Episode 7: Navigating Men's Urologic Health with Dr. Yaw Nyame

Urologic Oncologist, Dr. Yaw Nyame, joins us to discuss the critical yet often overlooked aspects of men's urologic health. We explore how modern detection methods can identify problems before symptoms appear, potentially saving lives through early intervention.

• Urologic health involves the entire urinary system plus male sexual organs
• Prostate cancer affects 1 in 8 men overall, but 1 in 6 Black men
• Black men are 60% more likely to get prostate cancer and twice as likely to die from it
• Waiting for symptoms before seeking care is often "waiting until it's too late"
• Early relationship-building with primary care physicians supports better lifelong health
• Testosterone replacement therapy carries significant risks and isn't appropriate for most men
• Cancer screening can often detect issues before symptoms develop
• Patient-partnered research helps create interventions that better serve community needs
• Simple practices like testicular self-examination should begin in your 20s

Talk to your family about cancer history, establish a medical home early in life, and don't wait for pain before seeking healthcare. Prevention is always better than treatment.

Chapters

• 0:11 Introduction to Real Health Black Men
• 1:17 Meet Dr. Yaw Nyame: Surgeon & Researcher
• 5:39 Understanding Men's Urologic Health
• 12:56 Prostate Health and Cancer Screening
• 18:09 The Importance of Regular Check-ups
• 25:40 Patient-Informed Research Approach
• 33:46 Addressing Racial Disparities in Prostate Cancer
• 37:05 Key Takeaways for Men's Health

Transcript

Grantley Martelly: 0:11

This is the Re al Health Black Men podcast, where we empower men to take control of their health. We provide vital information and build community support. Join us as we discuss everything from major health challenges to mental wellness to physical fitness. So if you're ready to level up your health and your life, you're in the right place. Let's get started. Welcome to another episode of Real Health Black Men. Thank you for listening. Today, my guest is a friend, Dr. Yaw Nyame. He is a part of the University of Washington School of Medicine and the Fred Hutch Cancer Center. According to the stuff I read about you, it says that you are a surgeon, a researcher, educator, a patient advocate. So we're going to talk about all of those things there. But instead of me trying to define you or what other people define you by in the writings, maybe we'll begin by letting you introduce yourself, telling us who you are, where you're from.

Dr. Yaw Nyame: 1:23

Sure, I was worried you were about to read that really long bio. You know our academic bios are always awkward. I feel like we probably could borrow from other industries where the bios sound less stiff. But let's see, how would I describe myself? So I would describe myself first as Ghanaian American. I'm really proud to identify as both.

Dr. Yaw Nyame: 1:48

I grew up in the great state of Oklahoma Great sometimes, not so great, others Great right now, because the thunder are rolling. And let's see, I went to undergrad at Duke University, so that's my alma mater. And then I went to graduate school, both in DC and in Chicago. So Northwestern is where I did my training for medical school and business school. How our training works, right, but I I was like a medical student, so I was paying money to become a doctor in chicago, at northwestern, and then you graduate, but then you're still learning and training, but that at least you're getting paid. Then it's a small salary but you're officially a doctor and that's residency. And I did that at cleveland.

Dr. Yaw Nyame: 2:42

And then, after six short years of training, just the brief six-year period of being an apprentice I came out here to Seattle and did more training, actually two more years, and then stayed, but finally I got my first quote-unquote real job where I practice urology. I take care of patients who have urologic problems. My extra two years of training was basically to become a cancer specialist, so, um, that's what I do. I take care of cancer patients, um, that have cancers that are specific to your urologic organs, if you will. So urology takes care of urinary and male sexual organs, and the prostate is by far one of the most common sites of cancer of any type, and that's a lot of what I manage and that's how we met.

Grantley Martelly: 3:39

That's how we met yes. So tell us a little bit about your family. Are you married? Do you have kids?

Dr. Yaw Nyame: 3:45

Yeah, I'm married, been married to my beautiful wife, uh, Christy. We met she met me at the very beginning of that short six-year journey uh, in Cleveland, that's where she's from and we got married towards the end of that journey. And we also had my daughter, my my oldest of my two kids at the end of that journey. So now we we have an eight-year-old and an almost six-year-old and, as you can imagine, our lives are busy and full, you know full of, yeah, lots of stuff going on at that age.

