Dozens of cases being found each year
More than four years ago 62-year-old David (not his real name) thought he was suffering from hypertension and visited his physician who decided to run several tests. One of the results changed the middle-aged man’s life forever: he was told he had prostate cancer.
“The only word to describe how I feel is devastation, I went to check my blood pressure and then I was told I had cancer. I did not know what to say – it took a long time for me to understand,” the man told Stabroek News in a recent interview. Since then, David has learnt all he can about the disease, has accessed treatment and has since been told he is cancer free. However, he has to make regular trips to the doctor to ensure that he remains that way.
David like many Guyanese men have been suffering silently from prostate cancer as it is not a disease that is discussed publicly as in the case of breast cancer and cervical cancer. He accepted that this may be so because men are not too keen to talk about the issue and pointed out that even though he accepted to do the interview he declined using his real name.
According to statistics available at the Guyana Cancer Board, between 2000 and 2007 there were some 577 cases of prostate cancer recorded and 427 succumbed.
But to get a clearer picture on how prevalent this cancer is in Guyana, urologist/surgeon Dr Deen Sharma said that the last time he checked his figure which was ten years ago, he was seeing 50 new cases a year. It is believed that the figure has risen since.
And according to Managing Director of the Guyana Cancer Institute, Thomas Eversley, most men prefer to access treatment privately and keep their illness a secret. As a matter of fact he said most men would prefer never to be examined in such a manner to determine whether they have the cancer and some even if they see symptoms, such as finding it difficult to urinate, prefer to ignore them.
Since the institute opened its doors in 2006, Eversley said they have only seen three men with prostate cancer, two have since died and the third never returned after he was diagnosed.
Regular screening
Since he was diagnosed David said he has been advising his friends and sons to get screened regularly and he feels that when a man reaches the age of 45 he should be screened regularly.
“The earlier you detect that something is wrong with you the earlier you can take action.” He recounted that during his treatment at the Georgetown Public Hospital Corporation (GPHC) he met some other patients “who drove fear in me” because they told him how painful their experiences were. But he later learnt that the men had such experiences because the cancer was detected when it was in the late stages and in fact one of the men has since died.
Dr Sharma, who works at Woodlands Hospital, in an interview with Stabroek News, said that the screening exercise is very expensive. He said Guyana like other countries does not have a public sector screening programme because of the cost but men can access this privately.
No early symptoms
Dr Sharma said that even though expensive the screening is important since there are no symptoms of early prostate cancer. As a result when Dr Sharma sees his patients most of them would have started to see symptoms of the cancer and it means that it would be in the late stages.
“The patient is a normal patient and the only way you can pick those up is if you have a screening programme. Unfortunately we do not have a screening programme in Guyana and a lot of countries don’t have screening programmes… because they are very, very expensive,” Dr Sharma said.
$50,000 screening fee
He noted that the screening for the Prostate specific antigen (PSA) has to be done yearly and it would be around $50,000, a sum most cannot afford.
Dr Sharma explained that prostate cancer “is a rainbow spectrum disease” as it can be very aggressive at one time and another time a person would feel nothing. He said it is internationally accepted that not every person who has prostate cancer needs treatment. The cancer first needs to be categorized and then it will be determined whether the person needs treatment.
The disease affects older men and according to the doctor the convention is that every man who lives long enough will get prostate cancer. However, he has seen a few younger men with the disease.
David recalled that after he did the tests his doctor advised him to do and he returned for the results, she began by telling him she had some bad and good news for him. She asked which news he wanted first and he told her the bad news and it was at that point she revealed that he had an enlarged prostate and he should seek treatment.
He cannot remember what the good news was as he was so “devastated” that he immediately returned home and told his wife. The good news he can remember is that his wife and entire family were very supportive and he was advised to seek treatment immediately.
Swollen breasts
He received further good news when he was told that the cancer had not spread and that it could be controlled with treatment. “I was told I was at stage two,” he said. He received treatment at the GPHC and this included hormonal therapy which, according to him, kept the prostate from becoming inflamed and the cancer from spreading. One of the side effects was swollen breasts which were also tender during the treatment. He accessed radiation treatment at the institute which saw him being treated five days a week for seven weeks and while he thought he would have experienced some pain, David said there was no discomfort. However, there were some side effects, which he had expected, and those included loose bowels, frequent urination and a burning sensation during this process.
He also experienced loss of appetite. One year has passed since the radiation treatment and David said all is well but he visits the doctor every three months just to be sure.
He has also suffered a reduction in his sex drive and he was told that this may change about two to five years after treatment.
What is prostate cancer?
According to the US National Cancer Institute website, prostate cancer is one that forms in tissues of the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum). It usually occurs in older men.
The website said that a man with prostate cancer may not have any symptoms. For men who have symptoms of prostate cancer, common symptoms include:
Not being able to urinate, having a hard time starting or stopping the urine flow, needing to urinate often, especially at night, weak flow of urine, urine flow that starts and stops, pain or burning during urination, difficulty having an erection, blood in the urine or semen, and frequent pain in the lower back, hips, or upper thighs.
