So long as diseases in the United States continue to be singled out for official "awareness month" designation, prostate cancer surely belongs among the chosen 12. As President Obama pointed out in his official proclamation:
Prostate cancer is among the most common cancers for men living in the United States, and despite the progress we have made in controlling it, the disease continues to take a devastating toll on thousands of lives every year.
After skin cancer, it is the second most common cancer in American men -- second only to lung cancer as a cause of cancer deaths. The National Cancer Institute estimates that 241,740 new cases of prostate cancer will be reported in the US in 2012 and that 28,170 men will die of the disease. The good news is that today, reliable diagnostic tests and numerous treatment options are available, and death rates from prostate cancer are now on the decline. (In 2010, for example, about 33,000 died of the disease -- nearly 5,000 more than are predicted to die this year, according to the American Cancer Society.)
Today, nearly 100 percent of men are still alive five years after diagnosis of prostate cancer, more than 93 percent are still alive 10 years after diagnosis, and approximately 79 percent are still alive 15 years after diagnosis. While those numbers are encouraging, the need for greater awareness remains: Prostate cancer rarely causes symptoms until the disease is far advanced and more difficult to treat. Thus, screening is essential.
Yet, even among men aware of the potential consequences, there is great reluctance to be screened for prostate cancer. That is because they are also aware that the physical evaluation begins with the dreaded digital rectal exam (DRE). Detection of hard or firm areas in the prostate raises the suspicion of prostate cancer and warrants further investigation. As described in a Johns Hopkins Medicine whitepaper on prostate disorders, the DRE, "which involves the insertion of a gloved, lubricated finger into the rectum, is mildly uncomfortable but extremely important."
"Mildly uncomfortable" may adequately describe the physical sensation, but it is an understatement when it comes to explaining the mental state of men (I think it is safe to assume the majority) faced with the prospect of having a gloved, lubricated finger inserted into their rectum. I put off making the appointment for my annual physical examination with my internist as long as possible because of it, and I doubt I'm the only one. He has been my internist for many years and is an excellent clinician. We've become friends. I am happy to have him check my blood pressure, lungs, heart rate, and such... but the thought of him inserting his gloved, lubricated finger into my rectum makes my skin crawl.
Last year, at the beginning of Prostate Cancer Awareness Month, the Prostate Cancer Foundation launched a brilliant campaign using humor to help men overcome their reluctance to undergo the DRE. The campaign, featuring a character named Branko, the Prostate Czech was a big success.
Now I just have to call and make an appointment with my internist. After all, it's National Prostate Cancer Awareness Month, and it has been so long since my last appointment that I'm out of Lipitor and there are no more refills left on the prescription.