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Prostate cancer is the most common cause of cancer deaths in Jamaican men. If caught at an early, localised stage, prostate cancer is curable. Even advanced cancer can be treated with drugs made more available under the National Health Fund.Yet, it is estimated that 40 per cent of men with this disease are not aware of the problem. Two-thirds of the men who present with symptoms of prostate cancer already have advanced disease. March 7-13 was recognised as prostate cancer awareness week. This week I will explain how prostate cancer can be detected at an early stage.

Digital rectal examination

Most physicians recommend a digital rectal examination along with prostate-specific antigen (PSA) testing for detecting prostate cancer. The digital rectal test allows the physician to appreciate the size, texture and uniformity of the prostate gland.

The gland enlarges as men get older but when the physician feels a stone-hard, enlarged gland, this suggests cancer. Some men are wary of this test because of the association with homosexual acts. However, the digital rectal examination is vital for identifying cancer in the prostate.

Prostate-specific antigen test

The PSA test detects levels of the prostate-specific antigen in the blood. This substance is normally produced by the prostate to liquefy the seminal fluid. When it is found in abnormally high quantities in the blood, it may indicate prostatic problems such as infection or an enlarged prostate due to benign prostatic hyperplasia (BPH) or prostate cancer. Together, these two tests indicate the likelihood of prostate cancer and thus the need for a prostate biopsy. Usually, the prostate biopsy can confirm that cancer is present.

Who should be tested?

Some physicians recommend that all men over the age of 50 have screening for prostate cancer. But persons with family members who have prostate cancer and consume a diet high in fat should consider screening for this cancer at an earlier age. While these tests allow early detection of the cancer, there is still equivocal evidence that early detection of prostate cancer improves overall health outcomes. Studies are being conducted to find out whether screening reduces overall death from this disease.

How often should men be screened?
There is no clear criteria for determining how often these tests should be done, but more frequent testing will identify more cancers. Again, the frequency of testing required will depend on the age and health of the man, his family history and other factors which put him at risk of having this disease. However, yearly screening is usually recommended.

Talk to your physician

The PSA test and the digital rectal examination are simple to do. Together, they permit early detection of cancer in the prostate by indicating the need for a biopsy. Newer treatments for prostate cancer have improved quality of life for affected persons. It is therefore recommended that men should discuss the risks and benefits of doing these screening tests with their health provider to improve their longevity and well-being.

Article by Dr Pauline Williams-Green, featured in Jamaica Gleaner News, March 26, 2008

Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians; email: yourhealth@gleanerjm.com.

For more information about prostate cancer, symptoms and treatment options, visit www.proxcelan.com.

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