Dr. Yaw Nyame: 4:22

Oh man, you wouldn't believe it, but they keep you grounded and humbled and the best part of my day is the on-haul Hearing what they've been up to and I try to read to them if the days hasn't been too long and we all have the energy for it.

Grantley Martelly: 4:43

Well, that's good. At least you get the time to spend with them. Um, you know, those 18 years are very important and they go pretty fast.

Dr. Yaw Nyame: 4:52

Take it from somebody who's on the other side the iphone is like the worst and best thing and it keeps giving me these reminders. You know, four years ago, five years ago, and it's like you know, it's hard to believe that much time has passed so quickly. So I really am trying to cherish every day with them.

Grantley Martelly: 5:12

Well, I applaud you and I encourage you. So our topic today is men's urologic health. Our discussion is going to focus around that topic and it's not a topic that I've heard much about at least focused from that area, men's urologic health. So if you could give us an introduction to what is urologic health and what is men's urologic health, and how we approach that topic, I'd appreciate it.

Dr. Yaw Nyame: 5:39

It's funny you mentioned this and I'm smiling because when I got into urology, that was furthest from what I thought I would be like when I, when I got into urology, I was like that was furthest from what I thought I would be doing as a when I entered medical school Right In fact, we used to have these teaching modules where we um did physical exams and interviewed patients in medical school and they were these paid actors that would help give us feedback on our bedside manner. And I remember, after we did the urology block, I called my dad and I said, dad, no matter what I do, it's not going to be urology, it's not going to be what we did. Today, man, I'm not doing any of this. But as I got further into my education, what I realized was there was a special bond between the urologist and his patient. You know, touching on really sensitive issues, managing like really impactful quality of life issues, um, that I really enjoyed. And I enjoyed being able to be, uh, that trusted source for for men and you know, guys, we're not always seeking health advice, we don't foster relationships with doctors in that way. So I felt like maybe I had like a more natural inclination and gift to have a bond with a patient in general, but with guys, and maybe I could use that to be their advocate, help them seek health.

Dr. Yaw Nyame: 7:04

So what is urologic health? Well, you know, really, it's urinary function. Right, that's number one. So when you think urology, you got to think kidneys, the tubes that drain the kidneys, the ureters and bladder, and then the bladder is kind of like a repository for urine that has to empty, and so the urethra is what empties it. Okay, so that's on the urinary stand, uh, function standpoint, and we all know like bladder issues are really common.

Dr. Yaw Nyame: 7:32

If you think about what like impacts your quality of life the most, you know once you get beyond, like having a clear mind, being able to walk and you know like have general function, like your urinary function and your bowel function, those are like important parts of your day, right? So anyone who has a disruption of that is starting to think like, hey, man, you know the things that I hear from friends, close friends, but happy a lot, is that a problem? Or, like you know it's I've noticed my stream is slow, or you any variation? That, right, and that's, uh, what your urologists take care of for men. Our bladder is empty through the prostate, right, so the prostate ends up being like has the potential to be a dam for urine flow. So when we talk about men's health issues on the urinary standpoint, it's it becomes the risk of having difficulty urinating when you get older, uh, and then kind of some classic urinary symptoms that people can have in all ages of life, which is kind of that overactivity, like am I going to the bathroom too much, um. The second component of it is sexual health, right, because I said u said urologists take care of urinary issues and sexual function related issues, especially for men, and so erectile dysfunction and fertility, those are things that you may seek a urologist for you may seek a urologist for. There are obviously diagnoses. I have to say this here right, if you have blood in your urine, that's not normal. You're supposed to see a urologist for that, okay? So there are things like that, right, kidney stones. There's a lot of stuff you may see for a urologist for, but when I think of men's health really from a quality standpoint, it's about urinary function, it's about erectile function, it's about fertility and those are probably like the three big categories that I would throw there.

