August 13, 2008

Touchy Subject Exam Still a Matter of Fear for Many Men

By Roger McBain, Courier & Press staff writer 464-7520 or [email protected]

Gridiron gods, NASCAR royalty and baseball heroes have come to Evansville in recent years to pitch for prostate cancer awareness.

The campaign continues this month with a visit by Frank Robinson and Ozzie Smith. The Major League Baseball Hall of Famers will swing into town Aug. 16 for "Striking Out Prostate Cancer," the seventh annual celebrity prostate awareness program presented by Evansville Cancer Center-Vantage Oncology and Tri-State urologists.

Similar organizations across the country have used sports figures, military leaders, politicians and others to get the message out. They've also promoted it with beer ("Pints for Prostate"), athletic gear days ("Sneakers @ Work") and a kayak journey ("Paddling for Prostate").

Icons of masculinity do their best to persuade us common men to do something too many of us don't even want to think about - bare our backsides, bend over an exam table and let a doctor slip a gloved finger up somewhere the sun never shines.

It's a reaction that wilts notions of masculine courage, especially when you consider the more invasive gynecological exams women routinely accept without making a big deal out of it.

For some reason, many men share a disproportionate fear of the digital rectal exam, says Andrew Reed, a psychologist at the Evansville Cancer Center-Vantage Oncology.

It's a silly fear over a simple exam that can let the doctor put his or her finger, literally, on abnormal growth in the prostate, the walnut-sized gland located

between the bladder and the rectum.

Avoiding the exam isn't just irrational - it can be lethal.

Prostate cancer is the most common non-skin cancer for men in the United States, striking one in six, according to the Prostate Cancer Foundation.

Current estimates anticipate more then 186,000 new diagnoses of prostate cancer among American men this year, with more than 28,000 dying from the disease.

As men's age increases, so does the risk for prostate cancer. Only one in 10,000 men younger than 40 is diagnosed with the disease.

The numbers leap to one in 39 for those ages 40 to 59 and to one in 14 for those 60 to 69, according to the Prostate Cancer Foundation.

More than 65 percent of all prostate cancers develop in men over the age of 65.

Because the disease can progress slowly, many elderly men die with prostate cancer, but not because of it.

Risky factors

The risks are much greater, however, for some. Men with a father, brother or son with prostate cancer are twice as likely to develop it than the rest of the population. That risk doubles again for those with two or more relatives with prostate cancer.

African-Americans are 56 percent more likely than Caucasian men to develop the disease and 2 times more likely to die from prostate cancer.

Current medical guidelines recommend screening begin at age 50 for white men and at 45 for African-American men and all others with a family history of the disease.

The good news is that early detection makes the odds for long- term survival excellent. With modern treatment options, more than 95 percent of patients treated for cancer discovered while the growth is still contained in the prostate gland are disease-free after five years.

It's a different story if prostate cancer goes undetected until the disease has spread.

"Only 35 percent of those people are alive in five years," says Andrew Reed, a psychologist at Evansville Cancer Center-Vantage Oncology.

"That's why annual checks are hugely important."

The digital exam is an important component in early detection, along with the PSA, a blood test measuring the amount of prostate- specific antigen in the subject.

Both tests are critical, each catching cancers that may go undetected if only one exam is used.

For some reason, however, it's difficult to get lots of men to do either.

Missed appointments

Some of that may have to do with a general male aversion to seeing a doctor for anything, especially if you don't feel ill. Studies have shown that men make one-half to three-quarters the preventive care doctor's visits that women do.

Reed has spent years wondering why.

He suspects that one reason is that unless they find out they have it, many men consider prostate cancer as something theoretical.

"Some don't realize there's a one-in-six chance they're going to get it in their lifetimes. And even if they do know that," he says, "that's theoretical. The finger is reality."

Organizers for events such as "Striking Out Prostate Cancer" look to sports heroes to help men overcome those kinds of qualms. That's the aim "when Richard Petty looks at you and says, 'Oh, for heaven's sake, get it checked - it's not a big deal,'" says Reed.

But the best spokesman for the cause isn't the most famous, says the psychologist.

Peer pushes

Reed recently spoke with a 45-year-old white man diagnosed with and successfully treated for early-stage prostate cancer. Because of the man's age, Reed assumed he'd gotten checked because of a family history, but he was wrong.

The man decided to get checked, he said, after a neighbor told of his diagnosis and treatment.

"I got checked," the man said, "and, dang, they found I had it."

If people like the man and his neighbor freely share their stories with others, they can have a big impact on lots of lives.

"With one in six men getting it, everyone knows lots of people who've had it," says Reed.

If all those who have successfully completed treatment "would just brag about it a little bit, if they'd say, 'Look how well I'm doing, despite the fact that I've had it,' it takes away the shame and the stigma," says Reed.

"Life after prostate treatment can be pretty darned sweet."


Major League Baseball Hall of Famers Ozzie Smith and Frank Robinson will highlight this year's "Striking Out Prostate Cancer" awareness program at 2 p.m. Aug. 16 at the Evansville Marriott.

Admission is $20 for one ticket, $30 for a pair, and $10 for those 16 and younger. Autographs are $40 per player, one signature per session.

The event, presented by the Evansville Cancer Center-Vantage Oncology and Tri-State urologists, is a benefit for Cancer Care Options, a not-for-profit organization that provides cancer medications for patients who can't afford them.

For more information, call Robin Lawrence at 474-6000.

n Illustration by Larry Fink / Courier & Press

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