HUTCHINSON — For 371 Kansas men, a trip to the State Fair this year may have been a lifesaver.
That's the number of potential prostate cancer cases discovered in screening tests the Hutchinson Clinic conducted at the fair last month.
Out of 2,569 men who got the free blood test at the fair, 160 had a level of 4 or higher for prostate-specific antigen, commonly known as PSA, said Lynn Harris, the director of marketing for the clinic who coordinates the annual screening in conjunction with the Prevent Cancer Foundation.
PSA is a protein that can indicate the presence of cancer in the prostate, a walnut-size gland below the bladder that is part of the male reproductive system.
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A reading of less than 4 nanograms of PSA per milliliter of blood has generally been considered medically normal. However, recent research has suggested follow-up tests are warranted for levels of 2.5 to 4, Harris said.
Of the 160 men who tested at 4 or higher, a dozen had PSA test levels of more than 10. An additional 211 men tested between 2.5 and 4.
Clinic doctors also conducted 43 physical prostate examinations and found eight men with prostate abnormalities.
All were advised to contact their physician for follow-up, Harris said.
The prostate screening booth has been a fixture at the State Fair for more than 20 years.
Funding for the project, about $30,000 to $40,000 a year, comes from the Prevent Cancer Foundation, the Hutchinson Clinic and its vendors, and charities associated with former Kansas Sen. Bob Dole, a prostate cancer survivor, Harris said.
Men who received the screening at the fair said they appreciate the effort.
Ronald Sturgeon said he'd had the PSA test done before at a doctor's office.
"It's a nice convenience when you can get it done at the fair," said the 65-year-old Hutchinson resident.
The quiet cancer
According to the National Cancer Institute, about 240,000 men nationwide will be diagnosed with prostate cancer this year and 33,700 will die of the disease.
Those numbers are comparable to breast cancer: 207,000 new cases and 39,800 deaths.
But prostate cancer generally draws little public notice and a fraction of the funding that goes to breast cancer awareness, which gets support from countless walk- and run-a-thons, celebrities, popular television programs and a donation checkoff on the eBay online auction site.
Even the National Football League has supplied its players with pink headbands, towels, hats and other accessories that will be auctioned off as game-worn memorabilia for the cause.
In contrast, September was National Prostate Cancer Awareness Month and passed relatively unnoticed.
Thomas Farrington, president of the Massachusetts-based Prostate Health Education Network, said he thinks economic and political factors have elevated breast cancer to prominence far beyond the attention prostate cancer receives.
Economically, screening and treatment for breast cancer are less expensive than for prostate cancer, he said.
"Men are not as open (about prostate cancer) as women are about breast cancer," he said. "Men have not made it a political issue."
Too much testing?
Even testing for prostate cancer has become a matter of controversy in the medical community.
On Friday, the influential U.S. Preventive Services Task Force, a group of physicians that advises the Department of Health and Human Services, issued draft guidelines against PSA testing for men without prostate symptoms.
The task force concluded that because most prostate cancers are slow-growing, early diagnosis leads to unnecessary anxiety and overaggressive treatment through surgery and radiation that can cause difficult side effects.
The task force "found convincing evidence that treatment for prostate cancer detected by screening causes moderate-to-substantial harms, such as erectile dysfunction, urinary incontinence, bowel dysfunction, and death," the task force report said. "These harms are especially important because some men with prostate cancer who are treated would never have developed symptoms related to cancer during their lifetime."
Virginia Moyer of the Baylor College of Medicine, who heads the task force, told the Associated Press, "We have put a huge amount of time, effort and energy into PSA screening and that time, effort and energy, that passion, should be going into finding a better test instead of using a test that doesn't work."
An opposite view
The task force recommendation drew an immediate negative response from testing advocates, including ZERO, The Project to End Prostate Cancer.
"The PSA test and advances in treatment have led to a 40 percent reduction in prostate cancer deaths since the mid-1990s, and 90 percent of all prostate cancers are now discovered before they spread outside the gland," the group said in a statement.
The American Urological Association also criticized the task force recommendation.
"Until there is a better widespread test for this potentially devastating disease, the USPSTF — by disparaging the test — is doing a great disservice to the men worldwide who may benefit from the PSA test," said a statement by association president Sushil S. Lacy, a practicing urologist and clinical professor at the University of Nebraska.
In 2009, the task force encountered controversy when it recommended against routine mammograms for women in their 40s.
Health and Human Services Secretary Kathleen Sebelius, a former Kansas governor, turned aside that recommendation and did not change federal policy on mammograms.
Harris said it is often women who motivate the men in their lives to get tested for prostate cancer at the State Fair.
"The wives would see the sign and make their husbands go have the test done," she said.
Travis Gray said parental pressure was behind his decision to get tested at the fair this year.
"They've been after me to get blood work of that kind," said Gray, a 41-year-old resident of Great Bend.
"That was painless," he said after having blood drawn for his test.
While the men who are tested at the fair are told to expect results within a couple of weeks, lab technicians at the Hutchinson Clinic stay after work on their own time to process the samples and results are usually sent out in a day or so, Harris said.
She said it's gratifying work. During her shifts at the fair this year, "I would guess I had maybe 20 individuals tell me we found their prostate cancer at the fair."