Jamaica: Men not returning for biopsies after prostate cancer screening

Jamaica Observer:-  APPROXIMATELY 50 per cent of the men who are screened for prostate cancer and told to do biopsies do not, apparently fearful that it will be a positive diagnosis.

Head of the Jamaica Cancer Society Yulit Gordon and consultant urologist at the University Hospital of the West Indies (UHWI) Dr Belinda Morrison made the disclosure during Wednesday’s Jamaica Observer Press Club at the newspaper’s head office in St Andrew.

The two said fear is one of the major barriers to screening compliance, agreeing that far too many men are afraid of the actual screening test, in particular the digital rectal exam, as well as fear of possible complications associated with surgery, in particular erectile dysfunction.

“They fear getting a positive diagnosis as well; this is why oftentimes when you call the men to come back to get their results they do not come back. At the Jamaica Cancer Society, we have a system where we call them to come back to get their results, as well as when the biopsy results come back, we call them to set up an appointment to see any of the urologists. Once you call them they just immediately think that you call them because something is wrong,” Gordon said.

At the same time, Morrison shared that the 20-year data from the Jamaica Cancer Society show most men visiting the doctor once or twice during that period.

“Yes, there is the fear of doing the physical exam, that’s one. There is the fear of the diagnosis and its impact on their life, especially as it relates to treatment-related side effects and it’s the fear of them losing their role or place in their relationship with their partners and their families.

“From the data, about 50 per cent of the men who were instructed to have biopsies done did not return. Fifty per cent! If men do not follow our recommendations, then when they do present, most times it is advanced. Consistency of follow-up is very important and if we want to send a message to men out there, we still have to take that extra step to see how they move from information to action. Why would you present for screening and you are advised to go and do a confirmatory test and you just don’t do it? It shows you just how deep this fear is,” Dr Morrison said.

But patients are not the only ones affected when they fail to return for further testing after screening for prostate cancer.

According to consultant urologist at UHWI Dr William Aiken, doctors are left feeling frustrated and angry when patients screened return years later with advanced stages of the disease.

“A lot of times these are people who, and sometimes very intelligent people, get the diagnosis and they believe that they are going to beat it with herbal treatment. There is this scepticism of the medical profession, which is highly prevalent, and I think it is increasing over time. There’s this notion that the pharmaceutical companies are in collusion with the doctors to rip the public off. Unfortunately they may come back, as they often do, sometimes years later, with more advanced disease. Sometimes it’s incurable. With that you usually have a sense of frustration and anger. This is not so much towards the patient, but just towards the whole situation,” Dr Aiken said.

He explained that the disease grows slowly when compared to other cancers.

“From the time it’s detected early to the time it may spread, it may take anywhere from five to eight years. It may take up to 10 years before you die from it. However, that’s just average. There are cancers that are highly aggressive and there are cancers that the patient will never die from. So it’s highly variable,” he said.

The Jamaica Cancer Society, as part of its campaign for Prostate Cancer Awareness month, which is being observed in September, will be staging several screening clinics along with public education presentations across the island throughout this month.

This year’s theme is ‘Men, the more you know, the less you have to fear’.

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