That awkward issue…

Quite a trio.

Lloyd James Austin III, the U.S. Secretary of Defense.

Charles Philip Arthur George, AKA Charles the Third, by the Grace of God of the United Kingdom of Great Britain and Northern Ireland and of His other Realms and Territories, King, Head of the Commonwealth, Defender of the Faith.

And my friend Jim, although that is not his real name, and who is a lot of wonderful things that I can’t mention because that might identify him; and since he no longer has an active public profile his medical situation is between him and his doctors, save for what he agreed to share here.

In his long and distinguished military career, Austin may have passed through Arkansas en route to one or another stateside assignment but was never posted here. Given the recently expanded mission of the Air National Guard base at Fort Smith and the on-going munitions manufacturing complex in the Camden area, an on-site inspection of either or both by the SecDef is plainly possible.

His Majesty has never visited Arkansas and there is no reason to believe he ever will.

Jim, though, is a native Arkansan, five generations deep; educated here and retired here after a working lifetime evenly divided, more or less, between private and public sectors, always in positions of high visibility.

The top man at the Pentagon, the British Sovereign and Jim: they have in common an organ specific to their gender and an ailment thereof that they share with tens of millions of men here, there and everywhere. They have a prostate problem.

That little gland, that one down there, the subject of so many dismal jokes and the source of so much illness and unnecessary death. Devilish thing, the prostate, almost guaranteed to cause a problem of one sort or another: enlargement and inflammation, or infection or – cancer. The odds of one or another affliction increase with age, until those over 65 can almost expect it. Prostate issues can mean incontinence, inconvenience, impotence. So easily diagnosed – but so often undiagnosed, a failure of patient and not practitioner.

In one recent 10-year period, about one in four incidences of cancer in Arkansas involved the prostate. Amid the carnage of last year’s legislative session, the General Assembly found it could do something beneficial: It mandated prostate cancer screening coverage by health insurance companies doing business in Arkansas.

Secretary Austin,70, was treated for prostate malignancy and then scalded for failing to notify the president and his national security associates that he would be hospitalized for treatment. Austin’s prognosis is termed “excellent,” which is likely higher than his political prognosis.

Queen Camilla’s husband, 75, chose to make public his tussle with prostate enlargement, which can occur in as many as nine of every ten men his age or older. Left untreated the condition is annoying but not lethal, and Buckingham Palace quotes His Majesty’s medical team as quite satisfied with his prospects. (His larger pain is the second of his two sons.)

So, now, Jim.

From the time he left college and began life on his own, about 40 years ago, he had always taken seriously every doctor’s insistence on a thorough annual physical exam. In recent years his GP has been an old college friend. So the checkup last month “was more of a visit,” Jim said. “We spent more time talking about ourselves, things past, things to come.”

What came next, about 24 hours later, was a telephone call from his old friend the doctor, “and there was a sense of urgency was in his voice.” The results of Jim’s PSA (prostate specific antigen) test, the most reliable indicator of prostate cancer, had soared to almost six times the previous, normal number. He urged an appointment with a urologist. Yesterday, if possible.

A digital exam by the specialist suggested nothing amiss. But then a second PSA screening returned the same troubling number, suggesting an MRI examination was in order. The images the technology produced confirmed a lesion on Jim’s prostate, but they could not establish whether the growth was cancerous or benign. The next step for Jim is a prostate biopsy.

He writes: “I’m told the procedure doesn’t take long, maybe 30 minutes. Squeamish or not, I know it has to be done. I want to know, I need to know, whether I have prostate cancer. I’m banking on one fact that seems to be undisputable: If detected early, prostate cancer can be cured and a man can go on with his life. That’s what I want to do.”

A presidential appointee, European royalty, Jim of Arkansas.

More to follow.

(EDITOR’S NOTE: Steve Barnes is a columnist with Editorial Associates in Little Rock.)