Dr. Yaw Nyame: 9:35

As a cancer specialist, I'd be remiss not to say that there is also probably a responsibility for most males to be thinking, as they get older, about their cancer screening and cancer surveillance. Prostate cancer is just so common that I think a good lens towards men's health is also the preventative things that you can do to avoid, you know, serious illnesses such as prostate cancer or even testicular cancer, right? So for the 20 and 30 year old guys who are listening, yeah, you should be checking your cancer, right? So for the 20 and 30 year old guys who are listening, yeah, you should be checking your jewels, you know, in the shower at least once a week. Maybe there's not a hard spot or anything weird Cause. That's good, that's just good maintenance right Um to to make sure you're keeping yourself in good health.

Grantley Martelly: 10:20

So we got to the blood in the urine and people doing cancer screening. We're talking about everything from the urinary system to the sexual health, to how we all function.

Dr. Yaw Nyame: 10:34

from that urological standpoint, and you know it's interesting. We're talking about urologic health and men's health, but also there's some hormone function too, right? Testosterone levels. Testosterone levels can be low in some men for a variety of reasons, and sometimes normalizing that can really improve quality of life. I'll plug this. I mean, this is not what we typically manage ourselves as doctors in the urology space. But you also want to think about the importance of mental health too, and I think that there are different types of shops that exist across the country that provide men's health support, and I think many of them are going to touch on from a urologist standpoint. Many of them are going to touch on from a urologist standpoint. Many of them are going to touch on all the different aspects of care and life that I just mentioned, and so it's a really important topic.

Dr. Yaw Nyame: 11:37

I think as a group and men of color you know, as a group, right and men of color sometimes we only take care of things when they're at an extreme right.

Dr. Yaw Nyame: 11:50

There's no preventative mindset, that maintenance mindset as much. I don't want to over generalize, but definitely that's what we hear when we're in our peer groups right, like when we have our advocacy group together, you and I. We hear the guys share that. So I think it was a really timely topic to just put out into the universe that you know if you're if you're a guy in your 20s, 30s, there's a role for you to be checking in with a doctor and asking questions and getting a better understanding of how all those things work, you know, and not waiting until you're 65 and not able to pee to be thinking about your prostate for the first time, right, or feeling hopeless if you're experiencing something like erectile dysfunction or sexual dysfunction in your 20s or 30s, to know that there are specialists out there and people who can help and think about it holistically. So that's part of what I hoped our discussion would be about today.

Grantley Martelly: 12:55

So let's continue in that vein. How does a person go about assessing their urologic health with their doctors? I mean, how would that start? Is that like a part of a regular annual exam, or is it a separate process?

Dr. Yaw Nyame: 13:10

Yeah, I mean, I think it depends on what station you're in in life. I will say that probably the most important person in the discussion around men's health and many of these topics I've talked about and maintenance and prevention, is your primary care doctor. They're trained specialists, often much better communicators, have a broad understanding of medicine and your health can be your biggest advocate. And so I think establishing a medical home meaning like having a doctor that you build a relationship with in the primary care setting, someone you see frequently is critical. And then I think, utilizing that person, hopefully you can make sure that you're getting in any questions or concerns you have about, you know, urology related health, you know. So those questions you know.

Dr. Yaw Nyame: 14:08

Again, it's interesting I was starting to go down this path but when I got the job to for urology in Cleveland, one of my buddies, his dad, pulled me aside. He said hey, man, these guys all your friends here, they're giving you a hard time about becoming a urologist. Like, why are you going into this? They're all going to be calling you in 30 years. And I was laughing and it didn't take 30 years, it would be. Literally took about five or six before the first guy phone and said hey, I got this problem. Is this normal? So, um, you know, I think the ways the, the, the primary care, and having that relationship is critical and then just not being afraid to put it out there right, asking that doctor if something you're experiencing is normal or abnormal, because they're going to be the ones typically that will say, okay, hey, we've checked your testosterone and slow, maybe you should go see a urologist or you know what, let's try this medicine for your urine flow. If it isn't better Now we're going to kick it to someone like Dr Nyame.

Grantley Martelly: 15:07

So it's not a separate set of tests. It's part of the primary care and then. So I'm trying to get at. You don't have to set a separate appointment and say I'm going for my urology test.

