U.S. Sen. Bob Dole broke new ground with prostate cancer, erectile dysfunction, Pepsi, and Britney Spears
Could the presidential candidate and war hero have been a candidate for active surveillance?
By Howard Wolinsky
U.S. Sen. Bob Dole (R-Kansas), 98, an unsuccessful GOP candidate for president in 1996 against Bill Clinton and a World War II hero, has died after a battle with Stage 4 lung cancer, his wife Elizabeth announced in a tweet on Sunday (Dec. 5).
Almost forgotten in obituaries was his bout with prostate cancer for which he, then 68, underwent a radical prostatectomy (RP) in December 1991 at Walter Reed Army Medical Center.
In his time, Dole became a standard-bearer for patients with prostate cancer, the second most deadly cancer in men, though several of his Senate colleagues and then U.S. Supreme Court Chief John Paul Stevens had been diagnosed with prostate cancer. The Kansas senator became a symbol like Betty Ford, the wife of President Gerald Ford, did for breast cancer in 1974.
They both urged patients to seek medical exams.
Dole also recommended that men seek the then new and controversial prostate-specific antigen blood tests, introduced in 1986. In fact, some women called Dole’s office seeking information about undergoing PSA testing themselves, exposing ignorance about the prostate gland and PSA testing.
William J. Catalona, MD, is a researcher and prostate cancer surgeon at Northwestern University’s Feinberg School of Medicine, was a pioneer in PSA testing and nerve-sparing surgery.
He said one time, he was in Washington, D. C., and received a message from Dole’s office to call the senator.
He called Dole who told him: “You saved my life. Can you come to my office right now, because I would like to show you around and have you meet some people?”
Catalona said: “When I arrived, he was a gracious, charming, and incredibly witty host, and he escorted me on a tour of his Capitol world, introducing me to a lot of well-known people. Then, he took me to a room where there were file cabinets filled with letters (more than 100,000 in number!) He was the first celebrity to go public about his prostate cancer and discuss the concerns men have about possible incontinence and erectile dysfunction with surgery.”
The late TV interviewer Larry King got Dole to open up about his prostate cancer and erectile disorder that resulted in Dole becoming a spokesman for Viagra.
This conversation made possible open discussion about prostate cancer impotence and those famous “little blue pills.”
(The ad: https://www.youtube.com/watch?v=oMeulTWdqiY)
The Dole, 98, announced he had advanced lung cancer in February 2021.
His battle with prostate cancer was more than 30 years ago, back in 1991, showing how durable treatments for prostate cancer can be.
Some of the Dole obits, such as in the Chicago Tribune and Associated Press didn’t even mention Dole was diagnosed with prostate cancer and underwent a radical prostatectomy in 1991. He did his famed Viagra commercials for Pfizer — now known for its COVID-19 vaccine. The Viagra ads became the butt of jokes even told by the sharp-witted Dole himself in 1998.
Oddly, AP mentioned the Viagra campaign, but not the prostate cancer diagnosis.
What would have happened to Dole if he were diagnosed in modern times with prostate cancer?
It was reported during the 1996 presidential campaign Dole had had a small, low-risk prostate cancer, which even back then was considered easy to treat successfully with radical surgery.
That was just when active surveillance, close monitoring of low-risk to favorable intermediate-risk prostate cancers, was available. More than 248,000 American men i. 2021 will have been diagnosed with prostate cancer this year, about half with low-risk disease.
If diagnosed today, rather than 1991, there is a chance Dole could have been a candidate for prostate cancer — though even today only 55% of American men make that choice over radical surgery or radiotherapy compared to about 90% in Sweden.
By the time Dole learned he had prostate cancer, he had already run two unsuccessful campaigns for the Republican presidential nomination. He thought his diagnosis would rule out another attempt. It didn’t. So Dole broke new ground.
No candidate for president who had been diagnosed with cancer had been elected. Dole’s death at age 98 is more proof that his cancer should never have been an issue. He ran and lost against Bill Clinton in 1996.
Dole also broke new ground in advertising as a politician promoting a commercial product — a soft drink in a 2001 Superbowl ad, referring to “my faithful, little blue friend” as he walks on a beach with his Irish setter and holds up a can of Pepsi in a “Joy Of Pepsi Commercial.” He said his blue friend made him “feel like a kid again.”
Pepsi also debuted an ad for the first time on the internet in 2001, featuring Britney Spears doing a suggestive dance. Dole, pushing 70, and his setter watched the gyrating Spears on TV in the ad. The dog whines and barks apparently at Spears’ sexy performance and a somewhat creepy Dole says: “Easy boy.” (https://www.youtube.com/watch?v=Jt8uNG02ixA)
Take that as you will.
Dole, who had a withered hand, was a can-do guy and embraced his prostate cancer diagnosis, just as he shepherded through Congress the landmark Americans with Disabilities Act that opened up the country to the disabled population.
He served as honorary co-chairman of Chicago-based US TOO, a national support group for prostate-cancer survivors.
(UsToo was founded 30 years ago by my late friend Jerry Chodak, MD, a University of Chicago urologist who created the intellectual framework for active surveillance. https://www.medpagetoday.com/special-reports/apatientsjourney/82547)
Dole even sponsored prostate-cancer screenings at the Kansas State Fair and the 1992 Republican Convention in Houston.
Many politicians and celebrities diagnosed with prostate cancer have followed Dole’s lead, including Generals Colin Power and Norman Schwartzkopf and Ben Stiller and Robert DeNiro, and Arnold Palmer. (https://www.medpagetoday.com/special-reports/apatientsjourney/82226)
Catalona said some young “stud” broadcasters tried to embarrass Dole by asking him if he was still on Viagra. “Without batting an eye, Senator Dole responded, ‘Well…, yes…. Viagra, Grecian Formula… whatever it takes …. And, by the way, once you get used to the taste, Grecian Formula is not bad.”
Dole was famous for his quips and also for putting his foot in his mouth.
Catalona said Dole brought prostate cancer awareness out of the closet and probably indirectly saved many lives by encouraging men to get tested.
The urologist recalled: “I sent him a note a few months ago when it was announced that he had lung cancer. He responded warmly with a hand-signed note that I will treasure. He was a remarkable and great man!”
Howard Wolinsky is a Chicago-based medical journalist who was diagnosed with low-risk prostate cancer in December 2010 and went on active surveillance (AS). He is the former medical writer for the Chicago Sun-Times, taught medical journalism at Northwestern U.’s famed Medill School of Journalism, and co-founded the first virtual support group for men on AS on the AnCan platform and co-founded the advocacy group for men on AS, Active Surveillance Patients International.