September is urology awareness month |07 September 2023
Dr Lespoir speaking at yesterday’s session (Photos: Joena Meme)
The Ministry of Health’s urology department in collaboration with the Cancer Concern Association, and the support of the Ministry of Local Government and Community Affairs gathered at the Takamaka community centre yesterday afternoon, to start a journey towards better health awareness.
The central theme of the meeting was to discuss urological disorders, primarily in men, but also in women, in order to raise awareness and promote education during urological awareness month in September.
It brings together a team of local health experts who will be sharing valuable insights into urology and its impact on overall well-being.
In a presentation, Dr Rahim Lespoir, urologist in the urology department, explained that the branch of urology encompasses everything related to kidney, bladder, prostate and male genitalia. His presentation also focused on prostate cancer, with the reasoning being that it is very common in Seychelles and the world.
When referring to the latter, he said the cells were regenerating in an uncontrollable fashion, citing alarming statistics for the United States in 2022, where out of 983,000 diagnosed cancer patients, 27% were diagnosed with prostate cancer during that year.
“It was the majority of the patients who had cancer. Prostate cancer was number one on the list,” he stated.
In regards to Seychelles in 2022, there were 102 male patients who were diagnosed with cancer. Out of these 102 patients, 33 were diagnosed with prostate cancer. Once again, this was the highest form of cancer.
“These statistics are very alarming because we are seeing that through the trend, it is increasing.
"Nobody knows for certain, and there is no fixed rule that says if you do something, you will definitely get prostate cancer. However, there are risk factors and contributing factors that increase the likelihood of a prostate cancer diagnosis," added Dr Lespoir.
Some of these factors include excess weight, which can lead to a hormone imbalance in men, sedentary behaviours, smoking genetics, where a family history of prostate cancer increases the risk and diet choices. It could also be a combination of all these factors.
Dr Lespoir noted that three-fourths of the time, when patients come to the hospital, they are asymptomatic in terms of prostate issues. Often, patients may initially seek medical attention for other health concerns, but upon closer examination, it may be discovered that their prostate-specific antigen (PSA) levels are elevated. In such cases, they are referred to another doctor for further evaluation to determine whether or not they have prostate cancer.
In the more advanced stages of cancer, patients often present with noticeable symptoms, including urinary frequency, interruptions during urination, blood in seminal fluid, a burning sensation while urinating, and difficulties maintaining an erection. Dr Lespoir stressed that it was important not to dismiss these symptoms, especially for individuals aged 50 to 60, as mere signs of ageing.
Instead, seeking medical evaluation is advisable, as these symptoms could signal underlying health issues, including prostate cancer. Early detection and intervention can significantly impact treatment outcomes and options for patients.
Dr Lespoir also pointed out the presence of blood in the urine, which may not always be directly linked to prostate cancer but could indicate complications related to other issues like bladder problems or kidney stones, among others.
"The first day you notice blood in your urine, it is essential to report it to us. Do not dismiss it just because it may not happen again immediately." He further explained that it was common for illnesses in this category to exhibit intermittent symptoms, appearing one day and then reoccurring after a few weeks, making early reporting and evaluation crucial for proper diagnosis and treatment.
It was pointed out in the discussion that drug users tend to receive fewer diagnosis of certain health issues compared to the general population. While it was important to acknowledge that direct research on this topic is currently limited, one prominent factor contributing to this phenomenon is the age disparity.
Typically, drug users are younger individuals, and the types of cancer discussed predominantly affect older adults. This age difference may explain the lower incidence of such diagnoses among drug users.
Dr. Lespoir's presentation highlighted various tests for detecting prostate cancer, including one that is often associated with a degree of discomfort or taboo among men. This particular test involves a digital rectal examination (DRE), where a healthcare professional inserts a gloved, lubricated finger into the patient's rectum to assess the prostate. “Just by doing this examination, as a doctor, you can get an idea on what to expect for future tests. This will help me as a doctor in my work, and you as a patient to get a good treatment,” he stated.
Another diagnostic tool mentioned by Dr Lespoir is the PSA (Prostate-Specific Antigen) test. This test measures the levels of a specific chemical in the body that can serve as an indicator of the prostate's health. Elevated PSA levels may raise suspicion of prostate cancer, although it is important to note that a high PSA level is not a definitive diagnosis on its own and further evaluation is typically required to confirm or rule out prostate cancer. The chemical is very sensible and can be increased in a number of different ways that has nothing to do with prostate cancer, such as having recent sexual activities. “When some patients come to me, I often advise them against doing things that may make your PSA level rise,” he stated.
Furthermore, ultrasound imaging of the rectum area can provide visual images of the prostate, offering additional diagnostic information. In some cases, a biopsy may be recommended as well. Biopsy procedures typically follow the DRE and PSA test. During a biopsy, a small sample of tissue is taken from the prostate for further examination. The doctor can then assess the likelihood of prostate cancer based on various factors and a percentage of confidence in the diagnosis. This comprehensive approach helps healthcare professionals make informed decisions about a patient's prostate health.
The series of meeting, which kicked off in Takamaka yesterday, will not be restricted to the south-west region. It will also cover the east, central 1 and 2, and north regions, as well as the inner islands. The overall mission is to ensure that every corner of the nation has access to vital health information.
The next session is scheduled for September 13 at the Pointe Larue community centre.
Sunny Esparon
