What do actor Sydney Poitier, the late King Hussein of Jordan, US Senator Bob Dole, and the late actor Telly Savalas all have in common? Each one waged a war against the deadly and often silent killer prostate cancer -- some have won the battle, others lost.

The disease, which tends to affect middle-aged and older men, is very much a problem here in Bermuda -- it beats out lung and colon cancer as the number one type of cancer affecting Bermudian males.

Despite the danger, many men still refuse to be tested and catch the disease early -- simply because they feel a bit squeamish about getting the dreaded digital rectal examination (DRE).

But as one cancer victim told The Royal Gazette , a simple exam can save your life -- and help preserve the quality of your life.

A 60-year-old carpenter, who did not wish to be identified, emphasised the importance of knowing family medical history when being screened for prostate cancer.

"James'' told The Royal Gazette that his father, grandfather and uncle had all died from the disease.

James said when his grandfather died 40 years ago, little was known about prostate cancer -- and said it was often misnamed "stricture''.

"My father, oblivious to his father's history, was not aware of prostate cancer. When his was diagnosed, it was essentially too late -- it had penetrated the soft tissue into the bone,'' James noted.

Since heredity is the most significant risk factor in developing the cancer, James said he was lucky to be armed with the knowledge of his family medical background -- and decided to be tested for the first time at age 50.

The first time James was tested, his doctor discovered he had an enlarged prostate (Benign Prostatic Hyperplasia) which is not cancer, but can have similar symptoms.

But James' doctor noticed that his Prostate-Specific Antigen (PSA) readings were higher than normal. Although there is no PSA level that tells whether or not you have cancer, the higher the PSA level, the higher your chance of cancer.

"Once the PSA levels started to elevate, I had a rectal ultrasound and a rectal biopsy which was found to be OK at that time,'' said James.

But the following year when James had a biopsy because his PSA levels were still elevated, he was horrified to learn that he had been diagnosed with cancer.

"My first reaction was that I was absolutely devastated... after getting over the devastation, I went to the hospital and got a CAT scan and a bone scan (to see if the cancer had spread).'' James decided to tackle the cancer head-on -- and decided to gather as much knowledge as possible about the disease, spending long hours on the Internet and reading different materials.

"Because in my particular case the cancer was confined to one side of the prostate, I had options...had it penetrated the soft tissue or bone, I would've had no options,'' he noted.

James had to make a decision between having radiation treatment or a radical prostatectomy.

Both methods of treatment have pros and cons. The radical prostatectomy is most successful in the early stages because the cancerous prostate is surgically removed -- but if there isn't an accurate assessment of how far along the cancer has progressed, there can be a recurrence after a year or two.

Radiation renders the prostate ineffective -- it kills the good cells and the bad -- but if the treatment doesn't work, there are no second chances and surgery is not as effective after radiation.

After that stage, the only option is hormonal treatment which retards the cancer's growth instead of destroying it.

James opted for radiation therapy at Johns Hopkins medical centre this past December, where he received 39 treatments over a two-month period -- spending about ten to 15 minutes in hospital each day.

James was lucky because he caught the disease early -- the treatment was a success and there is a 85 to 95 percent surety that the cancer won't recur.

But he noted that too many men -- especially black men -- are developing the disease because of the stigmas attached.

One of the symptoms of prostate cancer is the inability to have an erection; but James said one of the dangers of the wonder drug Viagra is that some men take the pill to cure impotency without looking into the root causes of the problem.

"A lot of people in the States and in Bermuda are not getting treatment because of their reluctance to get tests done,'' he said.

"Men tend to think because they're not suffering ill effects, there's no need for medical attention -- but the error in that thinking is that when the prostate has reached a point when the disease starts to manifest itself, it's too late.

"People think prostate cancer is death... I visited people who thought I was going look like a skeleton, but I'm looking better than I did before,'' he said.

"My cancer was detected early, clinically -- but had I not done anything, I could've gone another four years without symptoms and it would've been too late.'' Bermuda T.B., Cancer and Health Association education director Dorothy Morgan-Swan said prostate cancer is like the male version of breast cancer -- men need to become more aware about the importance of diagnosing the disease in its early stages.

"There's a big stigma with men and getting tested -- they're too embarrassed to have someone stick their finger up their bottom,'' she noted.

"It's not the most comfortable thing in the world, but it could save your life -- if it's found late and you have to get a radical prostatectomy, you can be left impotent afterward, which is all the more reason to get it checked.

"There can also be problems with employers, since most companies don't have a policy for handling chronic illness -- most families are financially wrecked and some patients have the attitude of `oh well, I'm going to die anyway'.

"It can be an awful disease to die from, because it tends to spread into the bones -- and once it has spread to the bones, you're not really looking at a cure, you're looking at radiation to slow down the disease and help with the pain.'' February is prostate cancer awareness month. If you haven't gotten the message yet, go and get tested -- maintain the quality of your life.

Prostate cancer patients and their spouses can contact the Prostate Cancer Support Group on 297-1037.