Sounding Alarm About Disease

In Charles County, Where Men Are Dying From Prostate Cancer At Startling Rates, a Campaign Aims to Educate Those At Risk

The preacher's words took flight in a small Pentecostal sanctuary in Southern Maryland, where men are dying needlessly of a treatable disease.

"Your body is special to God!" Bishop James M. Briscoe declaimed to 45 Sunday worshipers in the pews above the weathered linoleum floor of Free Gospel Church of Bryans Road. "God has not designed this thing for you to die prematurely! Some of you would rather not go to doctors. They would rather be in the darkness about their health. But the scripture doesn't say that."

So began a public health campaign to educate, examine and treat the men of Charles County as prostate cancer becomes a disease that is striking and killing them at an alarming rate.

Men, black and white, in Southern Maryland's largest county have the highest prostate cancer diagnosis and death rates in the state, and significantly above the national average. Local rates are climbing even as cases level off nationwide.

According to the most recent National Cancer Institute statistics, 254.7 black men per 100,000 people in Charles had a diagnosis of prostate cancer between 1998 and 2002. That compares with 226.8 in Maryland and 248.5 nationwide. More recent statistics put the rate for black men in the District at 235.6. White men also had elevated rates, with an even wider gap between local and national numbers: 174.1 per 100,000 in Charles compared with 157.4 in Maryland and 156.7 nationally.

"Like so much else about the disease here, that is a mystery," said C. Devadason, the county's health director.

The disease's prevalence in Charles over a decade has confounded epidemiologists, although they have some theories. The once-rural farming community is quickly becoming a suburb of subdivisions and strip malls, but the boom has left behind neglected neighborhoods where people have no health insurance. Many prostate cancers are slow-growing compared with other cancers and might not be life-threatening. But like many diseases, prostate cancer can go undiagnosed longer in men with poor health care, slimming their chances for survival.

And it strikes African Americans at 1 1/2 -times the rate as whites. Blacks make up a third of the county's population, one of the nation's fastest-growing black communities.

Although the U.S. death rate for prostate cancer was 38.5 per 100,000 in 2004, the last year for which statistics are available, in Charles it was 49.6. And there the disease killed at a rate 80 percent higher for blacks than whites. The District's mortality rate was 46.5.

Community and health experts have many theories for the high incidence in Charles: the tobacco use that drove the Southern Maryland economy for so many years; the jobs making gunpowder at the Navy base in Indian Head, which now makes high-tech explosives; the poverty of the isolated peninsula known as Nanjemoy.

Finding the right answer is likely to take years of costly, painstaking research. But a group of health officials, local activists and a tenacious state lawmaker have set their sights on what they say is a more urgent mission: educating thousands of men about the disease and screening and treating for free hundreds of low-income men, who are most at risk.

Experts are hailing the $280,000 program that began last month -- a shoestring budget by the standards of bigger public health studies -- as a potential model for low-income communities. Instead of scientists in faraway labs, the community is leading the way. Although the pilot program treats white and African American men, it is the black community that pushed for and has embraced the project.