that screens for prostate cancer. It looks for higher levels of prostate-specific antigen (PSA) in the blood. An elevated PSA test does not always mean you have prostate cancer. It could also reflect that your prostate is enlarged, which is common, or it could signal an infection or inflammation.
Your doctor may also conduct a digital rectal exam (DRE) to check your prostate for lumps.
Depending on the results of these tests, imaging scans and a biopsy may be ordered.
WATCH: How Gleason Grade Determines Treatment
Prostate cancer does not always behave the same in every man it impacts. The cancer can be considered “low-risk” and can be slow-growing, and treatment might not be necessary. In other men, the cancer may grow faster or more aggressively, requiring more immediate treatment. Because of this, there is some debate about screening.
The United States Preventive Services Task Force recommends that men at average risk between the ages of 55 and 69 years talk with their doctor about the pros and cons of prostate cancer screening.
The American Cancer Society recommends that men at average risk begin screening at age 50. Men who are at high risk of prostate cancer should begin screening at age 40. Men with a close relative diagnosed with prostate cancer should consider annual screenings in their 30s.
SurvivorNet experts suggested that men consider factors like their family history, genes, and age when deciding whether and when to screen.
Symptoms of prostate cancer may include:
- Urinating more often
- Waking up in the middle of the night to pee
- Blood in your urine
- Trouble getting an erection
- Pain or burning when you urinate
- Pain in your back, hips, thighs, or other bones
- Unexplained weight loss
- Fatigue
Prostate Health Among Black Men
The Prostate Cancer Foundation (PCF) has cancer screening guidelines with Black men in mind.
Since Black men tend to be diagnosed with prostate cancer at younger ages compared to other racial groups, the new guidelines state Black men should consider screening at 40 years old since this demographic group is regarded as a “high-risk population.”
WATCH: How to Address Racial Disparities in Cancer Care
“Few guidelines have outlined specific recommendations for prostate-specific antigen (PSA)-based prostate cancer screening among Black men,” researchers for PCF said in its report published in the Journal of Clinical Oncology.
“Discussions with health care providers about baseline PSA testing should begin by the time Black men are in their early 40s, and modeling data suggest prostate cancer develops 3-9 years earlier in Black men compared to their peers. Lowering the age for baseline PSA testing from 50-55 years to 40-45, followed by regular screening intervals until the age of 70, would reduce prostate cancer mortality in Black men,” the PCF said in its report.
RELATED: Black Men May Be More Susceptible To Advanced Cancer Due to Biomarkers in the DNA, Study Says
SurvivorNet holds an annual Close the Gap conference to educate, spread awareness, and ultimately work to eliminate racial disparities in cancer care. Our efforts aim to ensure everyone has access to education about cancer, screening recommendations, treatment options, clinical trials, and more.
Questions for Your Doctor
If you have experienced symptoms associated with prostate cancer or have a screening coming up, here are some questions you may ask your doctor:
- If I had elevated PSA levels, what could be causing that besides cancer?
- How long will it take to learn if my PSA levels warrant further testing?
- What treatment options are best suited to me based on my risk level?
- What financial resources are available to help with the costs of treatment?
- How long will my potential treatment prevent me from working or continuing normal activities?
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