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US Defense Secretary Lloyd Austin underwent surgery late last month to treat prostate cancer — a diagnosis and treatment plan he initially kept secret from his boss, and the American public. It wasn’t until several days after Austin ended up in the hospital due to complications from the surgery that the information was announced by the Pentagon.

Austin’s efforts to keep his health care scare under wraps backfired very publicly: Lawmakers on Capitol Hill demanded an internal review of Austin’s office and the Pentagon’s inspector general launched a probe into policies around the transfer of power.

But it was his efforts to keep details of his condition secret that caught the attention of longtime cancer screening advocate Howard Wolinsky. Wolinsky is a former medical editor of the Chicago Sun-Times who was diagnosed with prostate cancer in 2010. He now helms a Substack newsletter dedicated to all things prostate cancer called The Active Surveillor.

“Thirteen years ago, I was diagnosed with low-risk prostate cancer and came this close — my fingers are close together — of having surgery that, in the end, it turned out I didn’t need,” Wolinsky said. “And it put me on a path that I never expected of creating support groups for men with low-risk prostate cancer like I have.”

Noel King, host of Vox’s Today, Explained podcast, spoke to Wolinsky and about the stigma associated with a diagnosis like Austin’s and the fear many men have when it comes to the prostate exam itself; and to Dr. Michael Leapman, a urologic oncologist and associate professor of urology at the Yale School of Medicine.

A transcript of their conversation follows, edited for length and clarity.

Noel King

I wonder if we can get very basic, very remedial for a second, and you can just tell us what a prostate is and who has one.

Howard Wolinsky

The prostate itself is a gland. Often you’ll hear it’s the size of a walnut. But that’s kind of misleading. I mean, when…

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Vox is an American news and opinion website owned by Vox Media. The website was founded in April 2014 by Ezra Klein, Matt Yglesias, and Melissa Bell, and is noted for its concept of explanatory journalism. Vox's media presence also includes a YouTube channel, several podcasts, and a show presented on Netflix.

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