Mobile Unit Seeks to Bolster Prostate Cancer Testing Among At-Risk Groups

As an extension of a mobile testing unit for prostate cancer, Ash Tewari, MD, MBBS, MCh, FRCS, initiated the Million Strong Man Initiative to bolster prostate cancer testing among men at risk for prostate cancer, particularly among those who may experience barriers to health care access who may not otherwise have an opportunity to receive a test.

In an interview with CancerNetwork®, Tewari outlined the motivation behind the Million Strong Man Initiative, emphasizing shared decision-making between patients and providers and engaging these at-risk groups in a discussion about their health.

He began by highlighting the unique nature of prostate cancer to present itself in a variety of scopes, some appearing as lower grade and non-invasive, with others manifesting more aggressively. Despite this disparity, he explained that no guidelines exist on approaching patients about their risk for the disease, up until agencies such as the American Urological Association developed shared decision-making practices to discuss this matter.

He also outlined the prevalence of prostate cancer, in which at least 200,000 men a year are diagnosed, with a further 7% to 8% expressing metastatic or indolent disease. He concluded in suggesting that engaging patients in this discussion is a challenge, with many of them confronting barriers to health care access due to time constraints, lack of education about prostate cancer risks, financial toxicity, and proximity to a qualified practice, among other variables.

Tewari is professor and chair of the Milton and Carroll Petrie Department of Urology at the Icahn School of Medicine at Mount Sinai.

Transcript:

[The] Million Strong Man Initiative is an extension of my mobile unit for prostate cancer. Prostate is a common cancer, but it’s a bit of a unique cancer [in which] many of the patients have a very low grade, less invasive cancer, but there are some which are more aggressive cancers, and there is no clear cut guideline as to how to approach these patients [or] how to even engage them in talking. The American Urological Association and other agencies have come up with what we call shared decision-making, in which we bring up the discussion about prostate cancer, bring up the discussion about their unique risk of having a prostate cancer. We bring up, “What are the different tests which can be done? What are the pros? What are the cons? What are the [adverse] effects? What [are the] intellectual or psychological impacts of it? “

Ultimately, we need to bring up that discussion to the people [at risk for] prostate cancer. The bottom line is, [at least] 200,000 men every year get diagnosed with prostate cancer, of which about 7% to 8% of the patients have a cancer which is quite extensive, meaning it has gone outside the prostate, and many of them have very indolent cancer. How to engage them in this discussion is an important question and a challenge, and it is in more so of a challenge to people who do not have a great access to health.

[Barriers to] access to health could be because they are busy and working, [it] could be because of their understanding of their own risk and then understanding about the medical problems. [Barriers to] access to health could be the financial and [they] could be how far they are from a qualified group. All that combined in the access to health discussion is an important challenge in managing or delivering the care to men [at risk for] prostate cancer.

Reference

American Cancer Society. Key statistics for prostate cancer. Revised May 30, 2025. Accessed January 12, 2026. https://tinyurl.com/4sw23fme