A few months ago, it was Warren Buffet (82). Last week, it was actor Ian McKellen (73) and California Governor Jerry Brown (74). All these older men announced that they had localized prostate cancer. Buffet has completed radiation therapy; Brown is slated to begin it shortly. McKellan revealed that he’s been following active surveillance (i.e., monitoring, but not treating) in the six years since he was diagnosed.*
Because these men are all famous, the media have covered their stories, raising awareness about prostate cancer. And that’s good, right? Well, as with so many things about this complicated cancer, the answer is both yes and no.
It’s a positive thing, because it’s both useful and true to tell the public that prostate cancer is the second most commonly diagnosed cancer among men. And that most men don’t die from it.
But if this is the primary take home message, the media are doing their readers a profound disservice. One can imagine younger male readers concluding, “I might get prostate cancer when I’m really old, but if I do, it’s not a major issue. And I certainly don’t need to worry about it now.”
Looking at Ian McKellen’s comments in the Reuters report, readers are left with a confusing message. McKellen is quoted as saying, “many, many men die from it, but it’s one of the cancers that is totally treatable.” And later, “I have heard of people dying from prostate cancer, and they are the unlucky ones, the people who didn’t know they had got it and it went on the rampage. But at my age if it is diagnosed it’s not life threatening.”
How would an average man apply McKellen’s message to his own life? It’s easy to imagine him thinking, “yeah, a few unlucky guys die of it, but it’s really not a big deal. If I do get it, it’s curable. In the meantime, I’ve got bigger things to worry about.”
A recent survey conducted for Janssen Biotech, Inc. (which markets Zytiga®) validates this assumption: “A significant gap exists between the facts about prostate cancer and what men believe about the disease.” The report goes on to say, “Most of the men surveyed (63%) believe that they won’t be diagnosed with prostate cancer, and more than half (52%) believe that if they are diagnosed, the disease will not be fatal.”**
For those of us dealing with advanced prostate cancer, we read these news stories and the rosy prognoses for these famous old men, and we grumble, “why doesn’t the media get it?”
Because the reality is that for many younger men, for African-American men, and for men with a family history of the disease, prostate cancer is a very big deal indeed. There is nothing about prostate cancer–even the slow-growing, localized variety–that makes it a “good” cancer. By running the stories of these famous older men, the media may be raising awareness, but they may also be lulling men into a false sense of security, thinking that this “old man’s disease” is really nothing to worry about.
But before we get too tough on the media for emphasizing optimistic stories over what for many of us is a grim reality, we need to appreciate the unique communication challenges involved with prostate cancer.
On the one hand, there is the reality that “prostate cancer mainly affects older men with a slow-growing disease and have nothing to fear.” On the other hand, there is the equally true statement that “prostate cancer is serious and often deadly for some men.” The problem for the media is to communicate this seemingly contradictory messages clearly, concisely, and simultaneously.
Add in the current controversy over PSA screening, and it’s easy to see why public understating of prostate cancer is muddled, at best.
Is there a way out of this communications dilemma? Does a younger famous man, say around 40 or 45–preferably African-American–need to be diagnosed with prostate cancer in order to start clearing up some of this confusion? Or is there something else we advocates can do?
*Source: Chicago Tribune story, 12/11/12 http://trib.in/12nKs9A