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Reward: celebrity wanted.


Betty Ford and Happy Rockefellerdid it.

So did Shirley Temple and JuliaChild.

And Ann Jillian is still doing it.

These celebrated women tell theworld they lost their precious breasts to cancer and that the surgery hasn't ruined their lives.

But not a single male celebrityhas ever admitted losing his prostate gland. Why? Are men still quivering in "the closet,' afraid that women (and other men) will think they've lost their masculinity?

It's not as if there aren'ttens of thousands of males in the United States who could preach the gospel of early detection to their brothers. According to the American Cancer Society, 86,000 men were diagnosed and treated for prostate cancer in 1985, and about one million men are living with the disease. There must certainly be one well-known politician, movie star, or athlete among these hundreds of thousands of Americans who will stand up and claim a reward that's worth more than the best-paying lottery.

What would the lucky man win?

The satisfaction of knowing hehelped saved the lives of about half the estimated 25,000 men who die of prostate cancer every year.

Thanks to courageous women likeFord, Rockefeller, Temple, Child, and Jillian, there's probably no woman in the country who doesn't know that a lump is a signal to make an appointment with her doctor for a breast exam. But no prominent prostate patient has come out of the closet to tell his brethren about the importance of making an appointment to have digital rectal exams of their prostate glands every year after their 40th birthdays.

Unlike breast cancers, prostate tumorscan't be found by any type of self-examination; they have no easy-to-feel or easy-to-see symptoms. The only way to know if the walnut-sized gland, located high in a man's pelvis just below the bladder, is too large or too hard is by having a doctor's gloved finger palpate it by entering the rectum through the anus. That's what "digital rectal' means.

Is it possible that men refuse to lettheir doctors do the vital examination because it seems "undignified,' perhaps uncomfortable?

Possible--but not probable.

The rush of men to doctors forproctoscopies and colonoscopies after President Reagan's intestinal tumor was found in the summer of '85 contradicts this theory.

Can it be that men are afraidloss of the gland will leave them impotent, infertile, and incontinent?

If this is the reason formen's refusal to be examined and reluctance to speak out, they must be told that times have changed. Prostate surgery no longer means loss of masculinity, according to experts. Surgical techniques have improved so dramatically within the past few years that treating a localized prostate cancer doesn't doom men to impotence, infertility, and incontinence--if it's found early and treated by a surgeon with training and experience in preserving the nerves surrounding the gland.

The key life- and manhood-savingwords are "found and treated early' by "a surgeon with training and experience.' Urologic oncologists believe radical prostatectomy would already be a medical relic if all men had annual digital rectal exams after reaching 40.

That's why men need a celebrity.Men need someone who will stand up and say, "My doctor did a digital rectal exam, found my tumor early, and knew hot to do a prostatectomy without cutting any nerves. I'm not only alive but can satisfy my wife and could even have more children, if we wanted to.' Apparently a disease has to attack a celebrity to break into television, and no such man, so far, has been willing to tell the world he's had his malignant prostate gland removed.

What would happen if movie andtelevision idols announced that they no longer had their prostate glands but had dozens of women friends anyway? Men would line up outside urologists' offices to wait for digital rectal exams.

There's no other way to finda tumor early, before it has already spread beyond the gland itself. A prostate that's enlarged and hardened by cancer doesn't cause any symptoms until the tumor is advanced. It is wrapped around the urethra as it leaves the bladder, and symptoms of the disease that a man can notice --urinary difficulty and back pain--don't occur until it is too late to have life- and manhood-saving treatment.

Actually, the majority ofmen with prostate cancer have no symptoms at all, and this is why an annual digital rectal examination by a doctor is so important. If the prostate feels large or hard, a needle biopsy is done to see if any cancer cells are growing in it. Two blood tests--acid and alkaline phosphatase studies--can also be helpful in making an early diagnosis.

If a man doesn't see a doctoruntil he has pain, or if he finds blood in his urine, he probably has advanced disease --either stage C or D--and he is considered by most experts to be inoperable. Most treatments, surgery or radiation, are palliative; all hope of cure is gone.

So women are far ahead ofmen. Women have early warning symptoms of breast cancer they can find themselves, and-- thanks to newspapers, magazines, and such top-rated TV shows as "Dallas,' "St. Elsewhere,' and "Cagney and Lacey'--women know that finding the tumors early means their lives won't be changed.

Now men must be told that a prostatectomydoesn't have to mean severed nerves and muscles that can leave them impotent and incontinent --if the tumor is diagnosed early enough and the operation is done by a trained and experienced urologic surgeon. It's no longer necessary for thousands of terrified men to meekly follow their doctors into operating rooms for devastating surgery. Men need a celebrity to tell them that having annual digital rectal exams may give them life without penile implants and diapers.

Several years ago, a national televisionreporter decided that the time had come to do something about this information gap. She searched in vain for a prominent prostate patient to introduce a talk show on which experts would debate various therapies. Finally, she was forced to invite a woman who had fought for choices in breast-cancer treatment--but the program never appeared. The producer thought it inappropriate for a female to argue that males be offered various available treatment options for prostate cancer. So, because no man was courageous enough to admit he had the disease, millions of television viewers lost the chance to learn about this common male malignancy.

When the prospective emcee wastold the show was scrapped, she wasn't surprised. "Men just won't go public like women have,' she told the reporter. "That's what it would take to make men aware of how important digital rectal exams are to find prostate cancer early so they don't need radical surgery.

"It's just like breast cancer was. Ifa celebrity finally stands up and speaks up, we women will fight for their rights too.'

Photo: What America needs is a male Betty Ford orHappy Rockefeller to stand up and announce there is life after prostate cancer.
COPYRIGHT 1986 Saturday Evening Post Society
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1986 Gale, Cengage Learning. All rights reserved.

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Title Annotation:need for a spokesman for early detection of prostate cancer
Author:Kushner, Rose
Publication:Saturday Evening Post
Date:Nov 1, 1986
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