STAY WELL & SPARKLE: Bend Over!

Dr. Sam Christian
Dr. Sam Christian

That was all he told me. The dapper Dr. Royer was the logical choice to do my student visa application physical. He was our psychiatrist-advisor when I was president of the Dominica Association of Mental Health before leaving in 1977.

“WHOY!!!” I stifled a grunt.

Yes, I did hear the good doctor snapping the rubber gloves as he prepared to do my routine examination. But never having it done before, I had no idea what was in store. By the end of this article YOU will able to give others clear advice as to what to expect.

Dr. Velda Wade’s Health Centre

Fast forward 38 years. I am on the other side of the finger. I was sharing the honours with Dr. Malaker (radiation oncologist) and Bahamian Dr. Maureen Hall, both from Ross University, along with students. Together, we did heaven-knows-how-many prostate checks/rectal examinations last Saturday.

The Dominica Cancer Society membership (mostly female) supported in force. Yet, I was truly impressed by the maturity of the gentlemen-patients taking advantage of the program at Castle Bruce. So highly motivated were they, any advice given to them seemed like preaching to the choir. Ross’ Rosanna Emmanuel in charge of logistics, Dr. Wade, Nurse Vigilant and their team deserve full credit for doing a fantastic job organizing the screening.

Still, the homophobic taboo lingers in the population at large. And macho, macho men risk being taken down by prostate cancer rather than be “penetrated.”

Prostate cancer

The prostate is about the size of a groundnut (gwen peh) located beneath the bladder and in front of the rectum. The gland generally enlarges with age; a condition is called Benign Prostatic Hypertrophy (BPH). This is reflected in the number of times one has to get up at night to urinate (nocturia). Prostate cancer also develops fairly often and is usually slow growing. Upwards of 2/3 of elderly men have evidence of prostate cancer at autopsy that never caused noticeable symptoms. A sharp increase in nocturia suggests a fast-growing cancer and intervention is necessary.

For whatever reason, prostate cancer is more common in blacks. (Don’t worry; it all equals out. There are other cancers less common in blacks such as skin cancer). The good news is that treated prostate cancer generally has only 3-6% death rate depending on race. Cancers of the lung, colon and pancreas for example, are much more lethal.

Prostate cancer screening is traditionally involved annual Digital (finger) Rectal Exam (DRE) and Prostate Specific Antigen blood test starting at age 40. PSA can be ‘falsely’ elevated by prostate infection (prostatitis) and recent sexual activity. In the past, results higher than 4 required an ultrasound-guided prostate biopsy. Once cancer was diagnosed, that meant radiation or surgery overseas and or chemotherapy at the Princess Margaret Hospital oncology clinic. Risks of treatment include erectile dysfunction (impotence), difficulty urinating, incontinence and even hot flashes.

Screening changes

Some stubborn men were hoping the new recommendation meant no more finger exams. Awa!  Changes essentially involve more technical selection of patients. Those with a prostate cancer family history and black males should continue beginning DRE/PSA at age 40. Now, other populations can start at 50. Patients are carefully advised not to ride a bicycle and to avoid ejaculation for two days before the PSA test.

Listen here to details on new screening guidelines

My father was the first patient ever I diagnosed with prostate cancer. He was in his late 60’s at the time and was cured by radiation therapy. By God’s grace, his annual PSA remained normal the rest of his life. He slipped away full of years from other age-related causes. The men in our family know that genetically we are at high risk. We keep on each other about our check-ups. I give thanks and praise mine was good when done just last month.

This time I was prepared! Seriously; it’s really not that bad. Don’t be put off by all that guy-talk and crude humour. So much depends on the women of the family giving them that extra encouragement: Honey, I’ll go with you…Why die from embarrassment?

We all have to go some time. But when I do, it definitely won’t be because I was too carpor to take some stupid, little test.

My brother, t’will be worth it for just one to agree:

‘If it’s good enough for Doc, it’s good enough for me.”

Dr. Sam Christian is surgeon and health activist. He runs the Urgent Care on 137 Bath Road, which offers prompt medical treatment, surgery and acupuncture. He is radio host of the Medical Minute, Medical Adviser to the Dominica Cancer Society and author of the faith and fitness nutrition book, ‘Mannafast Miracle.’ Dr. Christian can be reached at 440-9133 or by writing to [email protected].

