Voices
This Cancer Is Killing Men. Where’s the Research?
There's a conspicuous silence surrounding prostate cancer.
May 31 2017 5:44 AM EST
May 26 2023 2:09 PM EST
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There's a conspicuous silence surrounding prostate cancer.
The second-leading cause of death among American men is prostate cancer. It's a disease that kills almost 30,000 men in the U.S. every year, and yet far too little emphasis is placed on its treatment and cure.
The popular line of thought is that clinical trials of nascent drugs and treatments are biased toward men -- but this is certainly not the case when it comes to prostate cancer. In fact, breast cancer research is federally funded at a level that's double the funding for prostate cancer research. And in the private sphere -- where industry is largely driven by profit -- diseases that are associated with women, such as breast cancer and ovarian cancer, receive much greater funding and attention than male-centric diseases like testicular cancer or prostate cancer. The percentage of men diagnosed with prostate cancer is about the same as the percentage of women diagnosed with breast cancer, but funding levels are out of kilter, which has created a real disparity.
The most recent figures from the American Cancer Society indicate that breast cancer receives more than double the funding that prostate cancer has -- with 161 grants versus 62, representing $90.3 million versus $40.2 million, respectively. But this isn't about men and women competing for funding; rather, it's about everyone having the chance for restored health after receiving a life-threatening diagnosis. Treating one type of cancer informs treatments for almost all cancers; the distinction is less about who receives funding but more about what kind of research is being funded and how cross-tumor and cross-hormonal profiles will apply across different cancer types. In short: Everyone should be getting funded.
Prostate cancer presents unique issues of disparity among distinct populations, which have yet to be researched. For gay and bisexual men, there are the complicating factors related to being both a minority population as well as being underserved by the health care industry in the United States, despite the overriding history of HIV and AIDS. The field of gay and lesbian psycho-oncology, which is the study of survivorship for gay and lesbian cancer survivors, has sprung up from the unique issues proved by that disparity -- and it's something that needs more attention.
And then there's this startling fact: The incidence of prostate cancer is 60 percent higher among black men in the United States than among white men.
When turning the unfunded matter into percentages of patient dissatisfaction, a study conducted by Malecare suggested that an overwhelming majority of prostate cancer patients felt most concerned about the research funding for prostate cancer and treatments and expressed a desire to increase the funding. Of that group, 28 percent of respondents felt there is a need for more accurate prostate cancer tests. Support group networks and programs such as Twice as Many and Out With Cancer help support specific groups, but they can't compensate for the additional stress to patients who know their particular type of cancer is underfunded.
Unfortunately, the debate around the U.S. health care initiative has further muddied the waters; it's diverted the public conversation from the absolute value of health care to discussions of its cost. If you look at comparable costs in other realms, health care is a bargain. The high cost of treatment opportunities or the high cost of doctor salaries or caregiver salaries or the hospitals seems exorbitant except in the context of what we pay for everything else. Did you know, for example, that we spend more money for research on abstinence then we do to help men with prostate cancer avoid impotence by a ratio of three or four to one? The discussion has been hijacked by people who would like to reduce funding for health care to even lower levels and to these emotional arguments that things just cost too much -- when, in fact, how do you value a minute of life?
The National Cancer Act of 1971, which signaled the beginning of the U.S. "War on Cancer," was signed by then-President Richard Nixon. After more than 40 years, this could be called the nation's longest-running war; and we can't let our defenses -- or our men -- down on this battlefield.
DARRYL MITTELDORF is the founder and executive director of Malecare, a nonprofit organization focusing on prostate cancer support and advocacy.