The painful truth about prostate cancer

If they could envisage the agonising, excruciatingly painful manifestation of end-state prostate cancer, most Jamaican men would likely be more inclined to get screened early and upon being diagnosed with the disease be proactive in getting treatment.

Consultant urologist Dr Belinda Morrison is convinced of this based on the many sad cases of the dreaded disease she has treated over the years, as men continue to fall victim to the digital rectal examination aspect of the screening process, as well as an ingrained unwillingness to speak about the illness with even their closet relatives and friends.

"The purpose of screening is to detect the disease at a very early stage, and if prostate cancer is diagnosed at an early stage, it can be cured. That means the man will lead a long, productive life, and there are many men who are examples of this, so once detected early by doing the rectal examination, by doing the PSA (prostate specific antigen) it can be picked up and their life can basically be saved," she told last week Wednesday's Editors' Forum hosted by The Gleaner at its North Street, downtown Kingston head offices.

"Once it is not detected early and it's at an advanced stage, it means that it's either advanced outside of the prostate, or its advanced in that it has spread to distant areas like the bones and the lymph nodes. They can present in various ways - severe back pain because it's involving the bones in the lower back, and if those bones are involved, the spinal cord is involved; sometimes men present with paralysis - they can't walk," she explained.

However, even before prostate cancer progresses to paralysis, a victim may have problems like constipation and emptying their bladder which are warning signs that it is getting worse, and when the spinal cord is involved or compressed then this can lead to paralysis.

But the physical suffering can be much more devastating, according to the consultant urologist.

kidney failure

"Sometimes men come in with kidney failure, so the lymph glands in the lower abdomen, in the pelvis become enlarged because the cancer spreads there. So it blocks off the tubes draining the kidneys - those tubes are called the urethras, and so there is an obstruction to the flow of urine from the kidneys, and they can develop kidney failure. They come in and you see them all swollen, they are essentially in kidney failure. Sometimes they might require dialysis," she explained.

There are still more warning signs of advanced prostate cancer such as blood in the urine.

"It can cause significant bleeding ... so these are ways that people with advanced disease can present and as I am describing it you are realising it's not pretty. But if you come in early, you can avoid all of that and your life can be saved," Dr Morrison warned.

The urologist was careful to point out that even men with advanced prostate cancer can benefit from treatment, but there are limits to its effectiveness.

"You can treat them, but you wouldn't be promising that you can cure them," the urologist told The Gleaner.

christopher.serju@gleanerjm.com