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Princess Margaret Cancer Centre is tackling inequities in health care head-on – bringing the lab to the patient.
Dr. Neil Fleshner, clinician scientist in UHN's Division of Urology and Love Chair in Prostate Cancer Prevention, has launched a mobile prostate cancer testing clinic in collaboration with The Walnut Foundation, a men's health interest and prostate cancer support group working with the Black community.
The initiative, which held its first mobile clinic at TAIBU Community Health Centre in Scarborough on Sept. 30 – the final day of Prostate Cancer Awareness Month – offers increased accessibility for Black men who are at a higher risk of prostate cancer but underserved in health care initiatives.
Known as "PSA Detect & Protect," the clinic will travel the Greater Toronto Area providing prostate-specific antigen (PSA) testing to men who otherwise might not have access to these services.
Due to social and genetic differences, Black men have been found to have not only a higher risk of getting prostate cancer, but also increased likelihood of more aggressive forms of the disease leading to detrimental symptoms and death.
The vast majority of research in the field of prostate cancer has been done in white populations.
"PSA Detect & Protect outreach clinic provides an opportunity to invite members of the community to participate in prostate cancer screening and research opportunities," says Dr. Fleshner. "This is particularly important, as it provides under-represented individuals an opportunity to access health and genetic services and contribute to our understanding of cancer, to improve patient care and early detection."
Dr. Fleshner's project takes a widespread approach to addressing inequities in health care for Black men, specifically in prostate cancer. The mobile clinic launched on Sept. 30 was sponsored by TAIBU Community Health Centre, a non-profit, community–led organization designed to serve members of the Black community in the GTA.
PSA tests cost about $45 without a referral from a doctor, which can be difficult to obtain. By providing these services for free, Dr. Fleshner and his team hope they will be able to reach men who otherwise wouldn't consider getting tested.
It's a simple blood test in which the sample is analyzed to determine the amount of prostate-specific antigen present. A higher-than-average sample can be indicative of the possibility of prostate cancer.
PSA testing provides an opportunity to help catch prostate cancer in the early stages, which significantly increases chances of survival. Because signs and symptoms in the early stages can go unnoticed, Dr. Fleshner's team is passionate about making sure men understand their own personal risk factors and options.
Risk factors for prostate cancer include genetic and family history, race and age.
"In an environment where Black men are 76 per cent more likely to be diagnosed and 2.2 times more likely to die from prostate cancer, health equity demands that resources be galvanized to change the course of this disease in Black communities," says Anthony Henry, President of The Walnut Foundation.
Black men are more likely to develop prostate cancer earlier than other populations. The disease is also more likely to grow quickly and spread to other areas of the body.
In addition to genetic risk factors, Black men often face socioeconomic barriers to care, such as delays in treatment and lower quality treatment, and less access to health education. Black men also have lower rates of screening than other communities.
"If caught early, prostate cancer can be treated early, leading to productive and quality lives," says Henry.
The mobile clinic at TAIBU saw 89 men tested. Dr. Fleshner will partner with other community health centres serving the Black community, with other dates being announced soon.
"I've been treating prostate cancer for over 30 years," says Dr. Fleshner. "Too many men of colour come in too late."