THOMAS A. FARRINGTON
President and Founder
September is recognized as "prostate cancer awareness month," a time when men are urged through highly visible promotions and special events to check their prostate health through screenings and other measures. It is also the appropriate time to become aware of the overall prostate healthcare predicament for men in this country. As men we like to think of ourselves as strong and indestructible. This macho attitude has led to a response to our prostate health needs in the same manner, disregarding the true facts.
According to the American Cancer Society 180,000 + women were diagnosed with invasive breast cancer in 2007, and 220,000+ men with prostate cancer. These are the leading causes of cancer for the respective sexes. Also in 2007, the ACS estimated approximately 40,000 women died from breast cancer with approximately 30,000 men dying from prostate cancer. While these statistics seem to closely track, this is where the similarity ends.
The U. S. House of Representatives Appropriations Committee is requesting level funding for the 2009 Prostate Cancer Research Program (PCRP) at $80 million for the fourth consecutive year. The PCRP is part of a larger program that includes the Breast Cancer Research Program. These Congressionally Directed Medical Research Programs are funded annually. For 2008 the breast cancer program was increased to $138.5 million and for 2009 the appropriations committee is recommending $150 million. Again, the recommendation is for prostate cancer research funding to remain at $80 million.
Medicare has a policy known as ?least costly alternative? (LCA). LCA dictates that cost is the prime factor in treatment and allows Medicare?s contractors to deny payment for additional cost of a more expensive service if a comparable service costs less, a sound concept in principle. LCA was first used on durable medical equipment such as wheelchairs. Now LCA is being applied to hormonal therapy treatment for prostate cancer. It appears that prostate cancer treatment alone is being singled out for LCA. Many prostate cancer patients are seniors who rely upon Medicare and are subject to LCA. The journal Cancer released a study that found that from 2003 to 2005, the number of men receiving hormone therapy injections fell by 14 percent while the number of surgical castrations rose by 4 percent. Some attribute this to an increased focus on using LCA as a way to achieve savings. Surgical castration, a traumatic and irreversible surgery is a less expensive form of hormonal therapy.
At least once every year a government task force will announce another guideline edict on the use of prostate cancer screening. These rulings are sometimes contradictory and made without consultation, to my knowledge, with any prostate cancer leadership or advocacy organization. The real problem is that ?PSA? testing and the ?DRE? are not always accurate or comprehensive diagnostic procedures. However, because of the scarcity of research dollars available for prostate cancer, these are the only tools available for early diagnoses. Mammograms, which use highly sophisticated imaging technologies, are used for diagnosing breast cancer. There are no such widely available imaging procedures for prostate cancer.
These are but a few examples of the lack of parity and responsiveness in our healthcare system for men?s prostate cancer needs. There are many others that can be cited but I think you get the picture that our predicament is not good, and you would have to ask ? Do Men Count? This predicament weighs on every man, but most heavily on African American men who have a 60% higher prostate cancer incidence rate and a 140% higher death rate than all other men.
A key factor contributing to the lack of resource parity with breast cancer is the success of women being great advocates for their needs and men not being engaged as advocates for our needs. Women stood up and were counted, and men have not - back to the macho problem. The system for allocating resources to needs, or causes in our country responds to action. I strongly admire and applaud the success that women are having, it supports my mother, wife, sister and daughters. I lend my support to these efforts and I am in favor of even more resources to fight breast cancer. However, similar breast and prostate cancer incidence and mortality rates would seem to indicate a need for similar resources and this should be a call to action for men. As an eight year prostate cancer survivor who lost a father and both grandfathers to this disease, and with two sons and two grandsons at high risk I have strong personal concerns, and I want to make all men acutely aware that we have much work to do.
We must put our stake in the ground and say no more will our needs be overlooked. Then we must stand up to be counted, and aggressively demand parity in research funding, an end to LCA for prostate cancer treatments and the research dollars to develop imaging and other accurate diagnostic tests. We must also demand an end to the continuous arbitrary screening guideline edicts which causes considerably confusion among men. Until we get all these in place we need emergency funding for a broad and aggressive education and awareness initiative targeting the men most at risk who are in the midst of a prostate cancer crisis. We must adamantly say to all our elected leaders that ?men do count? then demonstrate it through our actions. I ask that you start your own personal action campaign by immediately sending an email, or letter, to your elected officials stating the facts which I have outlined, and requesting their support for our prostate health needs. Use the subject heading title - ?Men Do Count!? Remember that action counts, and being macho doesn't.
Starting in September 2008, let us assess the adequacy of policies and resources to wage a successful war against prostate cancer as important aspects of each and every ?Prostate Cancer Awareness Month? in years to come. Men do count!
To email or write your U.S. Congressional Leaders please go to these websites;