Saturday, 10 February 2018

On the increase in Jamaica

A great take on Prostate Cancer by a Jamaican doctor...

Dr. Franklin Johnston

There are too many men dying of prostate cancer. The numbers dying from cancers before time is close to homicide, but spend is minuscule compared to the security budget. Are all lives of equal value? Many of high and low estate left and faced this implacable foe in silence.
In this 21st century cancers are still spoken of in hushed tones, so is it seen as personal failure or embarrassment? We don't know to avoid cancers, but we should avoid smoking and alcohol, as well as embrace healthy diets and exercise. The Institute of Health Metrics & Evaluation reports the major causes of premature mortality in Jamaica as diabetes, cerebrovascular disease, cancers, and road traffic crashes — and we add murder near top of the list.
A Pan American Health Organization report in 2012 indicates that for men the order was lung, prostate, and bowel; and for women breast, cervix and bowel cancers. The local cancer profile is “some 4,981 cancers in Kingston and St Andrew between 2003 and 2007-2536 in males and 2445 in females” (Jamaica Cancer Society).
Good national stats are hard to find, so we should do a better job as maybe cancer, not murder, is our real enemy. Cancer Research UK indicates death from prostate cancer has moved above the breast cancer rate. Is it so here? 
In Britain, there is debate as to why funding for breast cancer is twice that of prostate cancer given the death rate and the major donors are men. We wrote of the generosity of local Masonic lodges and enlightened self-interest works, but why do men give more to breasts than their own prostates and longevity?
Prostate health is important as prostate cancer is not inevitable. Men need to pay attention from early and do a routine prostate screening. We must eat healthy, good portions of fruit and vegetables, limit salts, sugars, fats which add allure to a meal but in excess is bad. Men's minds move to the extreme with regard to prostate cancer, but it is not a death sentence with regular screening, which is why deaths are so painful. Men need to care themselves as women do.
Prostate screening needs innovation as internal medical screening is technology intensive, and rarely invasive, which reflects research and development spending. Prostate screening is feral. Surely science can do better than sticking a digit into a man's anus? Is global research and development at fault, or trickle down not working? The Digital Rectal Examination (DRE) is the first step to declare prostate health, then a prostate-specific antigen blood test; imaging the prostate and finally a biopsy to harvest small tissue samples for testing. None is painful, but all have discomfort. Most men hate the DRE as the antithesis of manliness; some believe homosexuality is nurture, not nature, and fear that 50-year-old Mr Brown will “catch it” and emerge from doctor's office gay.
Peeps say women are used to vaginal exams since teenage, and it is still upsetting so consider a man who comes to DRE as an adult — see, where yuh a put dat? The prostate is sized like a coolie plum and grows with age, so as the space between “balls, penis and bladder” is small, it pushes the other furniture around and the small passage may be squeezed so urine dribbles or spurts irregularly not a steady flow. Some men have no symptoms of prostate cancer — no blood in urine, pain, frequent urination at night. But a few beers, lots of water or coffee late evening can also have the same effect.
Men own most things; have most money and big jobs but do not fund prostate things as imagined. Why? Some died and never gave donations. Peeps say more men donate, yet even after gaining the knowledge, men donate more to breast cancer than to prostate. Are men wary to be identified with the prostate but not with the breast? Peeps say men avoid prostate as people may think they have it or put “goat mouth” on them-superstitious despite iPhone and degrees!
What can we do? The order of premature deaths among men is murder, lifestyle diseases (heart, diabetes), cancers and car accidents. Prostate cancer is a big man killer and, as Cabinet is a powerful caucus of men, it should assist the Jamaica Cancer Society big time. Politicians moan about slavery and reparation they can do nothing about, but they can save black men's lives today. Will they? The Jamaica Cancer Society needs a user-friendly website with a discrete area for each of our five main cancers to lend clarity. The Prostate Health section would have cutting-edge reports (or links) on diagnostics, screening, symptoms, therapies and cures. Even politicians with cancers choose to die quietly “after a short illness”, not stand by the Jamaica Cancer Society. Why? Ronnie Thwaites, Member of Parliament, is in a Jamaica Cancer Society advert as a breast cancer survivor; who else? Minister of Health Christopher Tufton must publish approved local cancer remedies as many are duped daily. The Jamaica Cancer Society website must link YouTube or create local videos to demonstrate the DRE, PSA, diet, exercise, etc. We need a financial regulator to help people in a health crisis as many lose savings, car and house chasing fanciful cures when most vulnerable. Public education targeted to dozens of Mechanics and Freemason lodges; drivers, sugar estate, farm workers, male-dominated jobs and schools, colleges can all help as sustainable prostate health begins before 40. We can change the male health profile in a few years. Stay conscious!

Franklin Johnston: Feruary 2018