Dr. Yaw Nyame: 15:18

It's just part of your normal care, I think you can establish this to be part of your normal care. Now there are men's health clinics all around the country, so I think if you feel like you need that specialist, you go to their website. Hey, they take care of an issue that I want direct from a specialist information on. You certainly can request a referral, and people approach it that way. But I also want to normalize that men's health doesn't have to happen in a specialty men's health clinic. I think men's health is what an average primary care doctor is going to be providing his male patient when he comes in to see him. Problem is, too many of you guys don't have a primary care doctor right, so you don't have the opportunity to get that tailored men's health treatment or advice or care. So that's really what I wanted to answer your question. You know, I think you could have it both ways. Probably the easiest is just getting a doctor right and seeing somebody regular.

Grantley Martelly: 16:21

Okay. So we see a lot of ads on TV or or sometimes I hear on the radio about you know, as you get older, that you need you were talking about men's health, men's clinics. You know that you need to go because you need more testosterone and you got to get more testosterone because testosterone is what keeps you alive. Is there something to that or that as we get older, we need to be bulking up on testosterone?

Dr. Yaw Nyame: 16:49

oh man, this is not my specialty at all. What I will say is there's a lot of misinformation in the world. The one thing about testosterone replacement is that it's not benign, right. So remember, if you are, uh, of age where you're really wanting to be fertile and fertility is important to you, that if you take exogenous testosterone, that you know that any form of of that external supplement it's going to take, it's going to drive your sperm counts way down, okay, um, and so that that's not benign and definitely don't take it if you're trying to start a family or have kids.

Dr. Yaw Nyame: 17:31

The second thing is that it can cause your blood to get too thick, okay, so that's another reason, uh, to be weary and careful about. You know, advertising that just says, hey, any problem, you have, just take testosterone, right and three it's. You know advertising that just says, hey, any problem, you have, just take testosterone right and three it's. You know the effectiveness has only been shown in patients who actually have low T levels, okay, and have symptoms, okay. Both those things have to be true. So, if you have symptoms and your testosterone is normal, oh, I feel tired all the time and you know, know, I feel like I'm losing muscle mass. But you get your t checked and it's like you know, 400 and it's normal. Don't go replacing because there's no proof that that's going to be beneficial. And the same is true too if you go get tested. Your t is like 150 or low and uh, but you like are a marathoner, you feel great and energized and whatever.

Dr. Yaw Nyame: 18:27

I'm not sure replacement is what you need. So I think a lot of it has to be getting your your levels from. If they are low to a normal, and then um, and you have to be symptomatic from or have symptoms, so feel tired, feel like you're having a decrease in muscle mass, less libido from having low levels. And also don't forget and I think this is really critical that testosterone isn't just a freebie. Now, right, that there are real side effects. I mentioned, too, the fertility thing. Maybe some guys are like great, but I wasn't worried about that, but that thick blood can cause strokes and other issues if it's not being monitored. So this isn't like a medication you just want to be on and not worry about it. You definitely should be getting routine blood checks to make sure your blood's not too thick, yeah that's good.

Grantley Martelly: 19:20

Thanks for clarifying that, because we hear lots of ads about that. Now some men say that if I'm not having any pain, everything feels good. You know everything is working good. Why should I go to the doctor? Why should I care about my urologic health?

Dr. Yaw Nyame: 19:42

That's a great question, right. Health that's a great question, right. And the truth is that we have made so many advances in medicine that some of the things we're able to pick up don't present with symptoms anymore. We pick them up because you get blood work. I treat a lot of kidney cancer here in Seattle, right, and a lot of kidney cancers are picked up because we have cat scans now. So you go into the ed, your belly hurts or I don't feel very good, I have a little bit of diarrhea they get a cat scan, right, because we have that ability. Oh, by the way, no, the diarrhea probably just something bad. You ate, but you've got a small lump on your kidney, right.

Dr. Yaw Nyame: 20:21

So part of the reason you want to be getting checked in is like there's some critical blood work that can get checked as part of your primary care visits that help you stay on top and ahead of some potential issues. One of those is prostate cancer. Right, we've kind of alluded to it. We're talking about men's health. I think 315,000 people are going to be diagnosed with prostate cancer in the United States this year. To me, you can't talk about men's health, men's urologic health, and not talk about the risk of prostate cancer. Well, you know, if you want to beat it, one of the best ways to do it is to screen, and certainly you should at least be in a position to talk to your doctor about whether or not you want to get a simple blood test to be on the lookout for a cancer that affects one in eight men in the United States. I would say you have symptoms, as often waiting until it's too late. From my perspective, from my perspective.

