Home' Trinidad and Tobago Guardian : June 19th 2016 Contents • Twitter: @GuardianTT • Web: guardian.co.tt
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 doc-
tor 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
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
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
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 ultra-
sound done and subsequent biopsy.
Espinoza did not wait for doctors
to tell him to have the test done
annually. He knew he was predis-
posed, as his father died from
prostate cancer in 1995.
His first PSA test, he said, indi-
cated 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 sam-
ple being deemed 100 per cent can-
"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?"
Doctors, he said, found that the
cancer had been contained in the
prostate gland and were able to
Espinoza said he remains thankful
to God, his doctors at Medical Asso-
ciates, and to Commissioner of Pris-
ons Sterling Stewart and Deputy
Commissioner Michael Walker for
their support in expediting the
process to facilitate his surgery.
Men are more
Dr Fuad Khan, urologist and for-
mer 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 screen-
ings done year by year.
In a Guardian article a couple years
ago, Khan had indicated the intro-
duction 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 mil-
lion, plus the cost of disposables to
bring the machine here.
Khan recommended that the Uni-
versity 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
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
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
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 devel-
oped an enlarged prostate gland or
prostatitis---inflammation in the
gland. There is treatment for both
Prostate cancer screening
no longer taboo for men
SUNDAY, JUNE 19, 2016
...They have become more proactive with their health
"We need people, men to adopt the thinking that this (prostate) 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,"---Sherma Mills-Serrette, clinic manager, T&T Cancer Society.
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
It is recommended that both
tests be done, because none are
completely reliable on its own
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