It's a Guy Think

"Medication combined with certain kinds of psychotherapy work," Flaherty said. But first the man must recognize he needs help. Until then, well, it's not helping the guy cause -- or a guy's cause -- to suffer in silence.

YOU SAY "Prostate gland? That's in my throat, isn't it?"

THEY SAY How could you have missed the prostate memo? Starting in the late 1980s the Prostate Cancer Education Council began raising awareness of prostate cancer. By now the digital rectal exam is such an old joke it's no longer funny, even to guys who like jokes like that.

Still, avoiding a prostate check if you're over 40 or otherwise at risk is nothing more than a stupid-guy trick.

Cancer of the prostate -- the gland that makes seminal fluid -- is second only to lung cancer as a cancer killer of men, and it occurs 70 percent more often among African American men than among whites, according to the American Cancer Society.

Almost every man has a tiny amount of cancer in the prostate at an early age. No harm, most of the time. As men get older, the likelihood of a significant amount of cancer in the prostate increases, and sometimes even that is no problem.

"Our problem is trying to figure out who is going to die with it and who is going to die of it," said E. Roy Berger, an oncologist who specializes in prostate malignancies in New York and is the co-author of "Updated Guidelines for Surviving Prostate Cancer" (1st Books Library).

Survival is best for cancers caught early. The prostate-specific antigen test and digital rectal testing have proven successful at spotting cancers that require close scrutiny. (A debate continues about PSA testing, as some think it leads to the treatment of cancers that might not have been dangerous.) A 2001 survey by the Centers for Disease Control and Prevention found that 57 percent of U.S. men 40 and over had received at least one of the tests in the past year -- a decent showing, but there's clearly room for improvement.

For the proactive man, "there's some good data that shows vitamin E does decrease the instance of prostate cancer, and some data shows lycopene from cooked tomatoes also decreases the risk," Berger said. Others studies show selenium is effective as well.

And this just in: The April 7 issue of the Journal of the American Medical Association reports an eight-year study among 30,000 men ages 46 to 81 found frequent ejaculations cut the risk of prostate cancer up to 33 percent. Hoo ha!

YOU SAY "My belly is my badge of honor. I earned it the hard way. You're not getting it back."