Off the top of his head, Dr. David King can't think of a single one of his patients whose life would have been saved by the early detection of prostate cancer.
Because there have been far too many of them over his 28 years of oncological practice.
"Well," he finally said, "I just got a telephone call today about a gentleman who's in his 60s. He's hospitalized, totally bedridden and in pain because of extensive prostate cancer that has spread to his bones. It wasn't diagnosed until it started hurting. He had not been having annual exams.
"You know, guys are kind of funny about that," King, the Valley-based partner of Payson oncologist Dr. Lawrence Kasper, said. "They tend to avoid things like exams. Women are much more into annual mammograms and exams for breast cancer than men are into annual exams for prostate cancer.
"Of course, it's a masculinity thing. All men have that macho disease: 'Oh, there's nothing wrong with us!'"
Dr. Victor Henderson, radiation oncologist at Radiation Oncology Services in Payson, has witnessed that same "macho disease" which is why he emphasizes that getting annual prostate exams is "extremely important. If you can find the disease earlier, you have a much better chance at finding a curable management for it.
"At the early stage of the disease," Henderson said, "you can expect an 85 percent chance of five-year survival when treated aggressively."
While that number is impressive all by itself, its significance is magnified by the country's prostate cancer statistics.
After skin cancer, prostate cancer is the most widely diagnosed cancer in this country, where more than 198,000 new cases will be discovered this year, according to the American Cancer Society. It will kill 31,500 American men this year, making it the nation's No. 3 cancer killer, behind lung cancer in men and women and breast cancer in women.
One man in six will be diagnosed with prostate cancer during his lifetime, but only one man in 30 will die of this disease enough to account for about 11 percent of all male cancer-related deaths.
In Arizona, 3,600 men will be diagnosed with prostate cancer and 600 will die from it this year, according to an ACC report.
At all ages, African-American men are diagnosed with prostate cancer at later stages and die of the disease at higher rates than white men. The incidence of prostate cancer among African-American men is the highest known rate in the world.
This cancer is most common among men aged 65 years or older. About 80 percent of all men with clinically diagnosed cases of prostate cancer are in this age group. Because prostate cancer usually occurs at an age when other medical conditions, such as heart disease and stroke, may contribute to the cause of death, the actual number of men who die with prostate cancer rather than of it is unknown.
Ironically, this quiet and insidious disease can be discovered by a simple "prostate specific antigen" (or PSA) lab sample which takes about two minutes to complete. This test could detect an infection in the prostate, or the beginning of cancer.
Even speedier is a "digital rectal exam" (or DRE), during which the physician finger-probes for abnormalities in the rectal wall and prostate.
While the oncology community currently harbors more hope than ever for prostate cancer patients, no one is dancing in the streets quite yet.
The most encouraging development, perhaps, arrived in July, when the National Cancer Institute launched the SELECT prostate prevention study using natural supplements Vitamin E and Selenium and multi-vitamins. While the nutrients of Vitamin E and Selenium have long been thought to prevent prostate cancer, it is the purpose of SELECT the nation's largest-ever such study to determine conclusive results.
SELECT, which will be conducted over 12 years on healthy men aged 55 and older, is based in large part on previous research conducted at the Arizona Cancer Center, one of more than 400 participating sites in the United States, Canada and Puerto Rico.
"This is not something we're holding our breath about," Dr. King said. "We can't hold our breath for 12 years. But there is cause for optimism, otherwise we wouldn't be spending the millions and millions of dollars it takes to do a study like this."
The prostate, found only in men, is a walnut-sized gland located in front of the rectum, at the outlet of the bladder. It contains gland cells that produce some of the seminal fluid, which protects and nourishes sperm cells in semen.
Just behind the prostate gland are the seminal vesicles that produce most of the fluid for semen. The prostate surrounds the first part of the urethra, the tube that carries urine and semen through the penis. Male hormones stimulate the prostate gland to develop in the fetus.
The prostate continues to grow as a man reaches adulthood. It will continue to grow or at least is maintained after it reaches normal size throughout the life of a man as long as male hormones are produced. If male hormones are removed, the prostate gland will not fully develop or will shrink.
For 21 years, the longest-established prostate research and prevention site in Arizona has been the Greater Phoenix Community Clinical Oncology Program, which holds early-screening clinics throughout Northern and Central Arizona including Payson, where a clinic was held in Bashas' supermarket last weekend.
A consortium of five large Valley medical centers, the CCOP encourages all men to see their doctor or call toll-free (1-866-488-7753) for information on obtaining an early screening or to participate in the study.
What you should know
All men, and particularly African-Americans who are at high risk for prostate cancer, are encouraged to undergo a prostate exam. While no symptoms may be present, men should know the early warning signs of prostate illness:
A need to urinate frequently, or inability to urinate
Difficulty starting or holding back urine
Painful urination, or weak flow
Difficulty having erections, painful erection, painful ejaculation
Blood in urine or semen
Frequent pain or stiffness in lower back, hips or thighs
The greater Phoenix Community Clinical Oncology Program encourages you to see your doctor if you experience symptoms, or for early screening.
If interested in the Select study, call toll-free (866) 488-7753.