Aug. 20--The crossed legs. The reflexive cringe.
That was my doctor.
I was in for a physical. We'd been talking about this and that, and were getting to the end.
Of the visit, I mean, but that end, too. It was the last thing, when a euphemism just won't do: The doctor needed to check my prostate, which involves his finger in my -
But before I finish that sentence, I have to admit a certain cowardice I've been unable to overcome. I've stopped and started this column several times, mostly trying to avoid making any reference to my own anatomy. I've written it a dozen different ways. I've tried not writing it at all.
And attitudes like mine, I realized, are part of the problem. Men are dying. Thousands each year. Blacks much more often than whites. All because prostate cancer is a medical condition wrapped up in anxieties and taboos, sexuality and embarrassment. All because men don't want to talk about that finger, let alone turn their backsides on it.
It's not just the patients.
As the doc and I were wrapping things up that day, we decided together to skip what his profession gently calls a "digital rectal exam," and which men call something else. I thanked him. He thanked me. "It's not much fun for us, either," he said.
But it's also necessary (and we both survived the procedure six months later), as is a regular blood test, at least for guys of a certain age. There are plenty of cliches, but here's the one I hear most often: If you don't die of prostate cancer, chances are you'll die with it.
My grandfather had prostate cancer. There's a pretty good chance yours did, too, since one of every six American men will get it. I've known men in their 30s who've had surgery, and known guys in their 70s who've done the same.
The one thing I notice among the men who've had prostate cancer is that they don't fear the finger, or have much patience with men who do.
They don't get cute -- as I did -- about a doctor inserting a finger into the anus to palpate a patient's prostate gland, because they know that catching it early is the best hope a guy has for survival.
Two million Americans have been diagnosed with prostate cancer at some point in their lives. This year, more than 200,000 new cases will be found. More than 30,000 Americans will die. (I owe a debt to the Hampton Roads Prostate Forum for some of this data.)
Prostate cancer is second only to lung cancer as the one most likely to kill a guy, but chances are good -- above 99 percent -- that if you catch it early, you'll survive for the next five years.
The problem is that too many people don't catch it early. They don't notice the warning signs -- the ache low in their backs, or on their hips. They won't mention their worries to their doctors because they know what will come next.
Prostate cancer occurs more often among African Americans than whites and is diagnosed later. African Americans are more than twice as likely to die from it. The reasons aren't clear. A new study on care for all cancers, from the University of Michigan, suggests that quality and frequency of care might be the culprits, as well as those late diagnoses.
"Black cancer patients don't fare as well as whites," said Arden Morris, the study's author. "Their cancers are diagnosed at a later stage, the care they receive is often not as good -- or they get no care at all. Black patients may trust their doctor less, they may be unable to pay and the hospitals that serve more black patients tend to have fewer resources."
Whatever the reason, it's a tragedy. If you find prostate cancer in time, there's a better than 90 percent chance you'll get to live another decade, and good odds you'll survive for two.
That seems like a decent bet to me. Reason enough to get checked, that's for sure.
Here's another reason: So I don't have to write about this anymore.
Next time, I promise I'll put together something less discomfiting -- religion and politics, maybe.
In the meantime, do yourself a favor and make an appointment with your doctor. Get checked.
Donald Luzzatto is The Virginian-Pilot's editorial page editor. E-mail: donald.luzzatto@pilotonline.com
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