The Rev. Charles Sineath wasn't surprised when a close friend responded to a cancer diagnosis by soberly focusing on defeating that tumor.

A serious response was appropriate, in a life-and-death crisis. Try to imagine the response he would have received, said the pastor, if he had cheerily told his friend: "Why are you focusing on that prostate that is malignant? After all, your eyes are healthy, your hearing is good, your hair is in good shape, your teeth are sound, your arms and legs and liver and heart are all in good shape. With so much that is good, why don't you focus on that instead of on your prostate?"

That would be insane. Yet this parable sums up what Sineath and others at First United Methodist Church in Marietta, Ga., started hearing when they leapt to the forefront of efforts to address the health of their denomination. Last spring, the 5,000- member church steered nearly $60,000 of the "apportionment" it is supposed to send to the national church into regional United Methodist causes that its leaders believe "honor God" and are "scripturally sound."

Naturally, United Methodists on the left side of the theological aisle oppose this stance, since it hurts their agencies and seminaries. Centrists and even some conservatives argue that the Marietta congregation and others that are taking similar financial steps are being too negative. Why focus on the bad, they ask, when there is so much good in the church?

One side is convinced the United Methodist Church has cancer. The other disagrees and rejects calls for surgery. It's hard to find a safe, happy compromise when the issue is a cancer diagnosis. Ask the Presbyterians, Episcopalians, the Disciples of Christ and others.

So it raised eyebrows when United Methodism's best-known expert on church growth and decay called for open discussions of strategies to split or radically restructure the national church. Research indicates that United Methodists are increasingly polarized around issues of scripture, salvation, sexuality, money, politics, multiculturalism, church government, worship and even the identity of God, said the Rev. Lyle E. Schaller of Naperville, Ill.

Many people are in denial, while their 8.5-million-member church continues to age and decline, he said, in the Circuit Rider magazine for United Methodist clergy. Others know what's happening, yet remain passive. One group says the church should only pursue a positive agenda of missions and evangelism. This assumes United Methodists can agree on definitions of loaded terms such as "missions" and "evangelism." Another group yearns to find common ground on issues - such as redefining marriage, or the reality of the resurrection of Jesus - on which compromises would be just as controversial as orthodoxy or modernism.

It might be necessary, he said, to offer unhappy congregations a chance to pay a fee and exit the national church's tight legal structure, receiving in return clear titles to their real estate. United Methodist leaders may have to use a word they have refused to utter - "schism."

But Schaller is convinced there is another option - creating a tent big enough to hold liberal and conservative networks within a more flexible national church. Clashing churches would agree to disagree and the denomination would allow people the freedom to put their money where their mouths are.

The result would be United Methodist conferences defined by region, ideology, cultural heritage or some combination of the above factors. Evangelicals could go ahead and form their own conference and so could others pushing for gay rights, feminism and other liberal causes. There could be a conference for Hispanic or Korean churches. Urban churches might form a network and rural churches could, too.

Perhaps, suggested Schaller, modern America is so simply too divided to allow unity in a centralized structure of church government. Yes, breaking up would be hard to do.

"What is your preference?", he asked. "Should United Methodists continue to quarrel under the roof of a relatively small tent with a shrinking number of people in that tent? A more productive approach would be to accept the growing ideological polarization as the inevitable price tag on pluralism and as a fact of contemporary American culture."