First Hand: Marva Price, DrPH, RN, FAAN

Family Nurse Practitioner and Director, Family Nurse Practitioner Specialty at the Duke University School of Nursing

By Marva Price, DrPH, RN, FAAN

I first became interested in prostate cancer in 1996 when I saw fliers posted at Duke announcing a prostate cancer screening clinic. The clinic, organized by Duke prostate specialist Dr. Cary Robertson in 1990, is held once a year and is free to those who visit.

I wanted my husband, who had just turned 40 at the time, to get tested. While there is some debate among experts, many doctors recommend that men begin getting tested annually for prostate cancer at age 50.

However, doctors often suggest that men in high risk groups (African Americans or those with a family history of prostate cancer) begin getting tested at age 40.

My husband was tested, and he had such a good experience that I decided to volunteer at the clinic the next year. I’ve been a volunteer there for ten years now.

There are a number of dedicated individuals who work at the clinic including Pat Booth, a retired nurse whose husband had prostate cancer. Pat has volunteered since 1990. Also helping to organize the yearly screening is Dr. Robertson’s assistant Diane Dowdee and Mary Baldwin, nursing director at Lincoln Community Health Center in Durham.

The clinic is always held the third weekend in September and first opened at Duke University Medical Center (DUMC).

“The goal of the program was to increase screening among all men,” explains Price. “Dr. Robertson began to observe that few African American men attended the DUMC clinic, so he worked with Evelyn Schmidt, MD, director of Lincoln Community Health Center, to open the clinic at Lincoln.

Over the years, the Lincoln location has grown in attendance by men across ethnic backgrounds. In recent years, interpreters have been added to assist the Latino population with screening. Another clinic has also been opened at Duke Raleigh Hospital.

My official position at Duke is assistant professor in the School of Nursing. I love teaching nursing students, and prostate cancer screening has become another passion of mine. I spend a great deal of my time researching the disease and how to more effectively promote regular screening. Men need to be tested yearly.

The screening evaluation involves the digital rectal examination and a baseline prostate specific antigen (PSA) blood test. Subsequent annual digital rectal exams and PSA blood tests are used to determine if the protein specific antigen is rising and if so, how quickly.

Early detection of prostate cancer is essential since nine out of ten men who have an early diagnosis and timely treatment survive a minimum of five years, while only three out of ten who have been diagnosed at a late stage survive five years.

In 2006, 550 men came to the three Duke clinics. Each man who is tested is mailed his results. Those with elevated results or an abnormal digital rectal examination are asked to contact their health care provider, who may perform further evaluation or may refer them to a urologist.

It is important to note that those men with high or increasing levels of PSA do not necessarily have prostate cancer, and a doctor will need to determine how to proceed.

While the clinic is great, still more men need to be tested. Drs. Judd Moul and Daniel George can tell you stories of many of their patients who were treated at Duke and have gone on to live enriching lives.

I once received a call on Christmas Eve while on vacation from a man who participated in our clinic three years in a row. It was later determined that he had prostate cancer. He thanked me for my work at the clinic and called again later after his successful surgery.

It makes me feel good to know that Duke is committed to providing this service for the community. It can provide men with reassurance and peace of mind that they are doing the right thing to protect their health and it can provide them with an early diagnosis so they can be successfully treated and go on to enjoy life.