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Who’s Going To Pay

What seemed like a simple request, provide an excel spreadsheet in ten days, necessitated probing foggy memories and file drawers of old index cards. A digital request for a festering analog problem ─ Flint Michigan’s buried water pipes. Poor Flint isn’t alone when it comes to maintaining documentation for a deteriorating piping system. Updating and digitizing old records cost money─ who’s going to pay?

Perhaps if Flint had kept better records of their old water piping network, they would have known acidic river water presented a problem. Some decision makers must have had courses in basic chemistry. And now Michigan wants federal dollars to help pay for their poor judgment, because they don’t want to spend their rainy-day-fund. Who should pay us or them?Flint Water Tower

Months later, who’s speaking up for the thousands of lead contaminated children? Do the state officials care? Absence of malice, they’re plotting other children’s death. Don’t shoot. He’s already dead or  waiting to die, just like his neighborhood: The Ghetto

Life sucked from infants

Stuck in time with no dimes,

Just waiting on death.

Look here comes them buzzards,

To clean them black bones,

In the Ghetto.

Ah, life renewed

But not for Black babies,

Living in the Ghetto.

            Because the powers that be had decided years ago, not to make any investments. A systematic neglect designed to kill and/or push out the poor. Look out gentrification is around the corner. Swoop, there goes another buzzard to clean them-bones.

“Hands up,” the officer said.  “Don’t shoot,” the boy replied. The police didn’t shoot this time. The asthmatic boy returned to his polluted neighborhood and fired-up a joint. He took a deep hit and held it until his inflated cheeks burst open. “Ahhh,” he said as smoke billowed out. He then took a big sip of beer.

5, 10, 15, 20, how many more years will he live? Who knows? Like Flint, both lie dying and waiting for them gentrification buzzards to clean them-bones for them interlopers. Too bad Flint children are still ingesting poisons through no-fault of their own, other than being Black and poor: Living in the Ghetto

Can you spare a dime?

To buy us more time,

In the Ghetto!

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Advocating For the NIH

Patient Advocates from across the country were brought to Washington, D.C. by the AACI-AACR-ASCO to thank congress for the 2 billion dollars they approved for the NIH and to ask for their continued support. I had the pleasure of  walking with fellow advocate, William Rosvold, a New York pancreatic cancer survivor, on an early chilly morning from the Grand Hyatt to the Rayburn Office Building for a 7:30 am breakfast meeting. Where we were addressed by Representatives Tom Cole of Oklahoma and Brett Guthrie of Kentucky, whose republican party later that afternoon rescinded the Affordable Care Act, and there by potentially countering the full impact of the 2 billion dollar investment they had approved for the NIH.

We were divided into teams by states before breakfast and afterward each team visited their assigned representatives and senators’ offices. My first team consisting of  Dr. Link, Dr. Venook and Nicholas Bashour visited the office of Senator Dianne Feinstein, where we met with Ms. Elisabeth Fox. I shared my cancer experiences with her and how my family had three bites at cancer: 1) tongue in 1995 when my son was one-year old, 2) neck cancer in 1997 and 3) prostate cancer in 2008. Through it all, my wife Monica and my north star, supported me through cancers’ uncertainties.

Advocates in Pelosi's Office

From left to right are Dr.Link, me (Gerald Green), Ms Patricia Ross, Dr. Esserman, Dr. Venook, and Nicholas Bashour

I repeated my story with other congressional staff  as shown in Representative Nancy Pelosi’s office above and we ended our day after 5 pm to the aroma of fresh made popcorn in Senator Kamala Harris office with tired feet.

I look forward to uniting with my fellow advocates in the pursued of more NIH funding on Capitol Hill next May.

Twelve Oars for Prostate Cancer

Following the coxswain’s command, “stroke,” six black men dipped twelve oars into the water. Their muscles acted as one and pushed gallons of water in one big swish along both sides of the boat. The sun’s reflection dances in their eyes and warms their faces. “Stroke,” the coxswain sang out again and they propel their boat away from the rising sun. “Stroke,” twelve oars go down and then twelve oars come up.  Each stroke united us. Prostate cancer bonded our fate. Each of us chose a different therapy, and hopefully it’s decades before we meet our maker and become coxswains singing, “stroke.”Emile Scott 1

Emile Scott, my wife’s uncle, was rowing with his crew on lake prostate when I met him. Scott was a retired realtor and loved his grandchildren as much as he loved Easter Hill Methodist Church where he was one of the founding members. He raised his three daughters there and they in turn are raising their families there too. His family and close friends called him, “Scotty.” Brown big hipped women made his eyes twinkle and he loved cooking and sharing his meals with others, especially fried fish. A World War II veteran, he suffered from hearing loss. Sometimes his hearing aids buzzed, forcing everyone to talk louder, but that didn’t stop him from quoting bible scriptures.

