Afro-Trinidadian males at higher risk of prostate cancer

TENISHA SYLVESTER

Men in TT are at risk of having prostate cancer and lung cancer. The Ministry of Health has taken on the issue of non-communicable diseases (NCDs) and yesterday marked a revolution of how TT’s health sector treated with NCDs (diseases that are not easily transmitted from one person to another) especially prostate cancer in men.

This was one of several messages given by Minister of Health Terrence Deyalsingh at the Men’s Wellness Clinic hosted by the North Central Regional Health Authority (NCRHA) yesterday at the Colposcopy Centre, Mt Hope Women’s Hospital, Champs Fleurs. NCRHA staff members were greeted by a large number of men as the clinic was opened at 9 am.

"In TT we have an Indo- and Afro-based population. Afro-Trinidadian males are more prone to prostate cancer and we recently had a team from Palm Springs and what we found was that for a small amount of African males there is a particularly aggressive form of prostate cancer,” said Deyalsingh as he addressed the media.

“So we want to target the males of African descent to understand that they are more predisposed to prostate cancer than other racial groupings in TT. While we target all men I want the message to go out that the Afo-Trinidadian males need to be more careful and get their prostate specific antigen (PSA) levels tested so he understands whether or not he needs intervention.” The PSA is a chemical release from a normal as well as overactive prostate gland.

The minister indicated that the Men’s Wellness Clinic’s main focus was on prostate health and screening to inform men if they needed to see a neurologist who was also on location. “In previous days a prostate screening would be done using digital rectal examination whereby a doctor inserted his/her finger feeling the prostate gland and that was one of the reasons why men typically did not like to have their prostate checked.”

“What we are using here today is blood screening via PSA tests which is a blood test that measures in your blood the level of the PSA. Once a patient gets those results it will indicate whether he needs further examination or whether he is okay. It also gives each individual male a base line to further test every six months or year and compare whether their PSA levels is increasing or decreasing similar to blood sugar levels and its base line.”

Deyalsingh said that around the world and in TT there is not a lot of men venturing into prostate screening. “We are trying to get men in the habit of screening and finding out where their baseline is for PSA and then we can take further action. The problem we have in TT as it pertains to all cancers is that we do not have a culture of screening for both men and women.”

He said people usually sought medical attention when they started presenting symptoms of cancer which could be in stage one, stage two or the extreme stages which, therefore, became difficult to manage. “What we want to do is catch people at stage one or at the precancerous stage. Therefore, it is easier to treat, less expensive on the state and your chances of living longer and not dying from prostate cancer are better, that is what we want to achieve.

“It has been a challenge to get men to firmly grasp their health in their hands and do something about it. Today is the culmination of some efforts which started in Maloney, November 2018 and earlier this year and then today we have this overwhelming response. We estimate that we have between 700-800 men who have descended on these premises today for not only free prostate screening but for a variety of medical examinations from oral to sexual reproduction to stress management.”

Deyalsingh dubbed the clinic a "one-stop shop" where participants could get their eyes tested, gain information on the role of lung cancer nurse specialists and be introduced to the fast-track referral system for potential lung cancer patients by the NCRHA Lung Cancer/ Thoracic Malignancy Unit. While men waited to be screened there were numerous lectures taking place throughout the building on maintaining a healthy lifestyle, nutrition, type-two diabetes, managing high blood pressure. There were also interactive sessions at various information booths.

Lung cancer still prevalent

The National Alcohol and Drug Abuse Prevention Programme (NADAPP) was also present at the clinic giving pertinent simulations to men on the effects of tobacco use over a prolonged period of time which can result in tooth decay, emphysema, stomach ulcers, hearing loss, cataracts, deformed sperm and even cancer. They also advocated the use of the smoking cessation clinic at the Arima Health Facility which is the only functioning public cessation clinic in the country. The smoking cessation clinic started in October, 2012 and, to date, has had over 450 patients most of whom were able to quit smoking or significantly reduce their intake. Tobacco use in Trinidad is at 21.1 per cent and this is one of the root causes of chronic disease.

Deyalsingh said, “Due to the overwhelming response we have received we will use this as a pilot to start doing the clinic on a national level with all the regional health authorities involved to have a national men’s day so we can enhance this positive behavior towards men’s health."

The five top cancers that cause death in TT in both men and women are: prostate cancer, breast cancer, colorectal/ colon cancer, lung cancer and cervical cancer. The top two for men are: prostate cancer and lung cancer.

Deyalsingh said, "Lung cancer is caused predominantly by smoking and it does not mean that someone who does not smoke cannot get lung cancer but the figures will tell you that once you are a smoker, the chances of getting cancer are much higher.”

Men can get breast cancer

However, there are some men who can also get breast cancer. Javis G Sampson Hunte the breastfeeding trainer for clients and staff of the NCRHA gave several presentations to attentive men on male breast self examination and how to do so along with testicular self-examination.

In a short interactive session the Deyalsingh spoke with members of public who were quite eager to answer his questions on NCDs which is inclusive of diabetes, hypertension, high cholesterol and cancers. The minister also promoted three ways to reduce the risk of NCDs: exercise for at least 30 minutes daily, have a balanced diet and drink lots of water.

Asked by Newsday about the time frame it took for patients to receive their results from prostate screening, the NCRHA CEO Davlin Thomas said,in the past, the procedure would usually take two weeks but now it takes approximately two hours.

NCRHA Chairman Steve De Las said, “We have two tiers of persons—the ones who are not at risk from the initial screening and they get their results within a week but for the people at risk we are keeping them one time. You may have noticed congestion and that is because we are retaining men to see the neurologist, so we have the specialist on standby here today. So once a risk is identified they are seeing the specialist immediately because we have the results within two hours.

“What we have done is create this level of awareness where we can get to you before you can get to us. This is one of several initiatives and it would significantly lessen the burden on the state in terms of the cost to treat someone who has active stage-one and beyond cancer. That is usually when the price escalates, so early detection is best.”

Shalom Williams, 25 from Curepe told Newsday that he found the experience to be an informative one. “I was forced by my fiancé to come out to the clinic. I would really like to know my PSA as it pertains to prostate and lung cancer.”

Gregory Lee Kin from East Port of Spain found out about the clinic through the advertisements in the newspaper and found the initiative to be a great one. His common-law wife 58-year-old Debra Mitchell who accompanied him for support said, “What the Ministry of Health is doing is exceptional and they are getting and overwhelming response.”

Keston Vidale, 43, from Arima said, “ I appreciate the availability if tests at our disposal today. As men we need this, the frequency and the availability of testing.”

Jomo Elijah, 69 from El Socorro said, “I am thankful for the opportunity to get a while check up, free at one place. I can’t afford private doctors to go get this done so I commend the Minister of Health for providing the screening process and proper medication to those in need.”

Throughout the day there was live entertainment by Nicki Cosby and Amritam Shakti Dance Company among others.