November 28, 2012

Questions about Dr. Laura’s awareness of men’s health awareness

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Dr. Laura Berman, self-proclaimed “star” of “In The Bedroom with Dr. Laura Berman,” was allowed to post this on the Chicago Sun-Times website regarding Movember and mustaches and prostate cancer:

“Men greatly underestimate their risk of prostate cancer. Even though one in 6 men will be diagnosed with prostate cancer in their lifetime, almost two-thirds of men (63 percent) think it is unlikely they will ever be diagnosed with prostate cancer. This disparity between men’s risk of cancer and their perceived cancer helps to drive home the message that we need more awareness and education when it comes to this disease.”

Richard Hoffman, MD, MPH, FACP

Because I had questions about Dr. Laura’s level of awareness of this men’s health awareness issue, I asked one of our expert editors, Dr. Richard Hoffman, to review what Dr. Laura wrote. Here are his comments:

Dr. Laura presents an interesting perspective on prostate cancer. In a survey supported by the Informed Medical Decision Foundation, we found that men actually markedly overestimated the actual risk of being diagnosed with (35% vs. 16%) and dying from prostate cancer (20% vs. 3%). Maybe the Janssen Biotech survey to which she refers is an encouraging sign that men are increasingly knowledgeable about the risk of prostate cancer—4 out of 6 men recognize that 5 out of 6 men won’t be diagnosed with cancer.

The cancer risk statistic is also somewhat misleading because it’s inflated by PSA testing. Before PSA testing was introduced, the lifetime risk of prostate cancer was about 1 in 12. While PSA testing has doubled that risk, we recognize that up to 40% of PSA-detected cancers are probably overdiagnosed—they never would have caused any problems during a man’s lifetime. Even though PSA testing has led to over a million additional men being diagnosed with prostate cancer—the majority of whom underwent aggressive treatment–the lifetime risk of dying from prostate cancer has remained around 3%.

Another important point is that most prostate cancers are being detected in asymptomatic men. Unfortunately, there are no warning signs that are specific for prostate cancer. Urinary symptoms can be associated with prostate cancer, but are far more likely due to benign enlargement of the prostate—part of the normal aging process. Erectile dysfunction is also part of the aging process, though in older men it may be related to medical conditions such as diabetes or cardiovascular disease. While back pain is a sign of advanced prostate cancer, the vast majority of men with back pain—and swelling of the legs and feet and weight gain—do not have prostate cancer. Misinforming men that these are warning signs will just create unnecessary anxiety—and likely lead to unnecessary testing. Dr. Laura is on much surer ground admiring mustaches and recommending passionate sex.

And that is how you raise men’s awareness. We hope it raised the awareness of Dr. Laura, of other Movember promoters, and of editors at the Chicago Sun-Times. How low can that paper go?

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