The Cancer That Gets Little Attention

This year in the Bay Area, 4,940 men will be diagnosed with prostate cancer and 725 previously diagnosed will die from it, according to the California Cancer Registry.

That’s a total of 629 men per county, on average. Which is a lot of men, I’d say. Enough for nine Army battalions, 16 professional baseball leagues or a small city.

While prostate cancer is not necessarily the deadliest of cancers, it is certainly the most prevalent in our corner of the world - more so even than breast cancer in every Bay Area county but Santa Clara.

Yet little money is spent on prostate cancer research nationally - $1,950 for every death, compared with $12,250 for every breast cancer death and $31,750 for every AIDS death.

Moreover, well-intentioned primary care physicians who’d be alarmed at the first sign of a lump or lesion often are clueless as to what to do when the often-ambiguous symptoms of prostate cancer appear.

Finally, a hailstorm of information pummels a man and his significant other after the bad news arrives. What do you do? Wait it out? Cut it out? Burn it out? There are arguments, pro and con, for all three approaches.

Rudi Raab, a Berkeley cop, found all this out for himself in late 1995. That’s when Raab’s PSA test for prostate-specific antigen - came in at more than twice the high end of normal. Raab, only 50 at the time, had cancer.

Rudi Raab is on the road to recovery because his disease was caught early. That’s good for him and those close to him.

What’s good for the rest of us is that Raab’s friend, Julie Freestone, happened to be supervisor of community education and information in the Community Wellness & Prevention Program of the Contra Costa County health department in Martinez.

Freestone had been spending much of her time fighting breast cancer and tobacco. She knew what could be done to combat a public health menace. When she familiarized herself with the prostate cancer situation, she was appalled.

“I noticed a very obvious thread: People were wringing their hands,” Freestone said. “In California, nothing was happening in county health departments. Rudi’s HMO took 20 minutes to produce a pamphlet, which had to do with prostate problems, not prostate cancer. There was a lot on the Internet, but if people didn’t have access to a computer, they were in trouble.”

Last July, Freestone attended a prostate cancer convention in Houston. The speaker who set the place on fire was a breast-cancer activist.

“The men had breast envy,” Freestone said. “The woman was very clear that this would take a lot of in-your-face advocacy. The men had to do for prostate cancer what the women had done for breast cancer.”

Since then, a few interesting things have happened.

Freestone and two patients she met on the Internet set up a Web site in English and Spanish, the Prostate Action Network (http://rattler.cameron.edu/pacnet).

With organizations such as the American Cancer Society and the prostate awareness group Man to Man, Freestone is heavily involved in a petition drive aimed at presenting a million signatures to President Clinton and Congress by Father’s Day. It demands more money for prostate research.

Freestone invites people interested in joining the National Prostate Cancer Coalition to call her at (510) 313-6268.

In Washington, Rep. Ellen Tauscher, D-Calif., and 80 other Capitol lawmakers are co-sponsoring the Prostate Cancer Diagnosis and Treatment Act of 1997. It would expand research and education and provide for better early-detection insurance coverage.

Freestone says it’s often only the men who are the best-educated and the best-off who have the happiest endings to their prostate cancer horror stories.

“But this shouldn’t be a situation,” she says, “where only the privileged have the best outcomes.”

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