Prostate cancer is the second most frequent cancer diagnosis in men worldwide, and African American men are particularly at risk. To wit: One in six African American men will develop prostate cancer in his lifetime. African American men are 1.7 times more likely to be diagnosed with—and 2.3 times more likely to die from prostate cancer than white men. African American men are slightly more likely than white men to be diagnosed with advanced disease.

In light of these sobering statistics, when Greg Dickinson, MD, chief resident, PGY-4, Montefiore Einstein Department of Pathology, learned that Brian Wagner, RN, and Darciann O’Sullivan, RN, from the Department of Oncology were organizing a prostate cancer awareness event at Grace Baptist Church in Mount Vernon this fall, he signed on as a volunteer. And he offered to bring along a powerful teaching tool: a double-headed microscope.

Source of Inspiration

Dr. Dickinson’s offer was inspired by See, Test & Treat, a community outreach event hosted every spring by the Montefiore Einstein Pathology Department in collaboration with the Departments of Obstetrics & Gynecology and Women’s Health and Radiology. Funded in part by the College of American Pathologists, the day-long program features free breast and cervical cancer screenings with same-day results and follow-up care, if needed, for uninsured and underinsured women in the Bronx.

For the past few years, Dr. Dickinson and a group of his fellow pathology residents have volunteered at See, Test & Treat. They invite attendees to join them in peering through the lenses of double-headed microscopes (on loan for the day from Pathology’s Clinical Cytology Laboratory) to view cervical cancer cells and discuss what they’re seeing.

“It’s a great way to help women understand what the screening process is all about and the role we pathologists play in helping clinicians render an accurate diagnosis,” he says.

A Community Affair

October is Men’s Health Awareness month at Grace Baptist Church, located on South Sixth Avenue in Mount Vernon, NY. This year, Rudy Hart, director of the church’s Men’s Ministry, and Ed Randall, a popular TV and radio personality and baseball expert, reached out to Dr. Benjamin Gartrell, Director of Montefiore’s Genitourinary Malignancy Program and an assistant professor of medical oncology and urology at Albert Einstein College of Medicine. They invited Dr. Gartrell to collaborate with them in hosting an event to shine a spotlight on prostate cancer. 

The event offered attendees free PSA blood screenings, test results within 48 hours, and referrals for follow-up care for those who needed it. Guest speakers and panelists included Dr. Gartrell; Mr. Randall, a prostate cancer survivor and founder of Fans for the Cure; Hilda Haines-Lewis, NP, Montefiore Department of Radiation Oncology; Monique White, NP, a nurse practitioner from Dr. Gartrell’s team; and a nutritionist and three prostate cancer survivors from the Grace Church congregation.

An Uncomfortable Subject

Prostate cancer not only attacks a vital part of the male anatomy, it takes aim at a man’s sense of virility and self-worth. What’s more, the side effects of treatment, such as erectile dysfunction and incontinence, can be physically and emotionally devastating.

After being diagnosed, men often have difficulty accepting support from loved ones or acknowledging the fear, anger, anxiety and depression they may be experiencing along with the shock of being faced with their own mortality. So, it’s no surprise that many are reluctant to talk about the disease.

Creating a Safe Space

Dr. Dickinson found a quiet corner of the room, pulled together a small table and two chairs, and positioned the chairs at either end of the scope. That corner became what Dr. Dickinson called “a safe space” within the supportive environment created by the Mr. Hart.

He invited them to join him in viewing slides of tissue samples illustrating different Gleason scores. Intrigued, attendees lined up to take a turn. “When they sat down they would initially ask about the microscope,” says Dr. Dickinson.

Then something remarkable began to happen. “After they learned that I was a physician in training, some of the men spontaneously started telling me about their personal relationship to prostate cancer,” says Dr. Dickinson. “They shared that they’d had their prostate removed, or that they have a friend with prostate cancer or metastatic prostate cancer. One gentleman wanted to see more histology, so I directed him to the internet."

A Caring Courier

Greg Dickinson was not alone in representing the Pathology Department at Grace Church. He was joined by Janet Omene, Supervisor, Support Services, Pathology Customer Service, and Keisha Munn. Ms. Munn is one of 15 full-time, and two part-time, trained couriers who drive daily throughout the Bronx and lower Westchester to pick up patient samples from outpatient healthcare sites and deliver them to Montefiore Einstein Pathology’s clinical laboratories. The PSA screening event was personal for her: she grew up as a member of the Grace Church congregation, and she lost her own father to prostate cancer.

Throughout the morning, Ms. Munn shuttled between the church and Montefiore’s Moses Campus, delivering patient blood samples to the Oncology Department. The oncology nurses, in turn, sent the samples to Pathology’s Clinical Chemistry lab, where laboratory technologists Alexander Yakubov and Joshua Mirakhor processed them.

“Even though it was a male-oriented event, it was very interesting to me as a woman,” says Ms. Munn, who is in her 40s. “I wanted to listen to the Q&A session so that I can answer questions for the men in my life. I learned a lot about the side effects of being diagnosed and what can or will happen if you don’t get tested.”

“Prostate cancer is not just an old person’s disease,” she noted. “Early detection is so important. Many of the men who participated in the panel discussion are survivors who were diagnosed in their early 40s. They were lucky because they got screened.”

Have Double-Headed Microscope, Will Travel

Reflecting on his experience at Grace Church, Dr. Dickinson observed, “People came together, learned together and supported each other. The solidarity and information sharing was so nice to see. The Men’s Ministry encourages them to share their personal stories and vent. They also have a lecture series. It’s all about community building.”

Nurse Darciann O’Sullivan, the event co-organizer, agreed. “Montefiore is truly a community hospital,” she said, “and this was an amazing community effort.”

Dr. Dickinson was “a great addition,” said Nurse O’Sullivan. “Men are not very vocal about anything that has to do with their manhood. Having a Montefiore pathology resident on-site offering attendees an opportunity to look through a dual microscope was remarkable. It turned the PSA screening from an abstract concept into a relatable reality, helping them visualize actual prostate cancer and gain an understanding of what goes on internally.”

For his part, Dr. Dickinson plans to be on the lookout for future opportunities. He wants to broaden the reach of the double-headed microscope exercise as a non-threatening vehicle that helps bring people together to tell their stories, to voice their questions and concerns, and to learn about the medical science behind healthcare screenings – and the vital role pathologists play as front-line members of the healthcare team.

See, Test & Treat will take place this year on Saturday, May 16^th.  Dr. Dickinson will be there along with a group of his fellow Pathology residents, to show attendees what cancer cells look like when viewed through the lens of a double-headed microscope, and to talk with them about the importance of regular cancer screenings and the role of the pathologist in their health care.