Home' Trinidad and Tobago Guardian : June 30th 2013 Contents A14
Sunday Guardian www.guardian.co.tt June 30, 2013
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Black men are more likely to devel-
op prostate cancer or an aggressive
strain of the cancer as the disease
hides in an area that is difficult to
detect with current diagnostic tech-
This was the findings of a recent
study by the US-based Johns Hopkins
University on black men with "very
low-risk" prostate cancer.
It showed that Active Surveillance
(AS)---the current method to monitor
the disease---might not be effective for
black men as aggressive forms of the
cancer can be missed.
In a university publication, co-author
of the study Dr Edward Schaffer said,
"Monitoring even small cancers that
are very low risk would not be a good
idea because aggressive cancers are less
likely to be cured. It turns out that
black men have a much higher chance
of having a more aggressive tumour
developing in a location that is not
easily sampled by a standard prostate
The study suggests the development
of race-based diagnostic methods.
Agreeing with the findings of the
study, local urologist Dr Lall Sawh said
we do not have very accurate tools in
helping us to select which patients
should go for biopsies and which cancer
is likely to be aggressive and therefore
must be treated, or which cancer is
best left alone as the low aggressiveness
will mean that the patient is more likely
to die from a co-morbid condition and
not from the prostate cancer itself.
While AS is the current method used
in T&T, Sawh said that in May, the US
Food and Drug Administration (FDA)
approved three tests that would give
accurate readings on patients.
• Prostate Cancer Antigen 3---A urine
test that is done after the rectal exam-
• Prostate Health Index---A blood
test used to assess the chances of
prostate cancer diagnosis
• Myriad Polaris---A tissue test of
the biopsy specimen which predicts
the potential aggressiveness of
Sawh said the tests should reach T&T
by September, as local practitioners
would need time to learn the new tech-
He said the tests will eliminate the
currently used Prostate-Specific Anti-
gen (PSA) testing, a method of active
surveillance which measures the blood
level of PSA, a protein produced by the
High levels of PSA indicate a possible
presence of prostate cancer.
He said PSA testing was rejected by
the US Preventive Services Task Force
because of its low predictability in
detecting the cancer.
Khan: Men afraid of rectal exams
Health Minister Dr Fuad Khan said
AS remains the preferred method of
determining prostate cancer in T&T.
He agreed there was need for
race-specific studies, saying East
Indians and Chinese had lower
rates of developing aggressive
Khan, however, said the study
does not change T&T s approach
to prostate cancer.
"The study does not change
anything as they have indicated in
the last lines that more studies are
needed to determine if what they
found is correlated with true
prostate cancer behaviours.
"I don t believe any approach
will or should be modified at this
time. Active Surveillance is still
the management of choice."
Khan said the study reiterated
the need for men to undergo
prostate examinations, as delay
can lead to the disease progressing
to an advanced stage before it is
"What has been found is that
men usually delay going for assess-
ment because they do not like the
"It has been shown that the
delays can cause their demise
because when they finally go for
assessment, it is already at Stage 3.
"There are four stages of prostate
cancer, with Stage Four being the
He said most men were afraid
to undergo the digital rectal exam-
ination---where a doctor inserts a
lubricated, gloved finger into the
rectum to feel for enlargement or
growths on the prostate---because
of perceived homosexual under-
New tests to detect
prostate cancer coming
According to the WebMD medical
Web site, the prostate is a walnut-
sized gland located between the
bladder and the penis and just in
front of the rectum.
The urethra (urine tube) passes
through the centre of the prostate,
from the bladder to the penis,
allowing urine to flow out of the
The prostate produces a liquid
that strengthens and protects
sperm. During ejaculation, the
prostate squeezes this liquid into
the urethra and it's discharge along
with sperm to form semen.
WHAT IS THE PROSTATE?
Local urologist Dr Lall Sawh
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