AP/Wide World Bob Dole says don't avoid the doc's office

The variety, Dole cracked, is the human male.

"Either because of fear or embarrassment or whatever, they won’t see their doctor," Dole said in a speech at the American Urological Association’s Annual meeting in May. "And it’s not fair to their wife or children or their job or their community if they don’t see their doctor."

In an effort to say louder what other men's health advocates have said for years, the American Foundation for Urologic Diseases has declared September National Prostate Health Month. At least 37,000 American men die annually die from prostate cancer which was diagnosed too late.

"Our big thrust is to get men to lose their fears and to start learning about prostate diseases and prostate health, and to get their checkups," said Dr. Leonard S. Marks, founding medical director of the Urological Sciences Research Foundation and a Clinical Associate Professor at UCLA school of medicine.

What’s the Big Deal?

 

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As Dole noted, only 40 percent of all doctor visits are made by men annually. But in the case of prostate disease, it’s not just about failure to get a checkup, Marks said — men want to avoid the rectal exam involved in a routine prostate screening.

"They don’t want to do it if they can possibly avoid it," Marks said. "But the bottom line is, it just takes a second. It’s quick and it’s not painful."

The second reason, Marks said, is that men harbor fears — unfounded ones, experts say — that treatments for prostate disease will make them incontinent and impotent.

BPH: Common and Treatable

If a man has an enlarged prostate, known as benign prostatic hyperplasia, no surgery is necessary provided there is early detection. BPH can be treated with medication, such as Proscar (finasteride) or with dietary supplements. Even surgical options don't have to lead to loss of sexual or bladder function, doctors say.

Some with mild cases may even want to try saw palmetto, Marks said, the extract of a berry from a plant that grows in the southeastern United States and the Bahamas.

Saw palmetto was shown to reduce problems in urination in a study published in the Nov. 11, 1998 issue of The Journal of the American Medical Association, but not all doctors enthusiastically endorse its use.

PSA Test

The American Cancer Society and the American Urological Association recommend that every man over 50 and men in high risk groups — African-American men or those with a family history of the disease — need to start getting screened for the disease at age 40.

These screenings involve a digital rectal exam and a PSA test, a simple blood test in which a patient has blood drawn from the arm or another area, which detects the level of "prostate-specific antigens," markers indicating that the body is responding to cancer in the prostate.

A PSA above a certain level — usually 4 nanograms per milliliter — is considered abnormal. Usually, when the level is 4 or above, the doctor will recommend a biopsy, which can be done in the doctor’s office.

Some doctors believe PSA tests are not always necessary, but others like Dr. William Catalona of Washington University-St. Louis Medical Center, the urologist treating New York Yankees Manager Joe Torre for prostate cancer, call for biopsies at levels as low as 2.6.

Take-Home Message: Knowledge Is Power

Even with the growing awareness about the PSA test, Catalona, Marks and other doctors say they still see plenty of patients who come to them when their prostate cancer or other prostate disease has progressed well beyond the early stage.

"The take-home message is that knowledge is power," Catalona said.

"The earlier prostate cancer is detected, the more options they will have and the better chance they will have of being successfully treated."