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Prostate Cancer - the African Caribbean experience

Prostate cancer is the most common cancer in men in the UK and is the second most common cause of cancer related mortality.

prostatemed.jpgIn 2004 over 10 thousand men died from the disease. The illness is rare in men under the age of 50 with the largest number of diagnoses occurring in the 70-79 age-group. The highest incidence is seen in African Caribbean men in Jamaica.

During the 1990s, clinicians working in areas of North East London with a high concentration of men of African Caribbean origin became aware of an apparent frequency of prostate cancer amongst this group in comparison with European and Asian men.

As the cause or causes of prostate cancer are not yet known, explanations of the reason for ethnic variation remain speculative. Theories range from the biological to those involving dietary and lifestyle factors. jsu As in other conditions, population migration leads to changes in incidence patterns, suggesting that if biology is involved, it is only part of the story.

As interest in the variation of the occurrence of prostate cancer has developed, the experience of British Minority Ethnic communities in relation
to cancers of all types has become an increasing focus of concern. A growing field of research seeks to illuminate the experience of cancer within these communities and to identify needs, while pressure groups are campaigning for culturally sensitive and responsive services.

In 2003, the Prostate Cancer Charity launched its community involvement project to raise the awareness of prostate cancer through groups and organisations in different parts of the country. At Warwick Medical School a team of researchers working in psychosocial aspects of prostate cancer became aware of the lack of representation of men from ethnic minority groups both in the wider literature and in their own studies on information needs. Little was known about the cultural and sociological factors that were relevant to the experience of these men.

The Warwick Medical School team in collaboration with the Prostate Cancer Charity, and colleagues from Warwick Business School and Georgetown Medical School, Grenada, gained funding from Cancer Research UK to carry out a pilot study amongst African Caribbean men in Birmingham.

Our first challenge was to recruit men with and without prostate cancer to focus groups. This was no easy task with attendance at the groups ranging from one person to 16. Once the discussions were underway, however, most of the men needed little encouragement to give their views regarding the nature of prostate cancer and what might cause it, and to tell the story of their own health and experiences of care.

Most of the men had some concept of prostate cancer derived from the experience of a family member or relative. However, there were major differences in understanding and perception between older and younger men. Older men described prostate cancer as something that occurred with some frequency in the Caribbean but was not widely discussed because of taboos surrounding cancer in general. The cause was largely attributed to eating the wrong food or to living with anger or other negative thoughts.

Traditional remedies were important in respect to prostate cancer. The church was identified as a particularly valued source of support for both men and their partners.

Younger men, too, knew that prostate cancer was common amongst their communities. Those with relatives who had the disease had taken
steps to educate themselves while to others it was an illness associated with older men and was therefore something that was not of immediate concern. Most knew of traditional remedies, but when it came to anything as serious as cancer would go straight to the internet for their information; young men were largely very aware of physical fitness and health issues and identified a change occurring between themselves and the ‘old school ways’ of their parents’ generation.

This first phase of the study has clearly demonstrated one important point: African Caribbean communities are not static but are undergoing a process of transition and adaptation. Experiences and perceptions change between generations and while models of health care must be culturally sensitive, cultural stereotyping should also be avoided.

Men who participated in the groups were very aware of the need for public information on cancer in general and prostate cancer in particular. While older men could potentially be reached through the church, for younger men sports clubs provide great opportunities for contact and involvement. From individual interviews, currently in progress with men with prostate cancer, we hope to come up with methods of providing information that can be tried out and evaluated in a future study.

icast.jpgIf you would like to find out more about this research, you can watch a video on Warwick iCast

For more information about Prostate Cancer, visit the Prostate Cancer Charity website