August 9 2002

Prostate Cancer – A Subject Most Hispanic Males Avoid

But one that needs their full attention

By Victor Menaldo

Dr. Andrew von Eschenbach, Director of the National Cancer Institute, was the keynote speaker at a town hall meeting entitled: “The National Commitment to Cancer Research”, held on August 5th at UCSD’s Salk Institute.

Travelling from the Cancer Institute’s headquarters in Washington D.C., by way of special invitation from Congressman Duke Cunningham, Dr. von Eschenbach addressed a diverse audience with considerable aplomb. He briefed UCSD Professors, area health-care professionals, medical industry executives and representatives from the state government on prostate cancer, a topic often neglected by the Hispanic community and, for that matter, the community at large. The disease is an ingrained cultural taboo for many males, who often forsake prevention and screening, that cuts across racial groups and income brackets.

Indeed, emotionally-laden discussion about the universality of this very painful and deadly disease seemed, at times, to crowd out Dr. von Eschenbach’s focus on the three pillars of prostate cancer treatment: Discovery, Detection and Delivery, which he appropriately referred to as the three D’s.

Congressman Cunningham, who represents North (San Diego) County in Congress, is a prostate cancer survivor and was the brainchild behind the event. A self-described fiscal conservative, Cunningham is an unlikely champion of federal funding for cancer research. Yet, because the Vietnam-vet lived through an ordeal that he described as “more frightening than...Vietnam”, he continually stressed that “prostate cancer is a bipartisan issue”, color-blind threat to all men’s health.

It was a welcome surprise to hear Cunningham, a Republican whose primary constituents are affluent and white, echo Dr. von Eschenbach’s clarion call: tying the research leg of the fight against prostate cancer with delivery. During a pre-event interview, the waggish congressman stated with candor: “what good is it to have one (research) without the other (delivery to those who need treatment the most).” Along these lines and in tandem with Dr. von Eschenbach, who practiced urology before joining the NCI, Cunningham stressed that prostate cancer is, above all, a “social issue” that goes beyond “political and ethnic divisions.”

Cunningham assured the audience that he advocates legislation on medical research, which does not discriminate according to location and he decried funding that singles out specific universities, institutions or communities over others that are equally deserving of financial support.

In Representative Cunningham, it appears that the Hispanic community has an unlikely ally. First, he is interested in increasing research funding, an important priority for Hispanics because the benefits of research do trickle down to Hispanic males. And especially when they volunteer for research that helps identify and target what may be culturally/ethnically endemic diseases. Second, he is an advocate of public-private partnerships, a chorus-line that was sung repeatedly at the gathering. Through this vehicle, which Dr. von Eschenbach calls a “platform for care”, Cunningham envisages an opportunity to provide under-privileged individuals with access to cutting-edge treatment. However the proof, like always, is in the pudding.

So-called public-private partnerships, in which state governments either partially fund research or coordinate programs run by private groups or universities, have had a mixed track record. And California, which often serves as a “healthcare-model” for the rest of the country, has tended to embrace these much-heralded partnerships. Unfortunately, local community activists, healthcare professionals and recent immigrants, in particular, sometimes find that navigating through a convoluted network of federal programs, state agencies, private funders and volunteers, is an onerous experience. And, yet, cooperation between these parties represents the backbone of detection and treatment.

Thus, it remains to be seen if these partnerships are a panacea for individuals who, because they lack insurance or basic information, “fall through the cracks.”

Recently, the California State Government allocated funds, gained from recent tobacco litigation, to fund an innovative program that provides men with little or no health insurance with free prostate cancer care. The program, called IMPACT, covers both immigrants and non-immigrants.

However, there is still much that needs to be done, according to Audrey Tatum. Touching on the outreach challenges that affect IMPACT ' s activities, she stressed the need to bring the screening and diagnosis component, namely the initial tests such as digital-rectal exams and biopsies that reveal if males are afflicted with prostate cancer, up to par with the treatment-component.

Counter-intuitively, it turns out that prostate cancer screening, which costs upwards of $45 per patient, is not integrated into the pre-treatment of prostate cancer administered by IMPACT. Sacramento has approved legislation for statewide screening and treatment programs but due to current budget allocations the screening program has yet to be funded. According to Olivia Fernandez, program manager for the IMPACT program in San Diego County, it is the hope that as IMPACT develops a network of treatment facilities throughout the state that funding for screening will follow.

Discrepancies between treatment and detection, underscore one of the town hall meeting’s most important motifs; one that competed with the idea that the disease is a universal threat that does not discriminate on the basis of social distinctions.

Exciting medical breakthroughs versus inefficient delivery, private sector innovation versus outdated regulation and the increasing availability of prevention strategies and targeted treatment for affluent and white Americans, in contradistinction to lackluster care for the working class and people of color, still hinder progress in the fight against prostate cancer. In a struggle this universal and this important, against a disease that afflicts males and their families alike, it was made abundantly clear by the participants at this insightful gathering how absurd it would be to stop at the water’s edge. The failure to shore-up inconsistencies between political and social constraints and the potential for victory, like prostate cancer, is a color-blind dragon that remains to be slain.


Contact IMPACT for further information on prostate cancer.

The IMPACT program offers free medical treatment for low-income men with no or little health care insurance and has been diagnosed with prostate cancer. In order to qualify, you must be over 18 years of age and be a resident in California.

For more information regarding the program and how to obtain free treatment, please call the San Diego office at 1-800-253-9808.


Contacte al programa IMPACTO para información sobre cáncer de la próstata.

El programa IMPACTO ofrece tratamiento médico gratis para hombres de bajos recursos económicos, sin seguro médico y diagnosticados con cáncer de próstata. Para calificar solo se requiere ser mayor de 18 anos y tener un domicilio particular en el estado de California.

Para obtener más información acerca de este programa y como recibir tratamiento gratuito, favor de llamar a la oficina en San Diego al 1-800-253-9808. Para su conveniencia hablamos español.

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