Grantley Martelly: 21:23

Yeah, thank you for making that clarification, because that's a great way to say it. Obviously, you're better at it than me, but there's so much technology out there. Part of the reason for this podcast is helping men to see that the technology and the science is growing so fast that a lot of the things that they used to think about that they have to do. Now you don't have to do. Your blood tests will pick it up and your screenings will pick it up, and waiting for pain sometimes means that you're letting things progress in your body that you could have learned about if you were just paying attention or having your physicals or going to your doctor. Because I keep getting that question Once people find out that I have prostate cancer. The next question half of the time is well, how much pain did you have? You know why did you go in? Did you have pain? I was like no, there was no pain. There wasn't any pain until I got out of the surgery, right, and they're like well, how did you know I?

Dr. Yaw Nyame: 22:23

hear that all the time with newly diagnosed patients Like, doc, how can you be telling me I don't have I had this bad cancer, I don't have any symptoms? And I always say good because you know when you have symptoms it's usually too late or it's like too far advanced and so if you have no symptoms, have the in my opinion, oftentimes the maximum opportunity to help. Now you know, we could have two full podcasts on prostate cancer screening. It's not that simple, right, because certainly there is some potential downsides to having the blood test. But look, you can't find out if it's good or bad for you unless you go see somebody. Right, right? I think that's kind of the key message for today. The other thing is like Things have changed right, when I started in medical school and urology a finger exam, good old prostate check, dr Dre, as our friend Kojo calls it, dr Dre the digital rect work if it's abnormal.

Dr. Yaw Nyame: 23:30

We tend to get MRI right. We get a picture. All of this is non-invasive, it doesn't require any physical examination. Now, biopsy is invasive I'm saving that for later as part of the topic still. But at least by the time you get to that, biopsy, if you need it as part of your men's health, biopsy, if you need it as part of your men's health Usually have lots of corroborating data to say, hey, the risk is high enough that we should do this right and that's the kind of medicine we're trying to practice these days.

Dr. Yaw Nyame: 24:09

So I would say, you know, when it comes to how to do men's health, you know the first step is make an appointment with a doctor and the best time to do that honestly, for all the guys who are listening don't wait till you're in your you know, forties, fifties.

Dr. Yaw Nyame: 24:26

You know, build that relationship early, because the more of an established relationship you have with a primary care doctor, the more they can serve you. The more they know your values, the more they have of your history, the better the relationship they have with you to be your advocate. So I'm a big, big, big proponent of you know building these relationships early and you probably don't need to see them every year when you're in your thirties, every other year, every three years, something like that, and then they will be able to say, hey, you're due for your colonoscopy, hey, you're due for your PSA check and you know, hey, you're 45, now Probably should see each other every year, you know, and they're going to tailor it to what you need to us. I think that's a really nice approach to think of using for men's health care.

Grantley Martelly: 25:21

So any other topics on the men's urologic health that we need, any other areas we need to touch on. We touched on the you know, the bladder and the urethra, the urine, the cancer screening.

Dr. Yaw Nyame: 25:33

Fertility is the only thing we haven't talked about right, and I'm not a fertility specialist about, right and I'm not a fertility specialist. There are a lot of couples in america who want to be pregnant, who want to get pregnant, who can't, or have difficulty. Um, and this, like many topics in medicine, this is one of those quiet sufferings that a lot of people go through, a lot of young people who go through. I think, if, if we can normalize the discussion, you know that this happens and that there are doctors and specialists that help it is a great forum to do that.

Dr. Yaw Nyame: 26:10

And so what does a men's health urologist do in the fertility setting? Well, they usually do the evaluation of the guy, right. So that's as you, as you listener, and and that that's good to have somebody who checks you out to make sure that, from a fertility standpoint, things are working well. And I can say I, I myself, have gone through that process like that, right, it's awkward and you know, but it's, it's, it's good to do, right, because, listen, I'll tell you, whatever you think you have to do, that is challenging as a guy, the female workup is really intense and and so oftentimes it's uh, it's important to know that you have a doc that looks you over and make sure that things are working for you from a fertility standpoint if you're not able to get not able to get pregnant, and I think again, that's part of men's health. I will say that we define infertility so the difficulty to achieve pregnancy. We define that usually as a couple who have been attempting for a year.

