PROSTATE cancer appears to be the biggest health concern among men, especially those with whom the Jamaica Observer spoke. Men are not only worried about being diagnosed with and treated for the condition; most men are fearful of the exam that they described as “intrusive”.

Describing the process to diagnose prostate cancer in an interview with Your Health Your Wealth, Consultant Urologist Dr Robert Wan admitted that the test is two-fold, and that men are usually opposed to only one aspect of it.

“One is a blood test which nobody usually objects to – taking the blood to measure what is called the PSA or Prostate-Specific Antigen. If it is abnormally high, it would suggest that there is a chance that this person may have prostate cancer,” he said, adding that the generally accepted upper limit of a normal PSA is 4.0 ng/mL.

He said that at that level there is usually a 30 per cent risk of prostate cancer, and that the higher it climbs the greater the risk.

But, while men do not object to the blood test, Dr Wan said most men worry about the digital rectal exam.

“So, how it is accomplished, the man is usually lying on his side or he is bent over, and the physician would put on a glove, of course, and lubricate it with some water-soluble jelly, so it is pain-free,” the consultant urologist explained. “And the finger is inserted in the rectum, because the prostate gland can be felt with a finger in the rectum.”

He said the gland is then palpated, which is essentially the surgeon feeling the prostate for abnormality, such as a lump or a hard area.

“And if a lump or a hard area is found, then it increases the risk for prostate cancer,” Dr Wan continued.

If either the blood test or the digital rectal test is abnormal, the next test would be a biopsy.

With the biopsy, an ultrasound instrument is inserted into the rectum.

“So, the ultrasound instrument takes images of the prostate, so it is done live. So, there is a continuous display on a monitor and the surgeon would use that monitor to guide a needle into the prostate,” Dr Wan described. “A needle actually goes into the gland and takes samples out of the gland.”

He explained that the sample is then submitted to the lab and the pathologist would provide a report, which would indicate whether it is indeed cancer or not. He said that the report could also say it is borderline.

Dr Wan noted that the number one cause of cancer deaths in Jamaica is prostate cancer, so it is something to be concerned about.

“When a Jamaican man reaches 40, I think he should obtain a PSA test,” Dr Wan advised. “And a single PSA test at age 40 or 45 can give a good idea of what the risk is likely to be, and then we can take it from there.”

So, have you been screened for prostate cancer?