
Valdeen Shears-Neptune
For most men having an invasive prostate exam is emasculating and humiliating but for Thomas Espinoza, being proactive about men’s health shows the strength and courage of manhood.
Espinoza, a former superintendent of prisons, is doubtful he would be alive to celebrate his 60th birthday next month, had he shied away from having a Digital Rectal Examination (DRE) done earlier this year. This test entails the insertion of the doctor’s finger into the patient’s rectum to feel for bumps and abnormalities in the prostate gland.
A stickler for keeping abreast with his health, Espinoza noted that it was also not the first time he had done the test. Now on pre-retirement leave, Espinoza is recovering from surgery having been diagnosed in March with Stage 111 prostate cancer. The father of four had surgery done on April 7.
Espinoza had some words of advice for fathers and men in general: “Please fathers, do the tests, if not for yourself, then find out for your children, to lengthen your lives so you can be there for them. To see them grow into men and women and then to encourage them to do the same.”
Espinoza, who spent 38 years in the prisons service and is outgoing president of the Prisons’ Youth Club, said it was ironic that he had felt he was “on top of things” regarding his health.
At age 40, he had the Prostate-specific Antigen (PSA) test done. This test offers a rating from 0.0 to 0.4 as safe from cancer. A rating over four would result in the patient being urged to have a rectal ultrasound done and subsequent biopsy. Espinoza did not wait for doctors to tell him to have the test done annually. He knew he was predisposed, as his father died from prostate cancer in 1995.
His first PSA test, he said, indicated all was well and continued this way up until last year. His PSA tests, though, had been showing a steady increase in levels from 0.4 to 3.8 by the time he felt his first sign that something was wrong.
“I had no real signs that I was ill. Nothing, save for a funny sensation in my privates a couple months ago for two days. I also found that it took a little while longer for me to urinate, but I took medication for stoppage of water and felt fine. That’s the trick with cancer, it can creep up on you when you think you are as fit as a fiddle and in the prime of your life,” he said.
As an infirmary officer, Espinoza said he was known by his family and colleagues to be a watchdog for good health. He said red flags went up when he felt those funny sensations and he had another DRE done in February this year. This was followed by an ultrasound and biopsy.
Of the six samples taken, three came back malignant, with one sample being deemed 100 per cent cancerous.
“Think about it, had I just shrugged off that feeling, felt like I had done enough rectal tests and considered myself safe because my blood test said I was below the safe level, then where would I be today?” he asked.
Doctors, he said, found that the cancer had been contained in the prostate gland and were able to remove all.
Espinoza said he remains thankful to God, his doctors at Medical Associates, and to Commissioner of Prisons Sterling Stewart and Deputy Commissioner Michael Walker for their support in expediting the process to facilitate his surgery.
Men are more proactive—Fuad Khan
Dr Fuad Khan, urologist and former minister of health, said the numbers have definetly changed as men are more proactive and are accessing screening more.
“It may not have lessened the number of cases of prostate cancer, but it certainly has increased early detection and lives saved,” he stated.
Khan added that while the DRE was a “no-no” for years for most men, awareness and the new advances in treatment are assisting in increasing the number of screenings done year by year.
In a Guardian article a couple years ago, Khan had indicated the introduction of the robotic prostatectomy method. The treatment is minimally invasive and uses robots to remove the prostate gland. However, it would have cost the country over US$1 million, plus the cost of disposables to bring the machine here.
Khan recommended that the University of the West Indies consider purchasing one for training purposes. This aside, Khan said even with a cancer diagnosis, there are other options besides surgery.
Khan said The High Intensity Focused Ultrasound (HIFU) is highly recommended because it does not require any surgery. The procedure involves the insertion of a miniscule ultrasound tube into the rectum and the melting of the abnormal cells. It is also the only treatment that does not lead to erectile dysfunction. He said he has performed over four such procedures and to date, his patients are doing well.
Screening jumps significantly in one year
Sherma Mills-Serrette, clinic manager at the T&T Cancer Society supported this by saying the clinic has seen a significant increase in screening from last year to date. In a telephone interview last week, Mills-Serrett said last year the clinic recorded over 400 screenings for prostate cancer. However, to date, the figure has crossed 800, she noted.
The society, she added, is always working on strategies to raise further awareness and dispel the notion that the DRE tests is negative in any way.
“We need people, men to adopt the thinking that this test is as required as immunisation when you are a child. For protection, see it as a medical procedure and nothing else. See it as the test that could very well save your life,” Mills-Serrett said.
She also noted that people often allow fear of the unknown to get the better of them.
A prostate test, she said, is not conducted to detect only cancer. In some cases a man may have developed an enlarged prostate gland or prostatitis—inflammation in the gland. There is treatment for both conditions.
FACTS ABOUT PROSTATE
From birth to 40 the prostate gland remains unchanged. The gland is likened to that of a walnut and is supposed to be ridged or lined. If it is smooth then this is a sign that there is some sign of abnormality. This does not mean cancer. Early detection is the only protection against cancer.
It is recommended that both tests be done, because none are completely reliable on its own