Test early for prostate cancer

Screening for prostate cancer has
been and continues to be a controversial issue.

Recent studies published in the
British Medical Journal concluded that there is insufficient evidence to
support population-wide screening for prostate cancer using the prostate
specific antigen, or PSA, blood test, claiming that since the test cannot
distinguish between lethal and harmless prostate cancer, it results in
over-diagnosing and over-treating healthy men.

Controversial or not, one local
prostate cancer survivor recommends that men not only do their PSA on a regular
basis, “but start at age 30, not wait until they are 40.”

Cadion Ebanks Jr, a 54-year-old
compliance officer with the Planning Department, was diagnosed with prostate
cancer at age 44. By the time it was found, his cancer was stage 4 and
aggressive.

Mr. Ebanks had been experiencing
frequency and urgency of urination – symptoms indicative that there’s something
wrong with the prostate – for about a month before going to the doctor for an
ultrasound. The ultrasound indicated a “small spot” was present in the prostate
and his PSA level was excessively high, so the next step was the transrectal
ultrasound and a biopsy. The results confirmed what he had prostate cancer.

Considering his race and the fact
that he had a family history of prostate cancer, Mr. Ebanks would be considered
“high risk” of developing the disease. Nevertheless, even though he had heard
of the PSA test, he never requested it, nor engaged in a conversation about it
with a doctor.

“I felt fine and had no symptoms,
so I thought I was perfectly healthy,” he said. That’s the thing about cancer –
in its early stages, it rarely shows any signs or symptoms, hence, the importance
of screening.

Upon being diagnosed, Mr. Ebanks
asked if there was anything available to slow the growth of the cancer and was
given Lupron, a hormone therapy drug. The goal of hormone therapy is to lower
the levels of the male hormones, which cause prostate cancer cells to grow.
Hormone therapy can control but not cure cancer, and does not take the place of
treatments aimed at a cure.

Options

Mr. Ebanks was presented with the
options of surgery, chemotherapy and radiation therapy and, after doing his own
research, opted for low dose radiation treatment, which was administered every
day over a three-month period.

Ten years after his diagnosis, Mr.
Ebanks’ PSA level is less than one and he has received an “all clear” from his
doctor. He changed his diet, reducing the intake of red meat and fatty foods
and eating more fruit, vegetables and grains. He advises others: “Load up your
body with antioxidants because if your immune system goes down, you’re open to
attack.”

He now does a PSA blood test every
six months and encourages other men to do the same.

At this time, no medical or
scientific organisation has issued broad screening guidelines for prostate cancer.
However, for men wanting or needing to be screened, the options continue to be
the digital rectal exam and the PSA test.

Men at higher risk, for example,
those with a family history or of African Caribbean descent should discuss
starting testing at 45, and men considered at even higher risk should begin
discussions at age 40, for example, those with several close relatives diagnosed
with prostate cancer at an early age. The Cayman Islands Cancer Society also
recommends that men have both a digital rectal exam as well as a PSA when
undergoing prostate testing.

Throughout the month of November,
the Cayman Islands Cancer Society is partnering with the Lions Club of Grand
Cayman and the organisers of Movember to raise awareness of male cancer issues
and is offering free PSA vouchers and tests to eligible men at various Movember
events and at an educational awareness session to take place on Thursday, 18 November
at 7pm at the Lions Centre.

For more information on male
cancers, the Cancer Society or its programmes, call 949-7618 or email
[email protected]

Camila Muniz Ferreira is project coordinator of the Cayman Islands
Cancer Society