Editorial

Why we should heed Dr Aiken's recommendations on prostate cancer

Friday, September 06, 2019

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When Dr William Aiken, one of Jamaica's foremost urologists, speaks we tend to listen...keenly.

On Sunday this week we published a submission from Dr Aiken in which he argued that prostate cancer is being treated here in Jamaica as a 'Cinderella disease'; meaning that it hasn't received similar allocation and mobilisation of resources and investments as breast cancer — a predominantly female disease of lower incidence and mortality when compared to prostate cancer.

He points out that prostate cancer “disproportionately affects men of African ancestry and the risk of affliction increases inexorably with age, reaching its peak incidence in men in their 70s”.

With the Jamaican population documented to be ageing, people over the age of 65 will form 16 per cent of the population, up from the current eight per cent, by the year 2030. Against that background, “We can therefore expect an exacerbation of the high death rate from prostate cancer if we don't change the way we do things,” Dr Aiken submitted.

Among other things, he recommended that a credible 'champion' of the disease be identified; someone who men respect and who can therefore serve as a role model, particularly in the area of his “health-seeking” behaviour.

“This 'champion',” Dr Aiken contends, “would serve as the 'face' of a sustained public education campaign about prostate cancer and the importance of early detection through screening.”

He also recommended that the Ministry of Health and Wellness take the lead in establishing and facilitating screening of Jamaican men through the primary health care system, so that early detection of prostate cancer is accessible to them regardless of their financial resources and geographic location.

“This is particularly important, given the known barriers to accessing health care due to a lack of money/insurance, as well as geographic barriers, especially relevant to Jamaica given the mountainous and relatively inaccessible terrain of many rural areas,” Dr Aiken stated.

His third recommendation, we believe, is even more urgent than the others. The ministry, he said, must immediately address the maldistribution of urologists and cancer specialists, who are mainly located in Kingston and Montego Bay. Urban centres such as Mandeville, May Pen, Spanish Town, St Ann's Bay, Port Antonio and Morant Bay do not have any urologists while there are seven at Kingston Public Hospital alone.

Dr Aiken also told us that in the south-western part of the island, one part-time urologist serves a population of 793,000 people. If this is so, then we agree with him that this situation is “unacceptable and inexcusable, given that The University of the West Indies has been training consultant-level urologists since 1995”.

The other recommendations advanced by Dr Aiken — that public hospitals be outfitted with the necessary equipment for timely diagnosis and treatment, and that drugs scientifically proven to be of benefit in significantly improving survival in advanced prostate cancer should be accessible to all Jamaican men through subsidies by the National Health Fund — are worthy of action.

Health and Wellness Minister Dr Christopher Tufton has demonstrated a willingness to not only listen to health care professionals, but to act on their suggestions as well. We expect that he will do so in this case.


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