As Brian Quavar was wheeled into the operating theatre at Guy’s and St Thomas’ hospital in London, he looked up at the surgeon and joked, ‘how much sleep have you had?’
Being the first patient of the day, he was about to have life-saving surgery after being diagnosed with prostate cancer.
Although it was a shock diagnosis, it was one that Brian, now 60, had taken in his stride, despite the worrying lack of information surrounding the illness in Black men.
‘One in four Black men, as opposed to one in eight in the general population, are more at risk,’ the 60-year-old tube driver explains. ‘Unfortunately, there hasn’t been enough research on Black bodies and prostate cancer even though it affects us more as a community, so there is no understanding as to why.’
Like many men, Brian didn’t have any clear symptoms of the disease. He wasn’t in pain, or felt any strange lumps – the only thing that gave any sort of indication was his need to pee more than usual.
‘I had no real symptoms before my diagnosis,’ Brian, from East London, tells Metro. ‘I would say the only symptom would be getting up in the middle of the night to urinate regularly. I didn’t even think of it as a issue because I drink lots of liquid normally.’
However, after frequently getting up for the toilet during the night, he was urged by his partner to visit his GP.
A PSA test (a blood test to help detect prostate cancer) revealed higher levels than normal and Brian was called in for further tests. Following a biopsy, MRI and PET scan, he was diagnosed with localised prostate cancer – which meant it hadn’t spread.
Brian, who grew up in Trinidad, recalls: ‘I had my partner with me when we got the news, so I had that support, and I had done some research. I knew it wasn’t likely to have been fatal, or detrimental to my wellbeing – so I didn’t panic.’
‘I didn’t think: “Oh my god, this is the end of the world!”. I listened to diagnosis and I was told about the treatment options.’
Brian opted to have his prostate removed, rather than undergo radiation. However the operation, known as a radical robotic prostatectomy, came with risks, such as incontinence and erectile dysfunction. Both of these were dependent on the success of the surgery and how much ‘nerve spare’ (where doctors avoid cutting nerves near your prostate) surgeons could save.
Thankfully, the operation was a success, leaving Brian with 75% nerve spare. He was then sent home with a care plan, medical erection pump, and a catheter – which was removed after two weeks.
On the whole, he says, his recovery went well. However, one thing that Brian feels has helped him enormously over the past two years has been a prostate cancer support group specifically for Black men, called Brother to Brother, Man to Man.
The group was set up by nurses at Guy’s and St Thomas’ hospital with the aim of being a safe space for Black men to talk about prostate cancer and, ultimately, help squash stigmas in the community.
‘Staff found that not many Black men attended the regular prostate cancer group and felt that Black men would be more responsive to being in a group of people similar to themselves. And I agree.
‘It’s important for us as Black men to feel comfortable in a space where we can talk freely amongst ourselves, and not to be seen as in the minority.
‘We meet once a month and we’re able to share personal experiences and hear from experts in the field. It’s very supportive.’
Brian adds that groups like this are especially crucial, as prostate cancer is still stigmatised within the Black community.
‘It’s taboo for a lot of reasons. There is still a struggle in terms of getting Black men to ask for PSA tests,’ he says. ‘A lot of them still think the only test is the rectal examination – which isn’t the case – and for some men this is taboo. They don’t want anybody putting a finger up their bum.
‘The other issue is the fact that prostate cancer has to do with your sexual function – however, until it’s in the advanced stages, it doesn’t really affect you in that way. So some people think “what they don’t know can’t hurt them”, and they prefer to not know about any kind of treatment that would affect their sexual function.
‘However, as a Black man, it’s also important to me that more Black people speak out to remove the stigma around being tested or being treated for prostate cancer, as it still remains a taboo for many, across Black communities.’
What’s more, with the statistics highlighting Black men are more at risk of prostate cancer, Brian feels passionately about firstly encouraging Black men to get a PSA test and secondly, urging GPs not to turn them away when they request one.
He also stresses this is particularly important as often prostate cancer can be practically symptom-less – like it was for him.
Meanwhile, there are other hurdles in the way, which could be more easily remedied, such changing how coverage of prostate cancer tends to focus on white men.
‘When people share their stories, it’s usually white men,’ Brian points out. ‘However, even if they’re speaking about white men, it should be reiterated, somewhere in the narrative, that Black men are more at risk of prostate cancer.
‘This narrative is still if you’re a man over the age of 50, get a PSA test. But it should be stressed this is for the general population. However, if you’re a Black man, and you’re over the age of 45, you should be getting a test – that’s the guidelines from Prostate Cancer UK.
‘That distinction should always be reiterated wherever possible when cancer is spoken about.’
Since Brian’s surgery in 2021, his PSA levels are undetectable and he attends regular check ups. But following his experience, he’s more passionate than ever about getting people talking and squashing stigmas.
I would like to reiterate the message to Black men, that there is no shame in having any kind of illness.
‘It’s a taboo for a lot of people in the Black community where you don’t talk about your illness whether it’s prostate cancer, or mental illness or any other kind of cancer, or any other sort of this medical diagnosis – it’s not openly spoken about. So there needs to be more openness within the community.’
Brian is also involved in Macmillan’s recent Find The Words campaign, which encourages men to open up about their experience of cancer and reach out for support.
If you’ve received a diagnosis or are going through treatment, you can get support via Macmillan on 0808 808 00 00.
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