Grantley Martelly: 27:15

A year. Okay, Another question here is tell us a little bit about your research and some of the other things you do.

Dr. Yaw Nyame: 27:22

So you're a clinician and you're also a researcher have a 50% of my time doing research, which really, for us, has been building a program. That's a little bit unique in prostate cancer research in that we really value the partnership with cancer survivors and, specifically for us, we've been working with black cancer survivors, prostate cancer survivors, to co-develop a research. Co-develop, you know we call them interventions it makes it sound fancy. We're co-developing essentially, you know, plans of action that we get to study and test and perfect together. So you know, for instance, I've been preaching about PSA testing and you know we've been working on a project where we're trying to figure out what's the best way to do screening for black people across the country, and we've been putting in a lot of work over the last two years to come up with a research plan, as we call it, so that we can figure out hey, is it, you know, is approach one or approach two going to be the one that helps the most people? So it's a fun research practice. It's a little bit different.

Dr. Yaw Nyame: 28:53

I'm working with test tubes. I'm collecting a lot of samples presently. I mean, I used to do that kind of research but right now it's a lot about getting guys like you together, talking about your experience as cancer patients. Having you guys help us understand where the need is and what tools are going to make a difference in making cancer care better for black patients. But ultimately, if we make it better for those that are at the margins, we make it better for everybody. I really believe that, as an equity researcher, if we take care of the people who have the hardest time accessing health care, then we improve it for everybody else as well. That's really my mission.

Grantley Martelly: 29:42

So you talk a little bit about patient-informed research, and why is that important? Why do you think that's important?

Dr. Yaw Nyame: 29:50

Yeah, I mean, I think as clinicians it's easy for us to sit in the ivory tower and you know, everybody tells you oh doc, you're the expert, right? A lot of the things that we administer we don't live through. And so you have a 7, let's say you got a 9 am appointment with me. I don't know what happened on Monday. I don't know what your Sunday looks like. I'm new to Washington State-ish. I know I've been here five, uh, seven years. Actually I got to stop saying I'm new.

Dr. Yaw Nyame: 30:25

But you know, I don't know what it was like to drive over, you know the pass or to get here from Yakima or whatever. So, um, I don't know how much time you had to take off from work. I don't know who's in your social circle that you've talked to about your diagnosis. I know very little about what it's like to have incontinence after surgery. I tell a lot of men what I've heard it's like, but I haven't lived it, and so it's really important to me that we go straight to the source to understand what these problems are like. The source to understand what these problems are like.

Dr. Yaw Nyame: 31:03

When we do this, what we learn is how to modify our research so that it's better right, so that if we decide to open a study, people sign up for it. If we ask a question, it's one that's important and is going to have the most impact if we answer it right. And our field is littered with studies where really smart people got millions of dollars to do something but people wouldn't sign up for it or the results ended up not being that useful because I think they weren't as informed by patients as they needed to be, and you and I we've talked a lot about this. My analogy is like if I was going to open a coffee shop in your neighborhood, could you imagine if I didn't knock on a few doors and ask people what kind of coffee they like, if they thought they needed another coffee shop on the block? And what we do is the equivalent of just open a coffee stand, sometimes right next to the Starbucks, and then we're like, hey, how come we're not helping, how come we're not selling any coffee?

Grantley Martelly: 31:59

Not selling much coffee. Yeah, you didn't do your homework, you didn't do the homework right?

Dr. Yaw Nyame: 32:05

No, I think so.

Dr. Yaw Nyame: 32:06

It's just not about being patient-informed, honestly, right, but it's about being patient-partnered.

Dr. Yaw Nyame: 32:14

I think that the coffee shop analogy is a good one, that the coffee shop analogy is a good one and that you could imagine if you really had a target demographic that you wanted to sell your coffee to, maybe young people, you might open that venture with kind of a young influencer or someone who has a pulse on that community in that neighborhood.

