February 1, 2024
Duke’s Melody McNair says there are multiple reasons why Black men do not receive proper care when it comes to prostate health.
A program from Duke University’s Duke Cancer Institute strives to get Black men with prostate cancer more equitable health outcomes.
The program, led by Duke patient navigator and registered nurse Melody McNair, is designed to reach out to Black men who have visited a Duke Primary Care clinic either located in Durham, NC, where Duke University is located, or nearby, for PSA (prostate specific antigen) screenings.
If the initial PSA value for those Black men is above 1.5 and they do not respond to follow up attempts, then McNair reaches out to them personally. A PSA score is used by healthcare professionals to determine if they should proceed with a biopsy in order to more conclusively rule out prostate cancer. An elevated PSA score is often due to factors beside an enlarged prostate, but that is one reason for a higher score.
McNair said there are multiple reasons why Black men sometimes do not receive proper care when it comes to prostate health, some of their own making, some due to systemic issues.
“They may lack support to pursue treatment, or they don’t completely understand the process,” said McNair who is intimately familiar with Black men being hesitant about care. “They don’t want anyone to know they are sick. They’re supposed to be the ones to keep up the household. That was the case with my father.”
Edward Fogg, a 66-year-old Black man who was homeless when he received an initial PSA score of 4150, an extremely elevated score, reduced his score to .5 after McNair’s involvement.
“I didn’t want to be a burden on anyone,” Fogg explained, before admitting, “And I didn’t really care about myself.”
Not only did McNair search through Fogg’s records to find his sister’s phone number, she explained to Fogg what the numbers meant and what his treatments could accomplish. McNair also gave Fogg a parking pass and gas money to help him get to his appointments.
McNair connected Fogg with Dr. Hannah McManus, a medical oncologist specializing in prostate cancer at Duke. After McManus developed a treatment plan, Fogg’s prospects dramatically improved.
“This shows us that Mr. Fogg’s prostate cancer is responding very well to treatment,” McManus said. “I am hopeful he will live well for many years,” she said.
McNair worked at a community health clinic in Durham where she screened men for prostate cancer. Part of what frustrated her about that work was that she was never sure if the men received further treatment. Now, McNair is allowed space to ensure that men can receive proper treatment.
“I’m the middle piece, to connect what you don’t have to what you need,” she noted.
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