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Homophobic men & prostate cancer

By Eulalee Thompson

Prostate cancer is the leading type of cancer among Jamaican men but getting men to do regular screening tests is like hitting one’s head against a brick wall. Many men feel that just by doing the digital rectal examination, they bring into question their own sexuality.

IT IS an uphill struggle for the Jamaica Cancer Society (JCS) to entice more men to do regular prostate cancer screening tests. Only one in every 100 (or one per cent) of Jamaican men are turning up at the JCS’s cancer screening clinics.

Year after year, the number of men turning up for screening, remains virtually unchanged. For example, only 281 men were screened in 2000 and 282 in 1999 in a population of 2.5 million people. On top of this, most of the men being screened were actually having the test done for the first time, the Jamaica Cancer Society indicates.

Earl Jarrett, JCS chairman, said that men are reluctant to do the screening tests inspite of the fact that there are well-trained specialists available to do them. Their reluctance is strongly linked to widespread homophobia in the Jamaican society.

“Many men feel that by doing a simple digital rectal examination, it brings into question their own sexuality,” Mr. Jarrett said.

Some men attending the screening clinics say that they would prefer if the urologists were women and they are also concerned that if the prostate is found to be abnormal then, the treatment would interfere with their sex lives.

But whatever the reason, Mr. Jarrett says that if there is one initiative which JCS should grasp, it would be getting more men tested for prostate cancer.

“We have to specially encourage Jamaican men through public education campaigns and to bring the Jamaican man to an awareness of his whole body and his health. We want him to become more self-aware and to take the right steps to have regular screening tests,” he said.

The urgency to get more men interested in screening tests, surrounds not only the fact that prostate cancer, if detected early, has a good prognosis but because at a prostate cancer incidence rate of 304 per 100,000 men over 50 years, it is reported that Jamaica has the highest rate of prostate cancer in the world. Compare this incidence to breast cancer, the leading cancer in women, which has an incidence rate of 55 per 100,000. It is also reported in some quarters that about 50 per cent of the men over 50 have prostate cancer.

Two annual screening tests are recommended for all men aged 50 and over ­ a prostate specific antigen test (PSA) and the digital rectal examination (DRE).

The PSA test is a blood test measuring the amount of PSA in the blood. PSA is a glycoprotein found in prostatic epithelial cells. It is detected in small amounts in the serum of adult men but in most men with prostate cancer, the PSA level is usually increased.

But even if the PSA is done, the digital rectal examination (DRE) is also recommended. This is the examination dreaded by many Jamaican men. To perform the DRE, the medical doctor puts on latex gloves and inserts a finger into the rectum. With the inserted finger, the doctor can palpate the prostate gland to detect any signs of abnormality.

In a normal finding, the doctor would detect, no abnormalities but would not yet definitely rule out potential problems. If abnormalities are detected then further diagnostic tests would be recommended.


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