CHECK YOURSELF

Your life could very well depend on it.

This was the advice given by urologist Dr Lester Goetz who sounded an alarm over the high mortality rate of 38 percent of all men who are diagnosed with Prostate Cancer - a silent killer which was recently thrust into the public spotlight by Prime Minister Dr Keith Rowley.

What may not be well known is the fact that Prostate Cancer accounts for 20.5 percent of all cancers reported in Trinidad and Tobago and is the leading cause of mortality among men, with 63.1 percent prostate cancer cases being high risk of dying, said Dr Goetz. Urging men to get themselves tested from as early as 40 years, he said, “If you look at data of world studies on cancer, you will find that we are among the top three countries in the world in terms of mortality per population when it comes to prostate cancer.” In an interview with Sunday Newsday, Geotz said that prostate cancer is the leading cause of mortality among men in TT accounting for 38 percent, followed by breast cancer among women which accounts for 15 percent of all cancers. This newspaper was unable to confirm the statistics with the Elizabeth Quamina Cancer Registry but an official confirmed that prostate cancer was the number one cause of death among men.

Welcoming Prime Minister Dr Keith Rowley’s remarks urging men not to be too “macho” and get tested and raising public awareness on the issue, Goetz said that in TT most patients are high risk. This means that the cancer has left the prostate and spread to the bones and lymph nodes. “You don’t want it to spread. It is preventable if we can catch patients much earlier before they reach an advance stage.” he said.

The Department of Urology, San Fernando General Hospital (SFGH) latest study and publication on “Advances in Urology” authored by Ian Hosein, Rajendra Sukraj, Lester Goetz, Natassia Rambarran, and Satyendra Persaud, Goetz noted, found that 63.1 percent of prostate cancer patients in TT are high risk meaning that they come too late for tests and treatment. The study, which encapsulates a catchment area of 600,000 - about half the country’s population - found that 72 percent of the patients were of African origin.

It also found, he said, that Afro-Trinidadians presented at a higher risk, a higher Prostate-specific Antigen (PSA), and a greater speed at which the rate of cancer grows, more than any others.

“We think it may be genetic,” he said noting that “each year, we are discovering a lot of genes that is responsible for prostate cancer.” He said that 57.8 percent of those who had biopsies done at SFGH were found to have prostate cancer.

To contain the spread of cancer, he said, men are encouraged to do the PSA blood test and the Digital Rectal Examination (DRE) to pick up any signs of cancer before they experience any symptom.

The PSA will warn if there is a cancer in the system, and if so, a biopsy will then be conducted.

If the cancer is caught early, Goetz said, there is a potential cure, and 80 percent will live and may not even die from their prostate.

Noting there was a big difference in life expectancy due to testing, Goetz said, “People who we treated 25 over years ago are living because we caught them very early. There are people who come late and they only live for two years.” He continued, “We have patients who come to us bedridden.

When we ask what happen, they say they just stop walking. When we check, their legs are not moving because the cancer has left the prostate, moved to the backbone and compress the nerves going down to the legs so they become paralysed. Nobody wants to see a patient at that stage. They want to catch the cancer long before that and stop it from spreading.” Because TT’s has a large African and mixed population, Goetz said, “We recommend that men from 40 years examine their prostate and do the blood test every year and thereafter once a year. Don’t wait until you have a complaint,” he warned. The examination, he said, lasts a few seconds and was not painful. “It is just an unnecessary fear,” he said. Many men get tested on their own, some wives take their husbands for testing, some because they have reached the age of testing, and others because they have relatives with prostate cancer.

In relation to screening, Goetz said that at present it is not recommended internationally. However, he noted that previously Dr Allan Patrick, a senior urologist had done a lot of research in Tobago where he also had a screening programme going on for years. Data collected on that programme, he said, showed a significant amount of prostate cancer in Tobago. “The guidelines have changed since then,” he said, “and we now appeal to people to get tested. It is a very serious.” Meanwhile, it should be noted that the Trinidad and Tobago Cancer Society provides both the DRE and PSA testing at its 62 Rosalino Street, Woodbrook clinic.

Screening is offered at subsidised prices in a bid to make cancer screening affordable to the public.

Persons interested in making an appointment may call the society toll free at 800-TTCS (8827).

The prostate is a part of the male reproductive system, which includes the penis, prostate and testicles. It is located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). It produces fluid that makes up a part of semen.

Some symptoms of prostate cancer include difficulty starting urination, weak or interrupted flow of urine, frequent urination, especially at night, difficulty emptying the bladder completely, pain or burning during urination, blood in the urine or semen, pain in the back, hips, or pelvis that does not go away, and painful ejaculation.