Prostate cancer

What men should know about prostate cancer

Prostate cancer is the most common cancer found in men, with many men showing no symptoms, often for many years

One in six men in Bermuda will be diagnosed with prostate cancer at some point in their lives – and they can’t say they haven’t been warned about it.

Awareness events such as Movember and Man on the Run are now established health professionals set up men’s health screening programmes and continually push prevention advice on social media.

Yet, with the island recording higher incidence rates of prostate cancer than the United States, Europe and the Caribbean, doctors question whether the message is getting through.

Fear of the rectal examination, worry over the cost of treatment and plain testosterone are some of the possible explanations for men’s failure to get themselves checked regularly.

Given that 98 per cent of prostate cancer cases in Bermuda are diagnosed in men over 50 – the average age of diagnosis is about 65 – men are advised to get tested annually from the age of 40.

However, Dr. Michael Brooks, who recently held a session of free screenings at Dynamic Urology Services on Point Finger Road, notes: “Most of them were for years and years.

“They hadn’t had a general physical, and no sort of blood test.” received abnormal results and were sent for further tests.

“It was concerning because it’s a relatively high pick-up rate,” Dr. Brooks says. there who still believe that once they feel doctor’s advice when something happens, or they have some sort of symptom.

“With regard to prostate cancer, that is often the wrong approach, since in the early stages it is largely asymptomatic. Oftentimes, when you do get symptoms, it’s at a very advanced stage.”

Dr. Brooks and other doctors have tried to improve awareness.

“I have been on radio shows, promotions on social media, but men in comparison to women are less likely to get their health sorted out and be proactive and stay well,” he says.

“My only guess is testosterone. We think about going to the doctor to get things checked or have a wellness check.”

Dr. Brooks, who practiced in his home country Jamaica and the UK before arriving an additional hurdle when it comes to prostate cancer.

“The problem comes in with rectal examination. I think still for some men it’s a huge issue. They don’t like to have the examination. examination here than in the UK.”

Dr. Michael Czerwinski, a urologist at

Dr. Michael Czerwinski

Island Urology Services, advises a blood test can still provide doctors with the details they need.

“Even if people have hesitation about having a rectal examination, just say so. If that gives us a lot of information.

“Don’t just shy away from the whole thing because of it.” and Health Centre (BCHC) show an average of 48 men per year were diagnosed with prostate cancer in the decade up to 2019.

Bermuda’s age-standardised incidence rate is about 90 per 100,000 people, compared with about 70 in the US, about 60 in Europe and about 75 in the Caribbean.

Dr. Chris Fosker, the medical director at the BCHC, says this could partly be down to Bermuda’s ageing population and high proportion of black people – both risk factors for prostate cancer – while higher reporting rates could also simply mean prostate cancer is less likely to be going undetected.

Dr. Fosker says feedback from doctors at the Dana-Farber Cancer Institute in Massachusetts suggests further investigation is needed.

“Some of their prostate specialists have commented that they do see more challenges here in Bermuda than they see in Boston. What we are trying to do is dig into the why. We are early days on that.”

He adds: “We are working on a national

Dr. Chris Fosker

Dr. Michael Brooks

cancer control plan to try to strengthen how we can use our resources to improve cancer outcomes.” to cause hesitation. “Historically, men in Bermuda may have in their head that prostate cancer may get diagnosed but didn’t want to spend their life savings on prostate cancer treatment. They would rather leave their family some money. I talk to people, they look nervous, and we say there’s no cost, and they look up and say, ‘Oh ok, yes, I’m on board.’”

Other potential factors include complacency because of a lack of symptoms, and fear of treatment.

Dr. Czerwinski says: “For men who do have symptoms for prostate cancer, they may have pain in their bones. It can start to cause blood in the urine. You don’t want to wait until those things are happening because that can be a lot more aggressive at that time.

“Cancer is a word that nobody really wants to hear. But it’s a very variable word. I have this discussion with men all the time and see the responses of people. It can be crushing to hear.

“The majority of people with prostate cancer don’t die from it. Only about 3 to 6 per cent of men will die of it.

A survivor’s story

Kevin Smith shares his experience with prostate cancer

Iwent to the doctor for my annual physical and he told me my PSA count was high. I really didn’t know too much about that but came to learn that PSA stands for prostate

So, my GP sent me to a specialist, Dr. Michael Czerwinski and he said we’re going to have to take a biopsy on your prostate, the result of which was positive for cancer.

Naturally, I was a little concerned, but since I do get regular check-ups, I knew that they must have found the cancer in the very early stages, and I decided to have a positive attitude from the very beginning and come what may.

The next step was a visit to Bermuda Cancer and Health Centre. The doctors there gave me some options. I could go overseas for treatment, or I could deal with it here, and I decided I’d like to deal with it here.

I started taking hormone tablets, and I got a hormone shot, and a couple weeks after that, I started my radiation treatment. I have to say it was a very good experience at Bermuda Cancer and Health Centre. All the ladies there were wonderful to me. They made the experience so pleasant. When you walk in, it’s so nice, and everyone is so warm and friendly. I know I’m in good hands and that I’m going to beat this.

So here I am today as a survivor and life goes on. I believe this was just a little bump in the road for me, and I plan on getting to my momma’s age — and she is 97.

Kevin Smith with his 97-year-old mother

“Another bad word is chemo. In general, chemotherapy is not part of prostate cancer treatment in the initial stages.”

Living a healthy lifestyle, of course, improves men’s chances of keeping prostate cancer at bay.

Dr. Fosker says: “You need to stay a healthy weight. Secondary to that is exercise. If you are a normal weight but are still at risk. There’s stronger evidence for exercise than anything else in terms of

“Be aware of what’s happening in your family. If your genes are going to give you prostate cancer, you might as well know about it. You can start your checks at a younger age.”