Wednesday, July 18, 2007


It really wasn’t the “in thing” at the time. I was having trouble seeing and hated sitting at the front of the classroom, but that was the only way I could see the chalkboard. My teacher spoke with my parents and before you knew it, the once cool 7th grade class president was converted in to “a nerd”- I had to start wearing glasses. I was not a happy camper, but I have to admit that seeing clearer was very rewarding. My sister helped me to pick out some cool specs and before you know it I was “cute” again. My jump shot improved and I could sit further back in the classroom and I of course regained my “cool” status. Our vision is a blessing and the gift of sight should never be taken lightly. That’s why routine eye examinations are a must for African Americans so that we can detect diseases like glaucoma.

Glaucoma, a leading cause of blindness in African Americans, is a major cause of loss vision. It is often referred to as a silent epidemic because in the earlier stages, there are really no signs or symptoms. As the disease progresses, peripheral vision begins to decline and those affected will report squinting or turning the head to focus; but there is no pain present in most cases. So let us jump right in and learn more about the diseases of the eye we call glaucoma and what can be done to treat and or prevent them.

Glaucoma is actually a group of eye diseases that damage the optic nerve, which is the bundle of nerve fibers that carries information from the eye to the brain helping us to see. This nerve can be damaged by increased pressure in the eye, which occurs in glaucoma. There are two main types of glaucoma: open angle glaucoma, which is the most common form (about 95%), and closed angle glaucoma. It is estimated that about 66 million people suffer from glaucoma worldwide; of those approximately, 7 million are suffering from blindness. In the United States, it is estimated that by the year 2020, 3 million Americans will have the disease. Currently in the U.S., glaucoma affects 2.2 million people age 40 and older, with one hundred and twenty thousand being blind. African Americans are affected 3 to 4 times more than Caucasians and experience blindness four times more frequently. African Americans between the ages of 45 and 64 are fifteen times more likely to become blind when compared to Caucasians. The reasons for this disparity is unknown, however knowing the risk factors for the disease and having routine eye examinations can significantly reduce the number of cases of blindness and give those affected an opportunity to receive adequate treatment.

The major risk factors for glaucoma include: being African American, age between 35 and 40, and having a family history of the disease. There are some other risk factors for glaucoma including diabetes, severe nearsightedness, previous eye injuries/trauma, and prolonged steroid use. The key is increasing our awareness of this devastating disease and stressing the importance of being tested. We should all know about famous R&B singer Ray Charles who at age 7 went blind as a result of glaucoma. Some of you may also be familiar with Kirby Puckett, former Minnesota Twins and National Baseball Hall of Famer who woke up at age 36 with no vision in his right eye. These eyes could have potentially been saved with early detection and treatment.

Is HIV/AIDS a terminal illness?

This is a very good question and would have been a lot easier to answer in the late 1980s and early 90s. Before I answer, let me first define “terminal illness”. There are many definitions for a terminal illness, but the most accepted definition is an illness that is incurable and will result in death in a certain time period. This definition is commonly used by hospice agencies and helps to determine the patient’s eligibility for services. In the case of an HIV infected person in the 80s and 90s, treatment options where limited and many died from complications of AIDS. Since the introduction of Highly Active Antiretroviral Therapy (HAART), which is the use of multiple medications to treat HIV/AIDS, this disease has evolved from a terminal illness to a chronic illness and individuals are living longer lives.

With that being said, HIV/AIDS is a terminal illness if one does not have access to care and/or is non compliant with his or her medical therapy. HIV/AIDS patients who do receive adequate treatment and have access to care can live a normal lifespan. (c) 2007 Rani Whitfield. This article was published July 2007 at

Sunday, July 1, 2007

Prostate Cancer

Real Men Get It Checked!

Spring of 2004 was a busy time for me as I was preparing for the United States Medical Licensing Exam, Part I and completing my 2nd year of medical school. The phone call came from my mother and was of no surprise. She often called to check on me to see if I needed anything; I always needed something. But this phone call was unique and I could hear in her voice concern, worry, and a touch of fear: “Your dad has been diagnosed with cancer!” Huh? Say what? The man, who helped her to raise four kids, joined the military, graduated with honors from both undergraduate school and graduate school earning a doctorate in education, and turned down an opportunity to play pro football to teach; this could not be. But it was a reality, however, and at the age of 59, my father took on the battle of the most common non-skin cancer in America: Prostate Cancer!

In 2007 it is estimated that more than 218,000 men will be diagnosed with prostate cancer and more than 27,000 will actually die from the disease. There are approximately 2 million American men living with prostate cancer, unfortunately African American men are affected disproportionately. African American men are 56% more likely to develop prostate cancer compared to Caucasian men, and are 2.5 times as likely to die from the disease. The reasons for this disparity is unknown, but one thing we do know is that prostate cancer is the “male disease” and there is no reason why a man with risk factors or a family history of prostate cancer should not get his prostate checked. Real Men Get It Checked!

Fear of needles is a common problem encountered in physician offices, but when the idea of a digital rectal exam (DRE) is suggested to some men they break out running! The DRE combined with a simple blood test called a prostate-specific antigen (PSA) test are what we doctors use to detect prostate cancer. If the PSA is elevated and/or the prostate exam is abnormal, a biopsy of the prostate is usually performed to determine if cancer is actually present. Once the diagnosis is made, the different treatment options are then discussed.

The question is who should be tested? The American Cancer Society recommends that men begin testing (DRE and PSA) annually at age 45 for high risk populations which include African American men and men with strong family history of prostate cancer. Men at even higher risk, which would include those with more than one first-degree relative affected at an early age, could begin testing at age 40.

Primary risk factors for prostate cancer include being African American, family history of the disease, and older age. As men get older, the prostate, which is a reproductive organ increases in size and may cause symptoms of an enlarged prostate called benign prostatic-hypertrophy (BPH). Signs of BPH include waking up frequently at night to urinate; sudden or strong urge to urinate; straining to urinate; a weak urinary stream; dribbling after finishing urinating; feeling like the bladder has not completely emptied; pain or burning while urinating. These can also be symptoms of prostate cancer, but in most cases, there are no symptoms at all and that’s why early detection and screening is so important.

Some studies have shown that diets higher in fat intake are associated with an increased risk of prostate cancer. Thirty to 40 percent of the calories in American diets are made up of fat compared to Japanese diets that consist of only 15% fat. The incidence of prostate cancer and the death rates are significantly lower in Japan than those in the United States. Diets high in vegetables may lower the risk of this disease and there is also evidence that lycopene (an antioxidant found in tomatoes and tomato-based products), selenium (a trace element), and vitamin E may also reduce the risk.

Once the diagnosis if confirmed by, which is a grading scale used to determine how aggressive the cancer might be, is assigned, the different treatment options are discussed with the patient and the urologist (one who specializes in diseases of the urinary system and prostate). An in-depth discussion on treatment options is beyond the scope of this article, but there are multiple options including surgical, radiation therapy, hormone therapy, chemotherapy, and even observation (active surveillance). An intimate discussion between the patient and the surgeon must take place to decide what option would be best.

My father has done well and not only survived his bout with prostate cancer, but has remained cancer free since undergoing surgery almost 11 years ago. Since that time he has two brothers who have been diagnosed with the disease; and yes I got it checked. My daughter depends on her father and I have to do whatever necessary to prevent illness to watch her grow old. So I say to all those brothers who are too busy to see the doctor, feel as if it can not happen to them, or who are afraid of the digital rectal exam: your life and that of your family depends upon you and your decisions…REAL MEN GET IT CHECKED!

For more information on prostate cancer visit