Sounding Alarm About Disease

The journey begins in the pews of the county's black churches, where a few Sundays ago, Briscoe told his congregation that the long-awaited prostate cancer money had arrived. "It's for the underinsured and the no-insured!" he said before announcing that he had been tested to set an example.

"So many men are dying," said Dolores Datcher, a local health educator whose brother and late father were affected. "The community is finally coming together."

The illness is striking men such as the Rev. George DeFord, who went for a screening at Datcher's urging two years ago and learned that his prostate gland had a tumor, but, after successful surgery, he takes comfort that he is healthy enough to indulge his newfound passion for swimming. And Gerard Myers, a retired postal service manager, got the diagnosis 15 months ago after surviving bladder cancer in the late 1980s.

Some of these men have health insurance. Others do not or fall into a group of millions of Americans designated by health experts as the "underinsured."

"I had insurance at one point," said Don Sandidge, a self-employed contractor who beat testicular cancer but lost an uncle to prostate cancer. During chemotherapy for testicular cancer, he was unable to work and could not afford the $200 monthly insurance premium. He has not taken the prostate screening.

As his friend Mark Douglass, a deacon at Free Gospel put it, "It's not a fun test," referring to the rectal exam that goes with the blood test to screen for the disease. But after his screening a few months ago, Douglass told the guys at work they should get checked. One who took his advice discovered cancer.

Datcher started to reach out to men in her county three years ago, with a small grant from the University of Maryland. "I would come to a church with a roomful of men who would tell me, 'I have no insurance. I can't get treatment,' " she recalled. The cost of a screening by a private doctor varies, but Medicare provides a $45 reimbursement for the tests and $60 for an office visit.

Datcher enlisted the Ministers Alliance of Charles County and Vicinity, local health officials and Claudia Baquet, a doctor and specialist in health disparities at the University of Maryland School of Medicine, to approach Thomas M. Middleton (D), the county's longtime state senator. The community's dramatic testimony at hearing last year helped persuade the General Assembly to set up an 18-month program for screening and treatment.

But the Prostate Cancer Pilot Program had no funding. Middleton was back before the legislature this year, having persuaded state health officials to contribute $82,000 from Maryland's tobacco restitution fund. More money came from the county and from Baquet, who is using a research grant from the National Cancer Institute.

Health officials hope to reach 2,000 men at health fairs, ethnic festivals, barbershops and, of course, churches, screening perhaps 200. A converted schoolhouse in Waldorf will serve as the health clinic, to create a more personal setting than a hospital.

In Waldorf, Wayne Barnes, 58, is starting the county's first support group for survivors. He got his diagnosis in January and chose a radical prostatectomy over radiation or "watchful waiting," a wait-and-see course often recommended for elderly men whose cancer is slow-moving. With a brother and father who also are survivors, Barnes had faithfully been screened and considered himself particularly fit. "I never smoked a day and rarely drank," the Defense Department consultant recalled. He now proselytizes his black brothers, using his leadership of his local alumni chapter of Morgan State University as a bully pulpit.

The American Cancer Society estimates that prostate cancer will be diagnosed in 186,320 men in the United States this year, 3,420 of them in Maryland. The disease is the fifth leading cause of death among men older than 45, although many more have the disease but do not die from it. Early detection has dramatically improved five-year survival rates, although they are still worse for black men.