Let's talk about it

December 17, 2003

COLIN L. Powell underwent surgery Monday to remove a cancerous prostate gland, and his prognosis is said to be good. It's big news when the nation's secretary of state is treated for cancer, but it also underscores a fact that deserves even greater attention: Black men are at significantly greater risk of developing prostate cancer - and are far more likely to be killed by it.

Prostate cancer is serious business. It's the most common form of cancer that develops in men. It can be slow-growing, but it can also be aggressive and deadly. Like most treatable cancers, the best defense is early detection. Yet men are often reluctant to have annual physicals where a quick examination by a physician and a simple and inexpensive blood test are administered. Like many states, Maryland mandates that health insurance pay for the test for PSA, or prostate-specific antigen. And like many cities, Baltimore's Health Department offers the tests free of charge.

For several years, the American Cancer Society has trumpeted this message in the black community in an educational initiative called "Let's Talk About It" that's centered in churches and community centers. The campaign is aptly named - men don't like to contemplate their health and certainly not their reproductive glands. It's a telling fact that married men are more likely to be diagnosed. Their spouses drag them into checkups. But here's the reality: About one in five black men will be diagnosed with the disease, and 1 in 20 will die from it.

Why is the disease twice as deadly for African-Americans than for others? Researchers don't have a definitive answer, but it's thought to have a strong biological component - blacks in Africa and the Caribbean face a similar risk. A family history of the disease, obesity, a poor diet (high in fat and red meat) and high calcium intake also seem to increase the risk.

Mr. Powell was fortunate. Doctors think his cancer hasn't spread beyond his prostate. That's the potential benefit of a prompt diagnosis. Experts say all men should get annual PSA tests beginning at age 50; African-Americans and others with a family history of disease beginning at age 45. The point is not debatable. The prostate cancer death rate has dropped since 1990, when the blood test became common. The problem is that the test can't save the life of anyone who chooses not to take it.

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