Norman Schwarzkopf’s prostate cancer almost wasn’t detected. “When you are a general, the doctors don’t tend to do a thorough digital rectal exam,” says the leader of America’s Persian Gulf war forces.
Even though he had none of the symptoms, Schwarzkopf had been doing a lot of reading about prostate cancer. So, during a hospital visit for a different purpose, he asked a urologist to do a more thorough exam. The doctor felt a tiny lump.
In May, after a biopsy indicated cancer, Schwarzkopf had so-called nerve-sparing surgery that removed the tumor while avoiding the two problems that most torment men facing prostate cancer: incontinence and impotence. Today, says the 60-year-old retired army general, “I feel like a million dollars. … Everything is absolutely, totally back to normal.”
Schwarzkopf’s experiences are typical of both the problems that can hamper detection and the promise offered by quick diagnosis and new treatments in defeating a disease that, among cancers, is second in prevalence only to skin tumors.
A new blood test has the capability to detect prostate cancer before it has metastasized, and new surgical and radiation treatments can halt the tumor without debilitating side effects. “If it is detected early, you can be cured, and you can also have a normal life,” said Dr. Patrick Walsh of Johns Hopkins University in Baltimore.
Despite the advances, however, prostate cancer remains a devastating disease. Approximately one in every nine men will develop prostate cancer, about the same risk a woman has of developing breast cancer. This year, about 200,000 American men will develop it and 38,000 will die from it.
Part of the problem can be traced to the disease’s image. While it is more common than breast cancer, relatively few men are familiar with prostate cancer and fewer still are willing to undergo screening.
And unlike with breast cancer and other diseases, only recently have celebrity spokesmen begun talking about prostate problems.
“There’s been no Betty Ford (breast cancer), no John Wayne (lung cancer),” Walsh said.
That situation is changing. In addition to Schwarzkopf, former pro quarterbacks Johnny Unitas and Len Dawson have spoken out about their experiences, as have Sen. Bob Dole, R-Kan., and retired Sen. Alan Cranston, D-Calif.
Also, prostate cancer was reported as the cause of death for actors Bill Bixby and Don Ameche, rock musician Frank Zappa and entertainment mogul Steve Ross.
Nonetheless, in terms of public awareness, “We’re 20 years behind the women,” said Bill Whitmore of Boston, co-founder of one of the first prostate cancer support groups, US TOO.
As a result, research support has lagged. Funds for study of breast cancer, which strikes about 180,000 American women annually and kills 46,000, will total $262.9 million this year, or about 13.5 percent of the National Institutes of Health research budget. Research on prostate cancer will total $55 million, about 3 percent of the budget.
“There is no question that breast cancer is important, but prostate cancer also deserves some funding,” said Dr. E. David Crawford of the University of Colorado, chairman of the National Prostate Education Council, organized to encourage men to undergo screening.
The reasons for the disparities seem all too clear to many men. “Anything associated with sexual organs or the natural processes of elimination, men tend to be squeamish talking about it,” said Hank Porterfield of US TOO.
As a consequence, women visit doctors more often, are hospitalized more often and undergo more operations, according to figures compiled by the U.S. Department of Health and Human Services. Two out of every three health care dollars are spent on women.