Prostate cancer, research funding, and male vanity

As someone who’s living with prostate cancer, I applauded Louis Gossett Jr.’s testimony in Congress on the importance of prostate cancer research funding. If congress was listening, maybe I’ll live long enough for something else to kill me. But according to the American Cancer Society statistics, I shouldn’t hold my breath.

Fifty times more money is spent on research for breast cancer than is spent on prostate cancer. Does that mean there are 50 times more women dying from breast cancer than men dying from prostate cancer? Hardly. Every year 40,000 women die of breast cancer and 34,000 men die of prostate cancer. And yearly, there are only 15,000 more new cases of breast cancer than prostate cancer. Since mortality rates and occurrence figures are similar, what could explain why a woman with breast cancer is thought to be 50 times more important than I am? The answer may be related less to science than it is to male vanity.

Even today, prostate cancer is one of those diseases that for many is spoken of in hushed tones with the same acceptability as talking about gonorrhea, and other “embarrassing” illnesses. Many men with prostate cancer are reluctant to self-disclose because they believe the term automatically implies incontinence, impotence, or both. Our silence, for what ever reason, makes it acceptable for oncologists to present treatment “options” as if all were on an equal playing field.

When comparing two procedures an oncologist said to me, “six of one, half-dozen the other,” implying that the research data wasn’t definitive enough for him to decide which was the better procedure for my particular case. And therefore, I had to choose, even though my medical knowledge was derived from watching ER on television. I responded with “So the only way you and I will know if I made the right decision is if I live?” My smart-ass question was met with an embarrassed silence.

While well-known figures such as Louis Gossett Jr., Senator Christopher Dodd, Ambassador Colin Powell, Harry Belafonte, Senator Bob Dole, Louis Farrakhan, and Robert Goulet, have courageously discussed their prostate cancer, other less well-known men have not. Many of the 2 million are afraid that the general public (and especially women) will look at us and see only reduced sexuality and incontinence, whether or not it’s present and how mildly we might experience either.

I believe our fears parallel those experienced by women 20, 30, or 40 years ago when they received a diagnosis of breast cancer. We need to take a lesson from them. As they stopped looking at themselves as the disease, they took an active stand against it. On the internet I typed in “breast cancer fundraising March, 2010.” Just on the first 50 search pages, I found 70 events in 27 different states for March. When I substituted “prostate” for “breast” I found a pitiful 10 events in 8 states.

Maybe women are better organizers than we men. Maybe they are more likely to sponsor philanthropic events. Maybe they are more giving. Or maybe there is a reason that is more fundamental and related to our notions of what defines a “real man.” Our fears about real and perceived sexuality have consequences far beyond our own lives. Our silence perpetuates an inexcusable lack of research funds that not only may effect the length of my life, but millions of men who read this article, their sons, and male progenies that follow them. Women have known for a long time that self-worth is not related to the presence or absence of breasts. I think men need to understand that our value as human beings has nothing to do with what happens below our belts.

Stan Goldberg is the author of Lessons for the Living: Stories of Forgiveness, Gratitude, and Courage and the End of Life.