Prostate cancer lethal

CONSULTANT urologist Dr Belinda Morrison-Blidgen on Monday made an impassioned plea to Jamaican men, aged 40 and older, to take prostate cancer seriously as it is the number one cause of cancer-related deaths in Jamaica.

“Prostate cancer is a major problem. It’s the most lethal cancer that we see of all cancers,” she stressed while speaking to reporters and editors at this week’s Jamaica Observer Monday Exchange. “Men die from prostate cancer; it is not a trivial disease. We do know that some men have low-risk prostate cancer but they are in the minority and in our population where we have high-risk men, men die. This is the stark reality facing Jamaican men who are among a high-risk population of males of predominantly African ancestry but are usually nonchalant about the matter and of the mistaken view that ‘it can’t happen to me’.”

Further, Dr Morrison-Blidgen said the deadly disease is more common in black men and less common in white and Asian men. Dr Morrison-Blidgen said men with a family history of prostate cancer are also at increased risk, plus men who are obese tend to have a more aggressive form of the cancer if diagnosed. In addition, the consultant urologist said men who smoke are more likely to die from prostate cancer.

Besides the stark reality, Dr Morrison-Blidgen said there continues to be a struggle to get men to come in early for screening, as they are often fearful of the diagnostic tests. Men should get tested once a year.

“Screening is early detection of the disease way before the men have symptoms. So it still is a major challenge even though over the many years we’ve been putting information out there. The knowledge is there but the men are still not screening and I think for this year, probably one of the things we have to focus on is breaking down the barriers to screening — the barriers in terms of fear of doing the rectal examination, access to screening points, which is what the [Jamaica] Cancer Society is trying to do…and just the fears even in terms of follow-up on whatever diagnostic tests that there are and the treatment,” she said.

Highlighting the gravity of the situation, consultant urologist Dr William Aiken said prostate cancer is a major public health problem. He stressed that more needs to be done to try to decrease the mortality rate from this disease, noting that the only sure way to reduce the death rate is through early screening.

Dr Aiken said he is concerned “that despite many years of preaching this message [of screening], we have made very little headway in my opinion and I think we need to change the way we do things”.

“I think what we need to try and do, ultimately, is to take screening to the men in their communities — because the men who we want to reach, I don’t think we are reaching them and our incidents and mortality rates as far as we know has not budged by all this effort that we have made over the years…we really need to perhaps think about changing the way we do things to make a greater impact,” he said.

He stressed that while prostate cancer is known as a disease of the ageing male, the message has to be spread about screening, “because you tend to find that a lot of men in their 40s are a little bit nonchalant and they still don’t think it’s a disease that will affect them.”

Meanwhile, consultant haematologist/oncologist Dr Gilian Wharfe advised men at a higher risk of developing prostate cancer to get screened, so if they are diagnosed and the disease is detected early, they can have a better quality of life.

“As our population ages…and we have all of these other factors, the chances of getting prostate cancer increases and therefore people need to be aware of those risk factors and recognise that they are at risk and subject themselves to the screening. A urologist will tell you that treating at that stage is going to be associated with much better outcomes and far less complications associated with treatment than when they get to the advanced stage,” she said.

Dr Wharfe said patients have a lower quality of life because of the morbidity associated with advanced prostate cancer, noting that treatment will not cure cancer patients with advanced disease. She said, sadly, when some men eventually get tested at age 60 and over, the cancer is already at an advanced stage.

In the meantime, the JCS said prostate cancer can be effectively treated if diagnosed in its early stage, however, at an advanced stage, the disease will cost millions of dollars to treat and could result in possible death.

To know their status, men are advised to get a prostate specific antigen (PSA) test and a digital rectal examination (DRE) done by a urologist, family doctor or at Ministry of Health and Wellness health centres.

Men are also being encouraged to make healthy lifestyle choices by consuming a diet low in fat; increase their intake of fruits and vegetables; eat more fish that is rich in omega-3; and exercise at least 30 minutes daily.

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