Prostate Cancer Epidemic: Black Men Diagnosed at Later Stages

James Miller Jr.’s dream of being a homeowner had finally come true — which meant a trip to  Home Depot for supplies. As he walked the aisles of the home improvement store, his phone rang. It was his doctor with news no one wants to hear: Miller had stage four metastatic prostate cancer. 

His first question: “How much time do I have?” 

Maybe seven years, the doctor said. He was 57.

Miller’s story isn’t unique — it’s an epidemic hiding in plain sight. Black men face the highest rate of prostate cancer diagnosis of any racial or ethnic group in America. They’re diagnosed at later stages, often when treatment options narrow. They’re twice as likely to die from the disease compared to white men. These deaths are largely preventable. Yet in California, where Miller lives, no legislation specifically addresses prostate cancer screening or prevention.

Advocates say that’s unacceptable — and it’s costing Black men their lives.

What Every Black Man Needs to Know

The prostate is a walnut-sized gland that sits below the bladder, responsible for creating ejaculation fluid, explains Dr. Brent Rose, associate professor of radiation oncology at UC San Diego. One of the biggest problems with prostate cancer is most men don’t have symptoms until it’s advanced.

The most effective screening tool is a prostate-specific antigen (PSA) test — a simple blood draw, far more accurate than a digital rectal exam. Rose says many men avoid screening because they dread the rectal exam, but that test is no longer the standard recommendation.

The statistics are sobering: One in eight Black men will develop prostate cancer, compared to one in 12 white men. Black men are also diagnosed younger. That’s why the American Cancer Society recommends African American men start screening at 45 — five years earlier than everyone else.

“Why is it more common in Black men? The answer is, we don’t know,” Rose says. “There are two separate hypotheses. One is that it’s genetic. And the other is related to social determinants of health,” — factors such as racism, poverty, and disparities in health care access.

The pain crept into Miller’s lower back and hips first. Then came the frequent trips to the restroom. Just getting older, he thought. When he dropped 20 pounds in a few months, he chalked it up to his diet finally working. But then came chest pain. Finally, he went to the emergency room.

That’s when Miller learned those were the symptoms of late-stage prostate cancer. The once sturdy, get-it-done airport security screener was now riddled with cancer — hips, lymph nodes, thigh bones, ribs, and even on his skull.

“It was like a recording in my head. Oh my God, I’m gonna die,” the Riverside, California, resident says. “How did I get this? Is this karma? Did I deserve this?”

Miller admits he left Home Depot that day and went straight home and got drunk. Devastated, he started Googling, searching for any hope of surviving more than seven years. Depression quickly set in. After decades of neglecting his health and grinding through stressful jobs, Miller wondered if there was more he could’ve done.

“Most Black men, you figure, ‘I’m still breathing, I’m still walking around, I’m fine.’ We’re taught from when you’re a little boy, you grind it out, suck it up,” Miller says. “But we have the highest rates of prostate cancer.”

According to the Centers for Disease Control and Prevention, between 2003 and 2022, Black men had the highest rate of localized, regional, and distant prostate cancer. Meaning whether it spread to other lymph nodes or parts of the body, Black men were the most likely to be diagnosed with the disease.

“Black men are more likely to die from prostate cancer if they get it, on average, but not because the cancer itself is all that different,” Rose says. “It’s more likely that Black men tend to have more barriers to care. So getting diagnosed a little bit later or maybe not getting the optimal treatment.”

Secrecy Is Killing Black Men

Melvin Parker watched his wife fight breast cancer. After a lumpectomy on her left breast, twice a day radiation for one week, and four rounds of chemotherapy — in December 2022, she rang the bell. 

And then six weeks later, Parker got his own diagnosis: prostate cancer.

The 53-year-old Frisco, Texas, resident had no idea the disease ran in his family. His father had prostate cancer. Parker’s brother had it too, but only revealed his diagnosis after he finished treatment. Both brothers were diagnosed the same year.

“Coming from a family where my dad is very old school, very traditional, very private — we don’t share,” Parker says. “I’m probably the most transparent of the family when it comes to health.”

During a routine Veterans Affairs Department check-up, physicians noticed Parker’s PSA levels were high. Initially, they gave him tips on how to lower them. But a few months later, another test showed the levels were still high. 

“I was terrified. I was absolutely floored,” he says. “Is this my slow death? Is this the beginning of the end?”

Parker isn’t sure at what stage his cancer was diagnosed. The American Cancer Society states that prostate cancer stage matters, but doctors now look beyond it to consider risk factors — such as how aggressively it will grow and spread.

According to his doctors, the cancer had been growing in Parker’s body for a couple of years before detection. A month after his diagnosis, he underwent prostate cancer removal surgery. Six months post-op, the results were in. 

Today, Parker is cancer-free.

This story was originally published on Word In Black on January 30th, 2026