Heavy hearts gathered at Easter Hill for Scott’s going home service. Grief filled tears moisten the congregations’ cheeks as they said, “goodbye Scotty.” He lived life well; unfortunately his prostate cancer had metastasized before his prostatectomy and two cancerous spots appeared years later after his surgery on his pelvic. His pain became so great in his last days that he begged for relief only God gives. Now he sings with the other coxswains, “stroke.”

I hear him singing “stroke,” to my crew afloat lake prostate ─  twelve oars down and then twelve oars up, “stroke.”

U.S. Preventive Service Task Force changes PSA testing from a “Grade D” to a “Grade C.”

African American men welcome the change in PSA testing recommendations from the U.S. Preventive Service Task Force from a “Grade D” to a “Grade C.” This change reverses their 2012 decision against PSA screening of all men, to screening individual patients based on professional judgment and patient preference. Thanks to the leadership of Chairperson Dr. Kirstin Bibbins-Domingo, more African American men will have the PSA test option, which hopefully will afford African American men choices once denied. Will this lead to a healthier prostate? Maybe.

Remember a PSA test is but one data point, which will require analysis by patients and doctors. Patients and doctors must educate and/or reeducate themselves to the best practices on how to interpret this new data.

Let’s keep empowering all patients.

Prostate Cancer’s Time Zone

?

My writing therapy began 21-years ago, after my doctor sewed my tongue to the floor of my mouth so he could insert 30 multi-colored catheters through my cheeks to encircle the tumor in my tongue. He then slit my throat and installed a breathing tube. Engulfed in pain and stripped of voice, my nurse gave me used computer paper to write on, so I could communicate with her. I continue to write thanks to my wife, Monica, my shining North Star.

I survived that week of intense radiation treatment called Brachytherapy on morphine. I endured two treatments per day where a radioactive isotope was inserted into a catheter, then moved into position adjacent to my tumor where it sat for a few seconds before being removed and placed in the next catheter. They repeated this process for a couple of hours until all 30 catheters were completed. And weeks after they finished, I received external beam gamma-radiation therapy. I wore a specially designed lead mask to limit my head’s exposure to the radiation’s killing fields that robbed my taste buds, burnt my neck to a blacken hue, killed my right salivating gland and damaged my right jaw’s nerve. My body withered each day. I faked medical weigh-ins by stuffing rolls of nickels in my pockets, because my doctor had threatened to insert a feeding tube if I continued to lose weight.

After months of an enriched diet, which included ensure plus and Bryers Ice Cream I gained weight, only to reenter the hospital and have a cancerous tumor removed from my neck. Post surgery my right arm drooped, which made my weak jump-shot even weaker. I restarted intense pain management. Fortunately, Monica enjoyed shooting hoops with our precocious son, Charles. She later, introduced me to the writer’s group, “Cancer In Other Words,” where we help each other heal emotionally while traversing landscapes littered with radiation, chemo, and surgery choices.

At our writer’s group we would respond to prompts such as a bowl of pills, a series of words or pictures that would propel us to exotic lands where our souls would find peace when we read our writings to each other, transforming our four walls into a spiritual journey. At a previous writer’s session a fellow writer celebrated her fifth year post breast cancer treatment with a cake−a re-birthday of sort, and another writer announced his 10th year surviving colorectal cancer. We like counting by “5s,” unfortunately malignant tumors can return, like prostate cancer returning in a colleague after twelve years. Hopefully his new treatment will provide another twelve years. Some writers with multiple cancers have five year counting clocks staggered like time zones. For example, my first clock started ticking in 1995 for tongue cancer, the second one started in 1997 for neck cancer, and the third one started ticking in 2008 for prostate cancer and over time writing has synchronized my pain with my ticking clocks.

