Prostate cancer kills more people in Trinidad and Tobago than any other cancer. Despite these shocking figures, men over 40 continue to avoid the doctor’s surgery to be tested for the disease.
The latest statistics available, dating back to 2012, put the number of deaths caused by prostate cancer ahead of breast cancer by over 50%. It’s also the most common type of cancer in the country, according to the World Health Organisation’s data.
These numbers could be considerably reduced if more men were tested, for just $330 at the Trinidad and Tobago Cancer Society.
Yet, despite these damning figures, one of the biggest problems facing the Trinidad and Tobago Cancer Society (TTCS) is getting men to get tested for the disease, its second vice chairman Dr Asante VanWest-Charles-Le Blanc has said.
The month of September is celebrated throughout the world as Prostate Health Month.
The prostate gland is only found in men and lies just beneath the bladder.
Prostate cancer is the leading cause of cancer related death in T&T.
According to the WHO’s Cancer Country Profile for 2014, prostate cancer accounted for 34.8 per cent of the 1,100 cancer related death in males in T&T.
The estimated number of incident cases for prostate cancer for 2012 was 704.
There were almost 500 more incident cases for prostate cancer when compared to its nearest rival in men.
Colorectum cancer was the second highest in this country with an estimated number of 207 incident cases in males.
Phobia of what the rectal examination involves
And while prostate cancer can be defeated with early detection men are still not getting tested.
“The biggest difficulty is the phobia of what the rectal examination involves. Just that thought alone is a big phobia among a lot of West Indian men,” VanWest-Charles-Le Blanc told the Sunday Guardian an in interview on Tuesday.
“You know they question is it going to hurt? What’s going to happen and of course the fear on the other side of that is what if you find something?” she said.
VanWest-Charles-Le Blanc, however, warned that like many other health issues, prostate problems are not likely to resolve themselves without intervention.
They may even become worse with serious consequences, she warned.
“But still the biggest hurdle is getting the men here, just to get to this point is the biggest hurdle because you have to get over the myths of what the prostate exam entails,” she said.
One of the major myths is that some men believe that the brief penetration of the rectum can change their sexuality.
“But once we keep and continuously educating the public on the importance of screening and that is what the Trinidad and Tobago Cancer Society focuses on, screening being our best weapon against prostate cancer, and any other cancer as a matter of fact, because it gives us early detection,” VanWest-Charles-Le Blanc said.
“Once we continuously reiterate and repeat that and have that going then we can get over the hurdle,” she said.
Afro-Caribbean men are a high-risk group for prostate cancer.
“Because we are in the West Indies it is considered that that is the high-risk population, so from age 40 we recommend your first examination,” she said.
The prostate often gets enlarged gradually after the age of about 50.
After age 50 it is recommended that tests are done annually.
Only $330 to get tested
The prostate examination involves “two tests that go hand in hand”, VanWest-Charles-Le Blanc said.
Those two tests are the Prostate Specific Antigen (PSA) blood test and the Digital Rectal Examination (DRE).
The PSA is a blood test that examines levels of a specific protein produced by the prostate.
The TTCS charges $180 for the test and results are usually received in a two week period.
The second test is the Digital Rectal Exam (DRE).
“That is the one that everybody is afraid of,” VanWest-Charles-Le Blanc said.
One of the things men fear is the “vulnerable” position they are placed in, she said.
“The position I usually recommend for my patients is to put them in a fetal position so they are lying on their side, with their knees to their chest and obviously their posterior end is toward the examiner,” VanWest-Charles-Le Blanc said.
The second fear is the way the test is actually done.
“We use our index finger and we generally insert our gloved finger, which is lubricated, into the rectum and we are feeling the prostate,” she said.
“We are feeing the posterior aspect of the prostate and we are feeling for the size of the prostate because from experience we know what the size of the prostate should be, it feels most times like a walnut. We are feeling for an increased emphasis on the lobes and we feel the surface to see if there are any nodules. We feel the consistency to see if it is soft or hard,” she said.
All this takes less that a minute, she said.
“It is very, very quick but it gives us a lot of information so that along with the PSA allows us to decide what our next move is,” VanWest-Charles-Le Blanc said.
The TTCS charges $150 for the DRE.
The costs of the tests are subsidised.
VanWest-Charles-Le Blanc urges men to get tested.
One of the tell tale signs of prostate problems is difficulty in urinating.
“This is a cancer we can beat. You can survive this, you do not need to succumb to this due to ignorance, you can beat it and knowledge is power,” VanWest-Charles-Le Blanc said.
“It is not like a death sentence it is something that can be fought and the earlier that you detect it the better off you are. It does not mean no more of a sex life because that is what some men think it means. Men think if I take out the prostate I would not have anything else, but treatment has improved immensely, it has changed over the years and has become so much less invasive with earlier detection that it is amazing now how many prostate survivors we do have,” she said.