At 61, Marcus Ford spends most nights riding the Chicago Red Line or looking for a park bench or bus stop that can hold him over until morning. Sleep is rare. And after going through a battery of radiation treatments to treat prostate cancer, he can feel the toll of going too long without it. 

He’s waited months to be let into a shelter. Most of them are at capacity as the winter months creep closer.

“You call one number, and they give you another number, and then you call another number and they give you back to the first person that you call,” he said. “It’s a vicious kind of cycle that you’re caught up in, and it’s just a luck of the draw to get some sort of housing, even for a senior person like myself. But I’m working on it. And trying not to disintegrate in the process.” 

Two years ago, Ford was diagnosed with prostate cancer and early onset Parkinson’s disease. He’s on medication for both. For someone who dislikes even taking Aspirin for headaches, taking at least nine pills a day has been a challenge. And for the past year, he’s been homeless. 

He spends most of the day at the Center on Halsted, an LGBTQ+ community center in Chicago, where he can charge his phone and make calls. The center is also near his doctors at Thorek Memorial Hospital, so he can stay nearby for his appointments. 

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Despite everything, he has yet to miss a single doctor’s visit. During his year of radiation treatment, he used a free ride share service offered by the American Cancer Society. That was a godsend, he said — he would not have been able to go through with radiation otherwise. Those rides gave him a moment of normalcy and routine at a time when his life was anything but normal. 

Ford, like other Black men around the country, lives with a higher risk of dying from cancer due to factors out of his control. Black Americans have the highest death rate and shortest survival of any racial or ethnic group for most cancers — and Black men have the highest incidence, or rate of diagnosis, of lung cancer. Gay Black men like Ford, as well as bisexual Black men, are also less likely to be able to access screening for prostate cancer, which they are at a very high risk of developing. Overall, LGBTQ+ people have a higher chance of getting cancer and getting a late-stage diagnosis, which makes treatment more difficult.

From a young age, Ford had some understanding of the challenges he faced. Throughout his childhood, cancer seemed to be waiting in the wings for him. 

 “I always kind of felt like, ‘Oh my God, if I’m going to die, it’s gonna be because of cancer,’” he said. “My dad passed away when I was 14 of stomach cancer and I dreaded the day — he was 54, and I dreaded the day all the way up until my 54th birthday.” 

Black men’s mortality rates for prostate cancer are double that of White men, according to a new report from the American Cancer Society. Black men often have less access to quality treatment and frequently live with comorbidities like diabetes or hypertension, both related to chronic stress from systemic racism and discrimination. Out-of-pocket costs, including co-pays, can also be a barrier to early detection. Personal reluctance to see a doctor can also be a factor. Even though Ford feared cancer from a young age, he still avoided screenings. 

“Men tend to ignore their health until it’s almost too late,” Ford said. “I pretty much followed suit.” 

One day, something told him that he should take better care of himself and get checked out. He doesn’t remember feeling anything when he first got the diagnosis. Even now, he’s not sure if he’s fully accepted what’s happened — he mostly feels numb towards it. As a lifelong Christian, his faith has helped him begin to accept his situation.  

For the general population, 50 is the right age to start discussing prostate cancer with their doctor, said Dr. Justin Schweitzer, a primary care physician in New Jersey who specializes in LGBTQ+ health. But for patients at a higher risk, like Black men and those with a strong family history of prostate cancer, screenings should start at age 45 or ten years before their parent or other close relative was diagnosed.  

For Black LGBTQ+ people, discrimination stacks the deck against positive health outcomes: LGBTQ+ people are more likely to be unemployed and uninsured than cisgender and heterosexual people, and many are mistreated at doctor’s offices. High rates of anxiety and depression among LGBTQ+ people also contribute to behaviors that increase cancer risks, like smoking and binge drinking. 

“If a patient doesn’t have insurance, they are less likely to seek out care in general and less likely to have exams, blood testing, biopsies, etc., as they would have to pay out of pocket for each of those things,” Schweitzer said. As the medical director for LGBTQ+ Health at Cooper University Health Care, he said that many of his patients feel like they are not fully listened to or are “brushed off” when they seek medical help elsewhere.  

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When Ford thinks about cancer, he doesn’t think about all of those statistics or gaps in care. He thinks about losing his dad. He also thinks about his mother, who died from cancer when he was 48. She kept her declining health from him, despite their close relationship. They spoke on the phone several times a day while he was on the road, on tour with various plays as a costume and wardrobe designer. During a work break, he came home for his mom’s birthday in June that year. 

“I got to her house. She had gotten down to just a little shell of a person,” he said. “I got on the horn, I called my touring company, and I said, ‘You guys are going to have to find somebody to replace me, I think my mother’s dying.’ And sure enough, she had cancer. I stayed home with her. Three weeks after that, she was dead.” 

Ford took his mom to the doctor the day after he got to her house. She got her diagnosis. The cancer started in her bladder. The doctor suggested a chemotherapy port to begin treatment, but Ford and his mother declined. She didn’t want to be hooked up to any machines. They went back home and hunkered down. During those three weeks, he was able to spend the kind of time with her that he hadn’t been able to since his childhood. 

He believes his mother didn’t tell him about her declining health in order to protect him. Ford ended up doing the same thing, not telling his former long-term partner about his cancer until halfway through radiation. 

“I think the fear of it has actually become a part of me, which in some odd way has helped me to deal with it,” he said. “The inevitability of it.” 

Medicaid covers Ford’s cancer treatments. But Medicaid requirements are going to change thanks to President Donald Trump’s “one big beautiful” tax and spending law. Soon, he may no longer be eligible. By the end of 2026, Medicaid patients under 64 will have to work or volunteer at least 80 hours a month to get coverage — unless they are disabled, pregnant or have young kids. He’s worried about what that will mean for his future. 

“There’s a lot of risks for someone like Marcus in the next couple of years when it comes to Medicaid,” said Lucy Dagneau, senior director of state and local Medicaid campaigns at ACS CAN, the advocacy arm of the American Cancer Society. “This is just another barrier on top of the barriers that someone like Marcus already faces, being Black and gay and being in a system that doesn’t always treat him with respect.”

Not too long ago, Ford lived in a Chicago apartment with his former partner, who left the city to take care of his dying mother. Ford worked two jobs to keep up with rent, but couldn’t manage. For him, the dominoes fell quickly. Queer adults are twice as likely as the general population to have experienced homelessness in their lifetime, according to a 2020 study from the Williams Institute at the UCLA School of Law — and the majority were homeless for the first time as an adult. 

Across the United States, homelessness is spiking to record highs, which experts attribute to a lack of affordable housing. There are not enough resources to meet the demand. And for patients like Ford, the many health risks that come with experiencing homelessness can be even more dangerous. Homeless patients have high rates of cancer risk factors, late stage diagnoses, and increased rates of cancer death, according to the American Society of Clinical Oncology.

“This too shall pass. I have no fear as yet. Because I do have to be my own self-advocate in all of this,” he said. “Certainly, if I allow myself to fall apart because of my cancer or because of Parkinson’s, then I’ll be no good for myself and unable to navigate around the housing process.” 

Ford finished radiation treatment three months ago. His PSAs — prostate-specific antigens — are staying low after radiation. After his last check-up in late October, he’ll be back for more visits in three months. He has worn out several pairs of sneakers making it to doctor’s appointments. For now, those critical treatments are covered by Medicaid.