My Prostate cancer was detected after my Prostate Specific Antigen (PSA) score jumped from 2.2 to 3.15 in a single year, when it had been gradually rising. Physicians told me it was within the normal range of less than 4.0; however, my engineer’s voice said, “Don’t overlook the inflection data point.” Since PSA only indicates prostatic health, I requested a biopsy. My Gleason score of 3+3 considered low to intermediate cancer risk by some made me a candidate for active surveillance; however, my previous cancer experiences told me otherwise. I selected a robotic-prostatectomy. Post surgery my Gleason score of 3+4 suggested active surveillance may not have been appropriate.

It’s Time to Rethink Active Surveillance in African American Men With Prostate Cancer as suggested in a January 2016 article by Oleksandr Kryvenko, MD, an assistant professor of pathology and urology at Sylvester Comprehensive Cancer Center at the University of Miami Miller School. Just a year earlier Randy Dotinga’s article ‘Watchful Waiting’ Becoming More Common For Prostate Cancer Patients quoted Dr. Matthew Cooperberg, the Helen Diller Family Chair in Urology at the University of California, San Francisco, “Ultimately, the number of men who will die of prostate cancer because they chose active surveillance cannot be zero by definition.” In Geraldine A. Collier’s April 2016 article, Searching for reasons African-American men face increased risk of prostate cancer she stated, “Not only are African-American men approximately 125 percent more likely than Caucasians to develop prostate cancer, they are also 150 percent more likely to die, especially young men in their 40’s, because of a more aggressive form of the malignancy,” which reinforces Dr. Kryvenko’s point.

I was invited by the Research Advocacy Network to attend the 2016 American Association of Clinical Oncologist Conference, where I sat in on the Evolving Recommendations on Prostate Cancer Screening Panel discussion chaired by Dr. Otis Brawley. He had also chaired the US Preventive Services Taskforce’s 2012 decision that restricted PSA test for all men. Muhammad Ali had just died the day before and Dr. Brawley opened his discussion with an Ali quote. “The man who views the world at 50 the same as he did at 20 has wasted 30 years of life.” I had heard Dr. Brawley say in an earlier Ted Talk, “A good scientist understand three thing: 1) What we know, 2) What we don’t know and 3) What we believe we know.” I wonder, was their 2012 decision based on understanding 1, 2 or 3? Dr. Brawley said during his questioning and answer session, “He didn’t believe there was a biological difference between Black and White men’s prostate cancer.” He felt the disparity of treatment was the problem.

Advocacy groups like Prostate Health Education Network, which I’m a member, have petitioned them to revise their ruling. I’m hopeful within the next 30 years doctors will have solved prostate cancer detection and treatment issues.

How many men will die before we know?

Prostate Cancer Death: African-American men

Geraldine A. Collier’s April 20, 2016 article, Searching for reasons African-American men face increased risk of prostate cancer in the telegram.com stated, “Not only are African-American men approximately 125 percent more likely than Caucasians to develop prostate cancer, they are also 150 percent more likely to die (see charts in article), especially young men in their 40’s, because of a more aggressive form of the malignancy.”

In the article, Dr. William J. Catalona a prostate cancer surgeon who pioneered the development of Prostate-Specific Antigen PSA testing acknowledged, “Early detection holds the most promise to save the lives of African-American men and men of African descent.” He went on to say, “I was in practice before we had PSA testing and we used to see so much advanced disease; then most of the patients we saw (after PSA testing was instituted) had early stage disease and were curable. Now it’s like going back in time, being in a time machine.”

More men are showing up with advance prostate cancer, which doesn’t respond well to treatment ─ a fixable conundrum ─ just modify the 2012 American Cancer Society decision and encourage PSA testing for at risk men, especially African-Americans.

Become a Cancer Advocate

Vice President Joe Biden said, “The Prostate Cancer Foundation provides an answer to a 10 page grant request in thirty days,” to an audience convened in New Orleans at the 2016 American Association of Cancer Research (AACR) Conference on April 20, 2016. He went on to later say, “It’s time for the National Institute of Health to streamline its approval process.”

He talked about society being at an inflection point https://youtu.be/O7GJk5f_vQI Surveys conducted by the AACR show 80% of Americans want a cure for cancer and the Vice President said both Democrats and Republicans agree on this one issue.

It’s time to join the Vice President’s Moon Shot Team: Call your congress person and senator and tell them to get on board. Become an advocate for a cure for cancer.

America, what are we waiting for, more death?