DALLASThe American Urological Association is one of the premier
specialist medical associations and has done a great deal to advance
patient care in this field. I know the AUA works closely with AFUD,
the American Foundation for Urological Diseases, and I have a great
appreciation for the work you do. Although Im not a doctor or a
scientist, Im working with you to accomplish some of the same objectives.
I know that in the context of medicine, education takes many forms.
The kind of continuing education you are undertaking here in Dallas
is essential to your ability to stay on top of developments in your
field. But Im here today to talk to you about a different kind
of educationincreasing patient health awarenessand,
specifically, about reaching some of the most stubborn, obtuse, and
difficult patients aroundmen.
I dont think there is any doubt that our country produces the
most knowledgeable and highly skilled medical practitioners in the
world. And it is clear that medical research is discovering and
developing many innovative treatments for disease. Thats great news.
But skilled physicians and breakthrough medications wont do
patients much goodunless they see a doctor. And, sadly,
thats something a lot of men dont do. This unwillingness
to see a doctor, as you know, can have serious consequences.
Theres no doubt that men are not doing as good a job as women
when it comes to seeing a doctor on a preventive basis. A survey by
the Centers for Disease Control and Prevention said that men make
only 40% of total physician visits. And a recent survey by Mens
Health Magazine and CNN said that not nearly enough American men have
seen a doctor in the past year.
There are a lot of reasons for thisfear, denial, and
embarrassment among them. Some meneven some men with symptoms
who know they should see a doctorwont schedule an
appointment because they are afraid to find out what their problem is.
Ironically, advances in medical science give men more reasons than
ever before to see a doctor. This is a subject I know something about
personally. In 1991, I got some bad news during a medical checkup. A
routine screening showed I had elevated PSA levels. Further testing
confirmed I had prostate cancer.
This was tough news to take. Some members of my staff urged me to
keep a low profile. Get treatment, they said, but
do it quietly. I didnt take their advice. I issued a
press release and talked openly about the diagnosis, the treatment,
and the prognosis when asked about it during television appearances.
In doing this, I was inspired by the example of former First Lady
Betty Ford, who gave hope and courage to many women by talking openly
about her breast cancer. She urged women to do their own breast
self-examinations and to see their doctors for regular professional examinations.
Since my experience with prostate cancer, Ive urged
menparticularly men over 50to see their doctors more
often and to get regular examinations. Ive sponsored a Bob
Dole PSA screening booth at the Kansas State Fair.
Im not alone in speaking out. Other men, like General Norman
Schwarzkopf, and sports figures like Arnold Palmer and Don Baylor
have been talking about prostate cancer. They have joined in urging
men to see their doctors and be screened as appropriate.
An Even More Intimate Problem
I went through surgery to treat my prostate cancer. The surgery was
successful, and my recovery was complete. But my experience in
talking about prostate cancer led me to talk about an even more
intimate problem, namely, erectile dysfunctionED.
As you know, ED is a common side effect of prostate cancer surgery. I
spoke to my physician, and, at his suggestion, I enrolled in a
clinical trial for an experimental drug, an oral treatment for ED
that, of course, turned out to be Viagra.
I never really intended to talk about ED. But, last spring, I
mentioned it to Larry King during a conversation in the green
room before an appearance on Larry King Live. To my
surprise, Larry asked me about it while we were on the air. I
answered his questionpretty candidlyon national television.
What really surprised me were the responses I got to my
comments. I heard from men all across the country who were suffering
from ED and from women married to men with ED, as well. Ive
heard from physicians who dont specialize in urology, as well
as from those who do.
Almost all of the people who contacted me, by phone or by letter,
thanked me for speaking out on the subject. They talked about the
problem, about its impact on their lives and relationships, about the
difficulties they had in coming forward to seek treatment. These
people were encouraged that ED was becoming a recognized medical
problem, something that could be discussed openly.
Erectile dysfunction can result from prostate cancer surgery. But as
you know better than I, ED can be a marker for many serious
conditions, including diabetes, arteriosclerosis, and hypertension.
The doctor seeing a man with ED gets the opportunity to treat the
whole manto diagnose and treat the underlying conditions I
mentioned, and to talk about lifestyle factors that may be affecting
the patients health.
Getting the Message Across
It became clear to me that this is all part of the larger public
issue of mens health. Ive talked about some of the
problems, but there is a great opportunity here, as well. The
benefits to the public health systemand to societyof
communicating more about this subject can be enormous.
So, in recent months Ive been working on a broad range of
initiatives aimed at getting this mens health message across.
The response weve been getting tells us that we are
accomplishing a lot.
In our public health advertisements, we include an 800
number that men or their spouses can call to get more information.
The number connects them to AFUD. So far, over 10,000 men have called
that number. We dont know how many men with ED have seen a
doctor because of what were doing, but we know its a lot.
The feedback weve been getting from urologists such as
yourselves, as well as from other physicians, indicates that this new
information is having a very positive effect.
This is a great start, but theres more to be done. We can all
work together to raise awareness of the mens health issue.
Everybody has a part to play here. Men need to see their doctors more
oftenand to talk candidly with their doctors when they do
schedule a visit.
Policy makers need to see that patients have access to medical
attention. Patients also need access to innovative treatments as they
are approved and become available. Its been my experience as a
patient that physicians need to help men break the silence. They need
to ask when it seems as though men might be reluctant to talk about
You know, sometimes good things come out of bad experiences. I want
more men to see their doctors more often. And I want men to learn
more about their own health, to recognize warning signs, and to take
better care of themselves. Thats the goal Im working
toward. Again, I thank you for inviting me here today, and I welcome