Celebrity Prostate Exams Too Much Reality TV?
Brad Garrett Will Get a Prostate Exam on TV, but Doctors Wonder If It Will Help Cancer Awareness
By LAUREN COX
ABC News Medical Unit
Sept. 4, 2008—
Forget strapping on a plastic wristband or plastering a ribbon sticker on his car. Actor Brad Garrett of “Everybody Loves Raymond” is going all the way to raise cancer awareness.
Tomorrow evening, audiences can see Garrett bend over and get a rectal prostate exam during the multi-network celebrity extravaganza “Stand Up For Cancer.”
“Well, how do you not play a part in something so crucial as the battle against cancer?” Garrett told ABCNews.com. “I was honored to be asked to participate, and a humorous skit about a prostate exam to heighten awareness and prevention was right up my alley. No pun intended.”
It was director Laura Ziskin who reached out to Garrett to demonstrate the screening, according to Lynn Padilla, Ziskin’s office manager. Typically, the exam involves a patient bending over and a doctor probing the rectum with a finger to feel for abnormalities in the prostate gland.
Ziskin’s office is keeping the details of what exactly the cameras will show on national TV a surprise, but promises “It will be funny.”
Despite the humor, Padilla said the goal is to raise awareness about the exam among middle-aged men.
“That’s what we’re hoping, and while that segment is on, we’ll also show a lot of information about prostate cancer,” said Padilla. According to the Centers for Disease Control and Prevention’s latest statistics, 189,075 men in this country were diagnosed with prostate cancer in 2004, and 29,002 men died of the disease. Only lung cancer causes more cancer deaths in men.
Garrett’s prostate “exam” may be the first in network news, but he’s not the first to use celebrity to raise cancer-screening awareness. In 2000, Katie Couric underwent a full colonoscopy to raise awareness of colon cancer, and many doctors noticed a “Couric effect” boom in cancer screenings afterward.
Can Garrett Match the Couric Effect?
“There is no doubt that publicity about celebrities coming down with cancer or other serious illnesses often leads many people to come in for screening and testing,” said Dr. J. Jacques Carter, assistant professor of medicine at Harvard Medical School in Boston.
Carter remembers the mammogram boom after news of first lady Betty Ford’s breast cancer broke in 1973, and his colleagues at Harvard honored Katie Couric for her colon cancer prevention work.
“I would love to see the “Garrett Effect” show up a few years down the line,” said Carter. “However, whether Brad Garrett’s DRE [digital rectal exam] will do for prostate cancer screening what Katie Couric’s colonoscopy did for colon cancer screening cannot be predicted.”
The inevitable humor, and “ick factor”of 6-foot-8-inch tall Garret getting a digital rectal exam turned off some doctors, and made others worry that it would turn men away from the exam.
Doctors who have to perform rectal exams know how emotionally disturbing the process can be for men and their partners, even if the exam is painless and short.
“My gut reaction to this was ‘bad idea’,” said Dr. Anthony Smith, a professor and chief of the urology division at the University of New Mexico School of Medicine.
“Maybe I’ll be proven wrong, but I am just basing this on what I see in the clinic when we get to the point of my saying that I will need to examine a man’s prostate,” said Smith. “Most of the time that seems to be an immediate signal for people to get up and start heading for the door.”
But other doctors believe the public responds to disturbing events on TV — just look at the number of hospital dramas and forensic science shows.
“I think the public will be grossed out at the thought at first but then curiosity will take over and they will watch just for the voyeur factor,” said Dr. Mark Kawachi, director of the Prostate Cancer Center at City of Hope in Duarte, Calif. “People love to see medical stuff that they’ve never seen before. It’s like doing something that’s secretive or forbidden.”
Whether or not Garrett’s public prostate exam gets men into the doctor’s office or sends them out of the living room, doctors are having their own debates about the rectal prostate exams. The medical community has been debating the value of digital rectal exams for years.
Is It Really Worth It?
“It is important to know that few prostate cancers are identified through this mechanism [rectal exam] alone,” said Robert H. Getzenberg, director of urology research and professor at Johns Hopkins Hospital in Baltimore.
Other necessary tests might include a blood test called PSA and biopsies. Once these tests confirm cancer, some doctors even question how effective current treatments are.
“Treatments are also controversial because it is unclear how much either surgery or radiation alters the natural history of this disease,” said Dr. Peter C. Albertsen, chief of urology at the University of Connecticut Health Center in Farmington.
“We have no significant data concerning the impact of radiation versus conservative management,” said Albertsen.
But prostate cancer advocates say that the prospect of death outweighs clinical doubts about cancer screening.
“It’s sorely needed to bring attention to the disease,” said Jamie Bearse, COO of Zero the Project to End Prostate Cancer. “Ninety-nine percent survive prostate cancer when it’s caught early. The problem is that only about half of all men at risk for prostate cancer get tested.”
“Men are different animals than women in terms of taking care of their health. Any excuse is a good one to avoid going to the doctor,” Bearse said.