Urging men to overcome the fears that keep many from the doctor's office, Gov. William Donald Schaefer announced yesterday a statewide campaign of free screenings and lectures intended to reduce Maryland's high death rate from prostate cancer.
The assault on prostate cancer is the latest salvo in the administration's effort to end Maryland's dubious distinction as the state with the nation's highest death rate from cancers overall. In prostate cancer deaths, Maryland ranks sixth.
Mr. Schaefer also signed an executive order banning smoking in all state agencies, a measure aimed at curbing the leading cause of lung cancer.
For reasons that elude scientists, Maryland ranks among the top six states in deaths from all the major cancers: lung, colon, breast and prostate.
Governor Schaefer noted that prostate cancer is usually cured when caught early. But sadly, he said, many men fail to get routine prostate examinations because they fear hearing the bad news if the doctor finds the prostate enlarged.
"It's fear," Mr. Schaefer said at a State House news conference. "You don't want to know. That doesn't make a lot of sense, but it's a problem."
Now, state agencies are coordinating a fall campaign based on JTC the philosophy that hundreds of deaths can be avoided each year if men become more aware about prostate cancer and begin a program of annual screenings once they reach their 40s or 50s.
Urologists will be conducting free lectures on prostate cancer at senior centers, state agencies and colleges.
And most hospitals across the state will be offering free prostate examinations later this month or early next month.
Generally, the free exams will occur between Sept. 27 and Oct. 4, the beginning of National Prostate Cancer Awareness Week, but some hospitals will offer exams before or after that week.
Maryland Health Secretary Nelson J. Sabatini said the campaign costs the taxpayers nothing: Doctors and hospitals are donating their time, and TAP Pharmaceuticals Inc. of Deerfield, Ill., is donating money for promotional materials.
The target group is middle-aged and older men. Michael Naslund, a University of Maryland urologist, said men should start getting annual prostate exams by the time they reach 40 if they fit into two high-risk groups: black men, and men of any race if a close relative has had the disease.
Otherwise, annual exams should begin when a man reaches 50, Dr. Naslund said.
Located just below the bladder, the prostate is a chestnut-sized gland that provides part of the seminal fluid necessary for ejaculation. Cancers are thought to result from a series of genetic changes that may begin early in life but don't trigger tumor growth until men have reached at least middle age.
The traditional prostate screening is a manual examination, in which the doctor inserts a finger into the patient's rectum and feels the prostate to see if it is enlarged. Further tests indicate whether an enlarged prostate is cancerous, or swollen from a benign condition that strikes 80 percent of all men sometime during their lives.
Doctors have begun giving a blood test that measures the level of a protein that can become elevated if the prostate is diseased.
Dr. Naslund said the blood test, known as the prostate specific antigen or PSA test, is not a substitute for the rectal exam. The two must be used in tandem.
Most hospitals taking part in the statewide campaign will be offering both tests, a health department spokesman said.
"What's so tragic is that prostate cancer is absolutely curable if detected early and absolutely incurable if detected late," Dr. Naslund said.
He is director of the new Maryland Prostate Center, a clinic devoted to the early detection and treatment of prostate disease.
The center opens Sept. 24 at the University of Maryland Medical Center in Baltimore.
Mr. Schaefer, 70, admitted that he didn't begin getting annual prostate exams until a few years ago, when as governor he became interested in the role that prevention can play in curbing a host of problems ranging from cancer, AIDS and tuberculosis to teen-age pregnancy.
Sitting at Governor Schaefer's side yesterday was Attorney General J. Joseph Curran, who said a routine physical 1 1/2 years ago revealed he had prostate cancer. At 60, he had felt none of the symptoms, such as difficulty emptying the bladder and frequent urination, that plague some men who have prostate cancer or the benign disease.
"You don't have to have a symptom," he said. "You can feel perfectly normal."
Mr. Curran said his prostate was surgically removed and subsequent tests have revealed no traces of cancer.
About 500 men die from prostate cancer each year in Maryland which has the nation's sixth-highest death rate from the disease. Minorities in Maryland are hit harder than white males, according to the Maryland Department of Health and Mental Hygiene.
States with higest death rates per 100,000 men
Washington, D.C... .. .. .. .. ..42.7
South Carolina.. .. .. .. .. .. .30.3
Georgia.. .. .. .. .. .. .. .. ..28.6
Delaware.. .. .. .. .. .. .. .. .28.4
Vermont.. .. .. .. .. .. .. .. ..27.8
Maryland.. .. .. .. .. .. .. .. .27.8
Virginia.. .. .. .. .. .. .. ....27.6
North Carolina.. .. .. .. .. .. .27.5
Montana.. .. .. .. .. .. .. .. ..27.3
Alabama.. .. .. .. .. .. .. .. ..26.6
U.S Total.. .. .. .. .. .. .. ...23.8
Maryland death rates by race
Total males.. .. .. .. .. .. .. .27.2
White Males.. .. .. .. .. .. .. .22.8
Other Males.. .. .. .. .. .. .. .49.8
Prostate gland facts
* Where it is: Under the bladder and in front of the rectum
* What it does: The prostate gland secretes substances that form semen.
* Prostate Cancer: A malignant growth srises in the gland's outer zone, sometimes causing problems with urination by pressing on the uretha. The second-most common cancer among men, it often occurs in the elderly