Each September, the National Prostate Cancer Coalition celebrates Prostate Cancer Awareness Month to raise awareness and educate the public about prostate cancer and the importance of early screening to decrease the mortality rate in the United States.

"This year we are aiming to screen 20,000 men for prostate cancer," said Brooke Saltzer, director of communications of the National Prostate Cancer Coalition. They target men over 50, but they are especially focusing on African-American men between 40 and 50 years old. In order to reach out to minority groups and underserved populations, they have planned a screening schedule to drive through different cities and states, Saltzer said.

The full-scope screening consists of the PSA test (prostate-specific antigen) and the DRE exam (digital rectal examination). Both of these exams can help physicians make a more accurate diagnosis. Men who want to be tested can choose not to take the physical examination. All of the results are handled confidentially and sent to consumers via mail.

"In general, men are more squeamish about the physical examination," Saltzer said. "They are not as apt to take care of their health. By providing education and letting men at increased risk know that they should get annual screenings between the ages of 40 and 50 is what we are trying to accomplish," she added.

"One of the primary messages is that prostate cancer is very treatable if caught early, so even if the testing procedure or the screening procedure is uncomfortable, it is one of those things where the benefit outweighs the discomfort."

The PSA is a protein made by the cells of the prostate gland and the test measures the level of PSA in the blood. The DRE is performed by a doctor to detect bumps or anomalous areas in the prostate. In some cases a doctor might also recommend a biopsy of the prostate when recurrent PSA levels are high or when the DRE shows abnormalities. Laboratory results are used to determine if further studies should be conducted.

According to the National Cancer Institute (NCI), 218,890 men will be diagnosed with prostate cancer and 27,050 will die from the disease in 2007. Among the different ethnic groups, African-American men are disproportionately affected by this type of cancer, with an incidence rate of 255.5 per 100,000 compared to 161.4 per 100,000 in Caucasian men.

Prostate cancer is a men's issue that is sometimes hard to discuss. That's why men from all ethnic and social backgrounds seek support by reaching out to others who are walking the same path.

"We have guys coming from homeless shelters and captains of industry from Wall Street sitting side by side who have the same problems and help each other," said Darryl Mittledorf, LCSW, founder and director of Malecare, Inc., a non-profit organization founded in New York City in 1997 that provides support groups and guidance to men coping with prostate cancer.

"Diet is a huge issue," said Mittledorf. "We try to emphasize exercise, diet and healthy living and try to get the guys to support each other in those areas."

Malecare is also implementing a new online support community called cancermatch.com, where people living in different areas can get connected through the Internet. The main goal of this project is to help men living in isolated areas or minority men who may not feel comfortable going to a support group.

"This way the patient can connect from home with guys online and have a support group," Mittledorf said.

Mittledorf said in the past Malecare addressed the need to have support groups for minority populations. Now they even have a support group outside of Tulsa , Oklahoma , for Native-American men.

Malecare was also a pioneer in providing services for Spanish-speaking patients and, at one point, had a specific support group targeting Dominicans with prostate cancer. In regards to Latino men, Mittledorf said that what's needed are more Latino psychologists and social workers, both to speak the language and have a comprehensive cultural approach to Spanish-speaking patients seeking help.

Arturo Castro, M.D., is the medical advisor for the only Spanish-speaking group in El Paso, Texas, called "Entre amigos: de hombre a hombre," where men with prostate cancer and their families get together once a month at Del Sol Medical Center to share their stories and support each other. They also receive a basic course on anatomy, education on different types of prostate diseases and alternative programs and diet plans.

According to Castro, sometimes the financial factor interferes in the process of getting an early screening. "Some people cannot afford the cost of a PSA exam because they have other needs," and he added that "around 40 and 50 percent of the patients who attend the support group don't have medical insurance."

Another key point addressed by Castro is that Latino men in particular are not used to going to the doctor on regular basis and he emphasized the differences between Latino men born in the United States and Latino immigrants.

"There are cultural differences and educational issues that need to be taken into consideration when we study the problem of prostate cancer among Latino men," he said.

"It is important to encourage middle-aged men to get screened to prevent advanced stages of the disease and family members play a significant role in this crusade," Castro said and added: "Many Latino men are being encouraged by their children to get tested."

This September, if you want to get screened, you are sure to find some free screenings in your area.

The Drive Against Prostate Cancer is a mobile screening program that offers free and confidential screenings. It was implemented by the National Prostate Cancer Coalition in 2002 in partnership with the Drive Against Prostate Cancer, LLC to provide free screenings and physical examinations to men all across the United States .

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Isaac Itman is a writer for the OMHRC. Comments? E-mail: info@omhrc.gov

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