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A husband, father, son, brother, grandfather, friend dies every 17 minutes of every day from Prostate Cancer

More than 220,900 men will be diagnosed with prostate cancer in the USA this year, and more than 28,900 will die of the disease this year. Because early prostate cancer is seldom signaled by any symptoms, detection is extremely difficult without testing. Prostate cancer:

In the investigation of insurance payments for Viagra versus birth control, are the media in your area also looking at the gender discrimination of HMO’s and insurance companies in two additional areas:

1. Covering tests for women for breast cancer and not covering tests for men for prostate cancer. FACT: Almost twice as many men are diagnosed with prostate cancer each year versus women diagnosed with breast cancer. In addition, virtually as many men die of prostate cancer as women who die of breast cancer, and there is no treatment for prostate cancer to date that improves a man’s life.

2. Covering tests for girls for breast cancer and not covering tests for boys for testicular cancer. FACT: 7,200 boys 15-34 will be diagnosed and 350 will die this year from the disease, much greater than girls/women in that age group dying of breast cancer.

Also, a review of the disparage between the amount spent for research and awareness campaigns on the above should be of great interest. The National Cancer Institute estimates that they will spend $332.9 million on breast cancer research this year while spending $74.0 million on the study of prostate cancer and $0 on testicular cancer. Prostate cancer receives the least amount of funding per patient of all major cancers. Source: American Foundation for Urologic Disease.

The National Cancer Institute also reported that during the period 1950-1991, women's rate of death from breast cancer increased 2% while men's rate of death from prostate cancer increased 25%. Until the last few years, you never heard anything about prostate cancer. Even today, it's not a high priority on health programs or the news. There's no postage stamp or brochures at the post office. (The second Breast Cancer postage stamp will soon be issued to raise awareness of breast cancer and to fund additional research.) There’s no special research or funding organizations for prostate cancer, no national prevention month, week or even day.

This is not to say that everything that is being done to find a cure for breast cancer should not be done. However, where do men’s health issues fit in in your local news analysis and reporting? What about the fact that of the 15 leading causes of death, men lead in every single category.

If you’re interested, I’ve included some additional information on the subject which can be verified with a simple call to The National Cancer Institute regarding the facts on new diagnosis, death and research spending. Calls to HMOs, health insurance carries, etc. will verify the differences in coverage.

It’s difficult to come to terms with prostate cancer. Fear of openly discussing the disease; complex treatment decisions; painful side effects - survivors are often left feeling frustrated and powerless. Too often, men face a diagnosis of prostate cancer privately, searching for reliable treatments while hoping for the best. Meanwhile, the disease cuts a devastating path through the lives of hundreds of thousands of men and their families every year. Prostate cancer is the most commonly diagnosed non-skin cancer in the U.S. And is the second leading cause of cancer death (after lung cancer). It affects one out of every five men. A new case is diagnosed every three minutes. If a close relative has prostate cancer, a man’s risk for the disease more than doubles. With two relatives with the disease, his risk increases fivefold. With three relatives, his risk is nearly 100%. In recent years following public activism by AIDS and breast cancer advocates, mortality due to those diseases dropped. But the number of deaths due to prostate cancer will kill 28,900 men this year and more than double the number of deaths due to aids. Support for prostate cancer research lags far behind funding for other diseases.

In 1997, spending on research for every death from the disease looked something like this:

The scarcity of funding for prostate cancer research creates a vicious cycle. Young and established researchers are drawn to more profitable avenues of investigation; private enterprise views the field as too risky for investment; and ideas that might lead to a cure are conceived but never completed. Source: CapCure www.capcure.org

This public awareness and education program was conceived and instituted by the Prostate Cancer Education Council (PCEC) which represents urology, oncology, patient advocacy, minorities, clinical and behavioral research. Because of the alarming percentage of men presenting advanced, incurable prostate cancer, the PCED was formed in 1988 to promote awareness, screening and early detection of prostate cancer.

General Norman Schwartzkopf has served as national PCAW chairman since 1994 and in 1996 actor Danny Glover joined as co-chairman in order to help recruit African American men, who have the highest risk of prostate cancer in the world. In 2000, Arnold Palmer added his name to the ranks of men asking you to get a prostate exam. Over 220,900 men will be diagnosed this year and 28,900 will die because they didn't catch it soon enough.

It's important to note that it is not easy to predict which tumors will behave aggressively and which will act in an indolent fashion. If you're a man over 45, you don't need another excuse to avoid taking care of your health. Unless you think it's worth gambling your life. Retired General Norman Schwarzkopf said it best when he was diagnosed with prostate cancer - "You cannot sit back and do nothing because you'll never have perfect intelligence on the enemy...Get on with it."

Prostate cancer is the most commonly diagnosed malignancy in American men. It is curable if diagnosed early. Early detection is the key.

About 30,000 men will die from it this year alone. Men over 45 don't need another excuse to avoid taking care of their health.

But the argument against the use of the prostate specific antigen blood test for detecting prostate cancer has provided that excuse -- pitting public health officials and primary care physicians, who claim there is no evidence of PSA success beyond a reasonable doubt, against many urologists who ask why a 27 percent decline in prostate cancer mortalities in the past five years isn't evidence enough.

Despite American Cancer Society and American Urological Association guidelines that encourage doctors to offer a PSA test and a digital rectal exam while discussing the risks of the disease, too many doctors lean toward discouraging the test, focusing on misplaced convictions that the test discovers insignificant tumors and that it doesn't save lives.

Physicians who have deferred or waffled on PSA testing are losing their licenses and seeing their malpractice insurance carriers pay out millions of dollars to bereaved families.

In a November 2001 wrongful death suit, a widow was awarded $3 million in a case in which the doctor in question "did not tell the patient about [the high PSA level] or recommend further testing or follow up visits."

A study at Long Beach Community Cancer Center of 48 such prostate cancer malpractice cases determined that, of the 22 awards totaling over $8.4 million, roughly $7.5 million "could have been avoided if PSA screening and diagnostic guidelines . . . had been followed."

These cases have become legal benchmarks as the PSA debate has moved from the doctor's office into the courthouse. They should come as a warning to science and public health policy officials across the country: If you continue to delay a decision on PSA, lawyers and lawmakers will make it for you.

Urologists will tell you that, despite imperfections, the PSA test has changed the prostate cancer diagnostic landscape. Before it, nearly three out of four men diagnosed with the disease were in the late stages -- when prostate cancer is neither readily treatable nor curable. The advent of screening has inverted that statistic, giving men a fighting chance. Regional studies support that early detection reduces mortality. One study in Austria shows that prostate cancer mortalities were markedly reduced with widespread PSA screening.

Even though newer blood tests help clarify the likelihood of cancer when PSA is abnormal, we still need more research to determine better models for early detection. But should we doom the thousands of men who could die waiting up to 14 years for the results of a randomized trial to determine "perfect intelligence" on the PSA? With so many lives in the balance, how much evidence do we need to convince us that prostate cancer is our enemy, not the test that so often detects it in time to permit a cure?

Men over the age of 50 -- and even younger if they are at higher risk of prostate cancer (African Americans and men with family histories of the disease) should "get on with it." Set aside the excuses and resolve to be tested every year.
Source: Carl Frankel, an advocate for the National Prostate Cancer Coalition, is retired general counsel for the United Steel Workers of America and a prostate cancer survivor. www.post-gazette.com/healthscience/20020611hprostate4.asp