Consultant urologist Dr Belinda Morrison feels that if men would pay as much attention to their health as they do their cars, there would be a significant dent in the increasing numbers of cases of prostate cancer, which last year claimed the lives of more than 700 men.
“The problem is that they don’t have symptoms in the early stage, so you tell them to come just for a routine check, but it is not a disease that lends itself to symptoms in the early stage, and you know how we are as people – if you are not feeling ill, you are not going to the doctor, let alone men,” said Morrison, a past president of the Jamaica Urological Society.
“So they don’t go in because they feel they are all right, and even some of them, when it is advanced and they are not feeling well, they have to be dragged by their wives and their partners to come in.”
SERVICE ON TIME
But men seldom treat their health as they do their vehicles. Even if the car is not showing signs of mechanical problems, she said there are generally efforts to get it serviced within a prescribed time period.
“You are not going to drive your car until you see all sorts of things blinking on the monitor and then you take it to the mechanic because guess what? Chances are that if you wait until it is blinking, blinking for days or weeks, whatever is there will cost you more to fix, so you say, ‘No, let me do what I have to do’.”
The general reluctance of men, especially younger men, to get screened for prostate cancer, has contributed to it being the most common cancer in Jamaica and the leading cause of cancer-related deaths. According to the Global Cancer Observatory (Globocan), Jamaica was reported as having 1,309 new prostate cancer cases in 2018, which represented 17.8 per cent of all new cancer cases.
Yulit Gordon, executive director of the Jamaica Cancer Society (JCS), said that the Caribbean has been reported as having one of the highest mortality rates of prostate cancer worldwide.
“The majority of prostate cancer cases diagnosed locally are advanced or metastatic at presentation. This is primarily because of the low levels of compliance to screening,” she said.
Both the JCS and the Jamaica Urological Society recommend that men be screened annually for the disease. A digital rectal examination or a blood test to measure the prostate-specific antigen levels are generally the screening methods used, however; there remain several barriers to screening.
“It can be cured at the early stage; that is why we want them to come in early. It is a disease that can be cured, and you can live for the rest of your life normally,” said Morrison.
Unfortunately, most of the men she sees coming in to get screened are over 60 years old and generally seek intervention because they have been diagnosed with the disease. She finds that about two-thirds of those who visit The University Hospital of the West Indies, where she works, usually do so after the cancer is far advanced.
“So ‘advanced’ would mean that the cancer has started to extend outside the prostate or spread to distant areas,” she said.
… MEN FATALISTIC ABOUT DISEASE
While men have traditionally expressed their discomfort with the rectal examination associated with detecting prostate cancer, more modern measures, such as the use of a blood test, have created other avenues for screening.
But Dr Belinda Morrison feels that the method of screening is just one of the reasons for men’s apprehension.
Morrison finds that some men just take a very fatalistic approach to the disease.
“There are some men who won’t make an appointment to come and see you because they are afraid of what you might tell them. It is not the physical exam alone,” she said.
“Even sometimes when you do the biopsy and you show them, they say, ‘But I’m not feeling any way’ and you say, ‘Well, you are not supposed to’. There is that denial, and then there is a fear of what will happen with your treatment the erectile dysfunction that may come with the treatment and all of those things,” she said.
While treatment for prostate cancer is available, it can be very costly depending on where intervention is sought. Radiation and surgery are the two options for treatment, but these generally cost in excess of $2 million each to be done. Fortunately, treatment is offered at no cost at public health facilities such as Kingston Public Hospital and Cornwall Regional Hospital. The Government has also equipped the St Joseph’s Hospital with radiation machines, and so patients also benefit under the free user fee policy.
As part of efforts to intensify the fight against prostate cancer, the Jamaica Cancer Society, in partnership with the Men’s Fellowship of the Webster Memorial United Church, will be launching a male support group this month. The group will be called ‘Brothers United Against Prostate Cancer’ and is intended to provide emotional and spiritual support to newly diagnosed prostate cancer patients and survivors.