Men, get checked early!



More Barbadian men are taking charge of their health and facing up to a disease that threatens their longevity.

Prostate cancer, though still dreaded, is not as feared, and, according to the executive director and founder of Cancer Support Services, Jan Lynton, “men are stepping up to the plate and paying more attention to their health”.

For the last five years, Cancer Support Services has been raising awareness about prostate cancer and providing early screening for men by offering the prostate-specific antigen (PSA) test.

At the latest such event held on Saturday, Lynton told Barbados TODAY she was pleased with the turnout which she said had been steadily increasing.

Dr Sean Russell recommends yearly testing for prostate cancer.
Dr Sean Russell recommends yearly testing for prostate cancer.

“In the last few months, we were only doing about 60 or 65; today we did 105, and I find that younger men are coming out –– the age group between 40 and 45 –– more than older men 70 and up.”

Dr Sean Russell who was on hand to perform some of the tests and provide information, welcomed the news that younger men were coming in for testing.

He pointed out that prostate cancer tended to “behave like two diseases”, and could prove more deadly in younger men.

“In younger men it’s more aggressive; so you don’t play with it. It will take you out; that’s how it is. The younger you are, the most aggressive it is. In the older fellows, mid-70s and up, it tends to be less aggressive and it tends to just hang around there and make a bit of a nuisance of itself; and eventually it can advance and take the person away.”

Russell stressed that men should begin taking the PSA test as early as 35, and every year thereafter to reduce their risk of developing prostate cancer.

“Most people say 40; but there’s no harm in starting from 35; and the idea is annually. Whether there is a family history or not, the idea is annually.

I say that, because based on my own experience with my regular patients who will come for their medicals and once a year for their full check-up, I would do the PSA that one year is normal; and the next year it is not normal. And sometimes when it is not normal, it is prostate cancer. So if they decide to skip two or three years, when they do decide to turn up it may be too late; it may have advanced to a stage where you couldn’t get proper treatment. So the idea is to do it annually.”

The prostate gland is said to be walnut-shaped. And according to Russell, it is like a good-size guava, and is located behind the pelvic bone. He notes that men who have prostate cancer will experience common symptoms, including difficulty urinating, pain in the pelvic area and blood in the urine.

He, however, stressed that men should get tested and not wait until there are signs, because prostate cancer can be present even when some patients are symptom-free.

“In the past ten years, 100 per cent of the patients I have diagnosed with prostate cancer had zero symptoms. That means you do not wait until you get symptoms to try and deal with it. Typically, if you wait that late, it will be too late to effect a good result.”

There are two tests to diagnose the presence of prostate cancer. The PSA test measures the blood level of PSA, a protein that is produced by the prostate gland. The higher a man’s PSA level, the more likely it is that he has prostate cancer.

Dr Sean Russell performing  the PSA test.
Dr Sean Russell performing the PSA test.

There is also the digital rectal exam which men dread most as it involves the doctor inserting a finger into the rectum.

Russell points out that when both tests are done, men have a better chance of picking up the cancer.

“It is said roughly you get about 60 per cent to 70 per cent sensitivity with doing the blood test, it is more like 60 per cent with the rectal examination and when you do both it is more like 90 per cent. So in other words, if you do the blood test alone you have a 70 per cent chance of picking it up. If you do the digital rectal exam alone you have 60 per cent chance of picking it up. But if you do both, it’s like a 90 per cent chance of picking it up. So it’s still recommended to do both.”

Prostate cancer is not a death sentence and the earlier it is identified the chance of recovery is better. Russell says there are several ways to treat the disease, including brachytherapy which is a common and often successful method.

“Brachytherapy is like smart-bombing the cancer, because when you do the biopsy you can actually map out where the cancer is on the prostate gland. And then what you actually do is put radioactive seeds right beside where the cancer is and the radioactive seeds kill the cancer but leave the rest of the prostate healthy. Many of my patients have good results.”

In addition, patients can also opt for chemotherapy, or cryotherapy which involves the use of hyper-cold instruments to freeze the cancer.

Patients may also remove the prostate, but Russell cautions that this method often results in complications, including impotence and urinary incontinence.

He admits that experts are still trying to find out what causes prostate cancer, but he says there are several things that can increase your risk of developing the disease.

“Typically there are a group of things that are carcinogenic across the board – things in the diet that seem to increase the risk of cancer, whether it is colon cancer or prostate cancer and so on, whether it is highly processed food or highly fatty foods that will increase the risk.

“High fibre tends to lower the risk; higher amounts of the antioxidants A,C,E vitamins tend to lower the risk; and zinc tends to help the health of the prostate.”

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