Stick Your Finger Where?!

I last wrote about breast cancer in my informal “medical series” here on the blog so, to be fair, I’ll now address prostate cancer. Unlike the enthusiastic pink-banner-waving breast warriors-of-awareness, prostate cancer’s agents of information fly below the radar with little hoopla, few public endorsements, and no ribbon brigades. But statistically, prostate cancer is just as prevalent as breast cancer and results in about 30,000 deaths annually.

But how about a bit of good news to start? Most guys are familiar with the “probing finger” method of prostate examination, but how many have heard of the PSA blood test that can also be used? Ideally, the American Cancer Society suggests they be used in conjunction to help identify prostate issues, and generally only after age 50. But, fellas, there’s our loophole; you have the right to request the blood test and forego the finger.

Now, back the issue at hand (no pun intended). Prostate cancer, like many other cancers, increases in probability with age. Roughly two-thirds of cases are diagnosed in men 65 and older. And whereas a 40 year old man has only a 0.01% chance of being diagnosed with prostate cancer, a man aged 75 has a 12.5% chance. Which, incidentally, is twice the odds of a woman the same age being diagnosed with breast cancer. In fact, from age 55 on, men are at a higher probability of prostate cancer than women of the same age are of breast cancer. And over the course of a lifetime, men are over 30% more likely to develop prostate cancer than women are breast cancer. I don’t recall seeing any blue ribbons for that in the New Yorker.

And although men make up less than half of the country’s population, they are more likely to develop cancer of any major class but one. Digestive cancer? More prevalent in men. Respiratory cancer? Men. Bone, skin, brain? Men. Lymphoma, myeloma, leukemia? Still men. The only major class not led by men is cancers of the endocrine system, involving hormones. (And I dare say most men could offer an explanation for why women are number one in that.)

So I think we should begin a blue-ribbon brigade, to save the men. They are a minority in the populace, suffer a shorter average life span than women, and are at higher risk for debilitating disease. If that doesn’t deserve a ribbon, I don’t know what does. But I don’t think we can rely on super-aid-celebrities like Bono to go waving any flags for the cause (mostly because I think he needs to grow a pair first), so men, take a stand for yourselves. Wave your own banners and be your own warriors-of-awareness. And women, if you support the pink ribbon then you need to support the blue one, too. We have to fight for equal rights, equal awareness, and equal funding together, breasts and prostates alike.

Go blue!!

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Scaring the Girls

The American Cancer Society estimates there were a total of 254,650 new diagnoses of breast cancer in 2009 (actual records are only available until 2005; newer information has not been compiled). As a member of the female population, I am very aware of these numbers. Television commercials, full-page magazine ads, and a virtual who’s who of celebrity sponsors make it hard not to be. Everywhere I look is the ACS “pink warning,” in ribbons, scarves, posters, bumper stickers, etc., trying to “raise awareness” about breast cancer. (Personally, I’m wondering what rock a person could be living under to not be aware.) And, as usual, I felt the need to question the authorities that be and look into these numbers more closely.

First off, let’s take that number of expected new diagnoses – 254,650 – for the 2009 calendar year and compare it to the female population of 2009: 154,000,000 (roughly, estimated from Census Bureau population charts). So with no more than a pocket calculator, I can conclude that, in 2009, any given female’s chance of being found to have breast cancer was essentially 0.00165%. There are other factors, of course, especially age and family history, but this wasn’t exactly the death sentence I was expecting. From all the media hype and social awareness I had expected much higher numbers. But 0.00165%? That means you’d have to get 1,000,000 women together to find 17 with new breast cancers (and that’s rounding up). That means if the entire metropolitan area of Memphis, Tennessee, were female, less than twenty would have been diagnosed with breast cancer during the year. I’m as likely to be killed in a freak accident involving jalapeno poppers and a road grader. Okay, maybe not, but it’s still pretty remote.

Now before anyone gets their bra in a bunch, I understand that it should not be dismissed. Like any disease, I think it should be kept in the back of your mind and those more likely to be affected (women over 45, smokers, of African heritage, or with family history of breast cancer) should take whatever steps they feel are necessary to protect or treat themselves. Breast cancer contributes to some 40,000 deaths each year; that cannot be ignored. Period. But I don’t believe it’s the plague it is played up to be. For instance, according to the National Safety Council, women under age 45 are more likely to die of accidental poisoning than to develop breast cancer.

So – to continue poking around these ACS estimates – women under 45 were expected to comprise only 25,100 of the new diagnoses. Which drops the chances to a whopping 0.00027%. Did you catch that extra zero in there? Now scrounging up 27 new diagnoses would require 10,000,000 women. That’s only slighty less than the entire Paris metropolitan complex … or the populations of Los Angeles, Chicago, Houston, and Phoenix combined. And this is supposed to be a major concern? I’m more likely to be shot; to drown in a swimming pool; to die in a plane crash or from heatstroke; or even to suffocate in bed (according to the National Safety Council). I don’t see a lot of warnings about the dangers of bed-clothes. But maybe Martha Stewart has more up her sleeve than white sales and stock tips, eh?

The American Cancer Society’s own documents state, “95% of new cases and 97% of breast cancer deaths occurred in women aged 40 and older.” In fact, most breast cancers occur in women 70 and older, when chances of being diagnosed “skyrocket” to 0.016%. And one last percentage to throw at you … taken as a whole, over an entire lifetime, the average woman has a 0.125% chance of being diagnosed with breast cancer.

So why the media frenzy? Why the pink and celebrity sponsors and full-page ads? Why are they worrying college students and the MTV generation about something that really begins to pose a threat only at retirement age?

I don’t know, but it has provoked me to look into other concerns and do some digging. Consider this post the first of a series exploring medical concerns. And remember to take media “warnings” with a grain of salt.

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