For Black men, a prostate cancer diagnosis can bring urgent questions about more than the disease itself. It can raise concerns about whether the cancer was found early, whether every treatment option has been explained, how side effects may affect daily life, and whether cost, transportation, insurance, or access to specialists could delay care.1-7 Because Black men face higher prostate cancer rates and worse outcomes, knowing what questions to ask and understanding available treatments can be an important part of staying involved in care.
This guide introduces five medicines used alongside testosterone-lowering treatment for certain types of advanced prostate cancer: Xtandi, Nubeqa, Erleada, Pluvicto, and Zytiga. These medicines work in different ways and are not right for every man. Learning who may take them, how they work, how they are given, what research shows, and which side effects to watch for can help Black men have clearer, more informed conversations about prostate cancer treatment with their healthcare teams.
Xtandi | Nubeqa | Erleada | Pluvicto | Zytiga
Prostate cancer affects Black men at unequal and alarming rates. Recent information from the National Cancer Institute and the Centers for Disease Control and Prevention shows that Black men are about 67% more likely to be diagnosed with prostate cancer and about twice as likely to die from it as white men.¹
Black men are often diagnosed at younger ages, which can mean facing treatment, side effects, and long-term health concerns earlier in life.¹˒² Some Black men are diagnosed after the cancer has spread, which can limit treatment choices and make the disease harder to control.¹˒² There is no single reason for these high rates, and race alone does not determine outcomes.2-4,6,7 These findings make it especially important for Black men to discuss screening, treatment choices, medicine side effects, and available support with their healthcare providers.3,6-7
Although researchers continue to develop advanced prostate cancer treatments, social and healthcare factors can be just as important, and sometimes even more important, in affecting a man’s health and chances of doing well with prostate cancer. These factors include insurance coverage, treatment costs, where a person lives, access to specialists, treatment delays, communication, and low participation in clinical trials.2-5,7
Treatment is not the same for every man. The healthcare team considers whether the cancer has spread, whether it still responds to testosterone-lowering treatment, previous medicines or chemotherapy, test results, overall health, daily function, and personal goals.8,9 Health conditions such as high blood pressure, diabetes, heart disease, kidney problems, and weak bones may also affect treatment safety and monitoring.5-8 Medicines, vitamins, and supplements may interact with cancer treatment.⁷
Tell your healthcare team about every health condition, medicine, and supplement you take. Also share your health beliefs, personal concerns, and any problems involving cost, transportation, or access to specialized treatment.5-7 This information helps your healthcare team create a safer treatment plan made to fit your health needs and personal situation. Studies show that Black men can have outcomes similar to, and sometimes better than, white men when care is timely, culturally responsive, and supported by specialist access, financial help, transportation, and close follow-up.4-6
Getting the right prostate cancer treatment depends on more than a doctor’s recommendation. Your health, test results, insurance coverage, location, and access to specialists can affect which treatments work best and are available to you.⁵⁻⁷ Clear communication can help you take a more active role in treatment decisions. Do not assume every option will automatically be discussed with you.9
Ask what type and stage of prostate cancer you have, why a treatment is being recommended, and whether you need special testing. You can also ask about other medicines, clinical trials, insurance coverage, and help with treatment or travel costs.7-10 Research involving Black men shows that patients value shared decision-making but may not always receive complete information about treatment choices and side effects.8-10 Some men also report that they were never invited to consider a clinical trial.9,10 When few Black men join clinical trials, doctors have less information about how well prostate cancer treatments work, or what side effects may occur in the men most affected by the disease.9.10
Learning about your treatment choices can help you take a more active role in prostate cancer care. Xtandi, Nubeqa, Erleada, Pluvicto, and Zytiga treat different forms or stages of advanced prostate cancer, and each has its own benefits, risks, testing needs, and side effects. Ask your healthcare provider why a medicine is being recommended, what other options might work, and what support is available. All men should seek clear information, timely care, and a treatment plan that fits their needs. This is especially important for Black men, who face higher prostate cancer rates, a greater chance of serious illness or death, and social and healthcare factors that may affect their care.1-4,7-10
References
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking any drug or commencing or discontinuing any course of treatment.
Black men are more likely to develop prostate cancer and die from the disease than white men. They may also be diagnosed at younger ages or after the cancer has spread. Understanding the diagnosis, available treatments, possible side effects, and support resources can help Black men take an active role in their care and make informed decisions with their healthcare teams.
Treatment depends on the type and stage of cancer, whether it has spread, whether it still responds to testosterone-lowering therapy, and which treatments you have already received. Your healthcare team will also consider your test results, overall health, other medical conditions, daily activities, and personal treatment goals. Medicines such as Xtandi, Nubeqa, Erleada, Pluvicto, and Zytiga are used for different forms of advanced prostate cancer and are not appropriate for every patient.
Tell your healthcare team about every health condition you have, especially high blood pressure, diabetes, heart disease, kidney problems, or weak bones. Provide a complete list of your prescription medicines, over-the-counter products, vitamins, herbs, and supplements because some may interact with prostate cancer treatments. You should also discuss concerns about side effects, costs, insurance, transportation, or getting to a specialist.
Yes. Certain blood, tumor, imaging, or genetic tests may help determine which treatments are appropriate for you. Clinical trials may also provide access to newer treatment approaches, but research shows that Black men are not always invited to participate. Ask your healthcare team whether testing or a clinical trial should be considered based on your diagnosis and treatment history.
What can I do if cost, insurance, transportation, or access to a specialist is delaying my care?
Tell your healthcare team as soon as possible. A social worker, patient navigator, financial counselor, or treatment-support program may help with insurance questions, medication costs, transportation, or referrals to specialists. You can also ask whether the medicine’s manufacturer offers savings or patient-assistance programs. These barriers are part of your care and should not be faced alone.
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