Let the people say SC AMEN

Hollings' SC AMEN Program delivers prostate cancer education to Black men where they live

It’s a sunny Saturday morning in June, and a couple dozen Black men have gathered at Greater Unity AME Church in Holly Hill, South Carolina, to learn what they can do to circumvent some of the dire statistics about how prostate cancer affects them.

They’re taking part in the SC AMEN program offered by MUSC Hollings Cancer Center. The idea is that instead of preaching these statistics from Charleston — statistics like the fact that Black men in South Carolina are 2.5 times as likely to die of prostate cancer as White men — Hollings will go out into the community, where the people are, and bring to them not just information but also one-on-one assistance in accessing screenings and overcoming any barriers to care.

Hollings’ Community Outreach and Engagement program manager Melanie Slan conducts this program in church halls, YMCAs — anywhere that’s willing to host. Holly Hill, population not quite 5,000, some 50 miles from Hollings, is exactly the type of place that needs the information that she brings.

“My mission — not just my job — my mission, my passion with prostate cancer, is to ensure that all men in South Carolina have access to screening and treatment services,” she said. “Our focus is to let men know early detection saves lives. That’s our mantra. Early detection saves lives.”

During the program, she shares information about how prostate cancer might affect the men in the audience. For instance, prostate cancer is more common in Black men and tends to develop in Black men at younger ages. And while 5% to 10% of prostate cancers may be inherited, most men with prostate cancer don’t have a family history of the disease.

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But she doesn’t want them to despair over these statistics. She also shares information about the available screenings, what they entail and their limitations, and she encourages them to begin screening at age 40 or 45 because, as Black men, they are at higher risk for developing prostate cancer.

“We want them to — if they’re going to find a cancer — to find it at a stage where it’s small, it’s early, it hasn’t spread. And of course, it’s more treatable,” she said.

She also talks about her family’s personal experience with cancer, including her husband Stephen’s recent diagnosis with early-stage prostate cancer. Slan urges the men to listen to their wives and girlfriends who encourage them to see the doctor. Too often, men put off regular health care — and, in fact, she was the one who finally made the screening appointment for her husband.

“I always say the S is for Slan, not Superman,” she said. “It’s good to have that partner to encourage you to go ahead and do the right thing. So, if you have that spouse — don't call it nagging. It’s because she loves you and wants to keep you around.”

With Stephen’s doctors, the Slans have chosen “watchful surveillance” for the time being. That’s one of the benefits of early detection — that they have more choice in how to handle the cancer.

Slan acknowledges that there’s a lot of fear — about cancer in general and about the effects of treatment. Men might fear the loss of sexual function after treatment for prostate cancer, for example.

“Talk with your doctor because there are ways to treat those side effects and manage those side effects during treatment,” she tells the group. “And often, once your treatment is over and your body has time to recover, you can get back to normal.”

“My mission — not just my job — my mission, my passion with prostate cancer, is to ensure that all men in South Carolina have access to screening and treatment services. Our focus is to let men know early detection saves lives. That’s our mantra. Early detection saves lives.”
— Melanie Slan, Community Outreach and Engagement program manager

She also brings information about lifestyle choices that can help with cancer prevention, like not smoking and eating fruits, vegetables and whole grains while limiting red meat.

As part of the program, the men complete a questionnaire testing prostate cancer knowledge before the presentation and again afterward. The Office of Community Outreach and Engagement, led by Marvella Ford, Ph.D., associate director of Population Science and Cancer Disparities, tracks the answers to determine how well the program gets its point across.

All participants in SC AMEN are followed for three months by patient navigators whose job it is to connect the men to places where they can get screened and then, if necessary, to resources for treatment. In the first 10 months of the program, the Community Outreach and Engagement team has conducted 13 sessions in front of 122 men — 88% of whom were behind on their screenings. Patient navigators have helped 27% to complete screenings and 66% to schedule screenings; the navigators are still working with the remaining 7%.

As she closes out the session, Slan returns to the main point that she wants the men to remember.

“Talk to your doctor about your known risk factors and what you can do to lower your risk. Discuss all available treatment options with your doctor. Early detection increases treatment options. And remember — early detection saves lives. If you remember nothing else, remember that early detection saves lives.”