Dr. Yaw Nyame: 32:38

So that's like taking it one step further than just talking to some young people. But you know what, why don't you help me with the design of the interior and the menu? And like, hey, do you think like young people care if the coffee is from Ethiopia or Brazil or whatever? Right, that's what I think we're doing. That's different in the research is that we're taking it one step further than just saying what do you think is important? But it's like come along for the whole ride and we've seen that how fun and impactful this process has been. And I think between you and me we're on the verge of something really big developing within the next year or two for our research team, which includes you, and that's exciting.

Grantley Martelly: 33:25

I think we do some good, interesting work on interesting teams and the stuff that we are studying is very interesting. You talk about your research is focused mainly on black men, because prostate cancer affects men. Why do you think focusing on that subset is so important?

Dr. Yaw Nyame: 33:46

Yeah, black men are 60% more likely to be diagnosed with prostate cancer in the United States. I said one in eight men would develop prostate cancer in the US, one in six if they're black or have a strong family history. The reason for that we don't know right. So I think oftentimes we jump straight to the biology. But you know, biology definitely plays a factor. But not all of this risk is what you're born with, right? So there's got to be some other environmental components. So when I say environmental, I use that as a big catchphrase for a lot of different external factors. I don't know, is it stress? Is it the water? Is it the air? I mean it could be or is it some combinational all of that?

Dr. Yaw Nyame: 34:33

Probably the most sobering thing is black prostate cancer patients are twice as likely to die from prostate cancer as their peers. This has been true for over 50 years. I have a student who is doing a project with me and you know we were calculating the burden of prostate cancer death among black people and it came out to 1.5 million years of life lost over the last 50 years per 100 000 black people right, like men over that time period. That's a staggering amount of burden that has been shouldered by the community. To me, this is like a public health crisis. You know, this isn't just an interesting statistic on disparities. This is something that we are living through, we've lived through for 50 years. It needs to be addressed. And you know, I think when I think about what we're losing, we're losing culture, we're losing economic stability, social stability, often when we lose men in their 40s, 50s, 60s and 70s to prostate cancer.

Dr. Yaw Nyame: 35:52

So to me, this is something that's critical to address. You know, I said, my equity lens always has me thinking how do we make it better? How do all boats rise? And I think, if we can really address this particular disparity by figuring out ways to better inform patients about screening, how to support better access to treatment, how to access better survivorship care once you've been treated, making sure you have the latest and greatest, and we can make those tools available to our most vulnerable populations, it's kind of a slam dunk that that kind of information could also help other people and other populations. So that's the drive. We talk about quality care all the time, right. One of the key tenets of quality care, as defined by the National Academies of Science, is that it be equitable. I know that's a bad word these days, but you're not delivering something of high quality if it's not equitable, and so that's the focus of what we do.

Grantley Martelly: 36:57

Just to wrap this up, what would I mean? What would you say are the three takeaways that you would like the audience to get from this conversation today?

Dr. Yaw Nyame: 37:05

I think, learn to be curious about your own body and health, especially for the young fellows out there. I mean, I'm not embarrassed to admit that I didn't know very much about the prostate or men's health until I was well into my, you know, almost 20s, late 20s, right In medical school. And so be curious about what's going on with your body and protect it. You know, take good care of it. Number two you know it's never too early to establish a medical home. Doctors, we're here to help. We want to help, we want to get to know you too and know what's important to you and support those things right. So building a foundation and a medical home early allows you to get knowledge and get reputable, credited knowledge in your back pocket and then also, hopefully, you build a relationship that sustains you for a long time, because that's important.

Dr. Yaw Nyame: 38:04

And then number three you know I think a key tenant of men's health is selfishly, I'm going to say is prostate cancer, and I think I want to increase awareness about that as an issue to include with all the other things that are important to men's health from a urology standpoint. You know, making sure you pee good, making sure the erections work, making sure that you have good fertility and that your testosterone works well. But don't forget, you know, to be curious about your prostate cancer risk. You know, talk to your family, talk to your siblings. You know, talk to grandpa. Just make sure you understand what your risk is, because you know screening may be something that you want to consider at an early age, like 45 or 50.

Grantley Martelly: 38:55

Well, thank you very much and I look forward to us having another conversation in the near future, but thank you for your time today To support this podcast. Go to buymeacoffeecom forward slash real health black men Buymeacoffeecom real health black men and to become a corporate sponsor. Send us an email. Bye.