Copyright 2012 Dominica News Online, DURAVISION INC. All Rights Reserved. This material may not be published, broadcast, rewritten or distributed.

Disclaimer: The comments posted do not necessarily reflect the views of DominicaNewsOnline.com and its parent company or any individual staff member. All comments are posted subject to approval by DominicaNewsOnline.com. We never censor based on political or ideological points of view, but we do try to maintain a sensible balance between free speech and responsible moderating.

We will delete comments that:

  • contain any material which violates or infringes the rights of any person, are defamatory or harassing or are purely ad hominem attacks
  • a reasonable person would consider abusive or profane
  • contain material which violates or encourages others to violate any applicable law
  • promote prejudice or prejudicial hatred of any kind
  • refer to people arrested or charged with a crime as though they had been found guilty
  • contain links to "chain letters", pornographic or obscene movies or graphic images
  • are off-topic and/or excessively long

See our full comment/user policy/agreement.

16 Comments

  1. The Believer
    August 8, 2016

    God made man to his own image and likeness so that make man supreme and how they wasted it.they don’t choose what is good or bad for their body, they into everything, and at 40 they get worried and everything pile up on them. The system you born with is guarantee to last for 3 scores and ten untouched. We behave foolishly and abuse our system and give doctors extra work. When a human is unable to draw out his or her own pension should be given the chance to say goodbye to the world quietly. All the hustle and bustle and it is a must go.

  2. Doc boy, you are exceptional you disseminate lots of medical information; but based on some of the response you get, I doubt that many who read understands the importance of the information you dispense.

    I cannot be brief, since I am a very detailed individual, I hope my input here will not be repetitious, as I do not wish to be repetitive. Nevertheless, I hope that most of us know that cancer begins in cells, which are the building blocks that make up all tissues, and organs of the body including the prostate. Normal cells in the prostate, and other parts of the body grow and divide to form new cells as are needed. When normal cells grow old or get damaged, they die, and new cells take their place.

    Sometimes; however, this process goes wrong; new cells form when the body doesn’t need them, and old, or damage cells do not die as they are expected; causing a build up of extra cells, which forms a mass of tissue called a growth, or tumor. As we know growths in the prostate can…

    • Continue:

      As we know growths in the prostate can be benign (not cancer), or malignant (cancer).

      Benign growths; such as benign prostatic hypertrophy are not life threatening; they do not invade the tissues around them; they do not spread to other parts of the body, and can be removed, and usually do not re-grow. Malignant growths: prostate cancer sometimes poses a threat to life; such growths most of the time invade nearby organs, and tissues, such as the bladder, or the rectum, and may spread to other parts of the body; such malignant growth can be removed; however sometimes return.

      Prostate cancer cells can spread by breaking away from a prostate tumor, and travel through the blood vessels, or lymph vessels and reach other parts of the body, the new tumor will have the same kind of abnormal cells, the same name as the primary, or original tumor: i.e., if the prostate cancer spreads to the bones, the cancer cells in the bones are actually prostate cancer cells.

      The…

    • Continue:

      The disease is metastatic prostate cancer, not bone cancer, and that is the reason it is also treated as prostate cancer, and not bone cancer! Because I do not wish to occupy too much space, I will devote the rest of my comments testing. When one is tested, and abnormalities are found indicating prostate cancer, other tests are needed to help deciding what treatment is best.

      One important test should be the “Tumor Grade Test With Prostate Tissue;” that is the prostate tissue that was removed during a biopsy can be used in the lab test; where the pathologist studies the prostate tissue under a microscope to determine the grade of the tumor, which indicates the difference in the tumor tissue to that of normal prostate tissue. Tumors with higher grades tend to grow faster than those with lower grades.

      They are also much more likely to spread; doctors usually use tumor grade along with an individuals’ age, and other factors to decide options, and treatment. The most…

    • Finally:

      The most commonly used system for grading prostate cancer is the Gleason score, which range from 2 to 10. In order to arrive at the Gleason score; the pathologist view the patterns of the cells in the prostate tissue samples, the most common pattern of cells are given a grade of (1) which is most like normal prostate tissue to 5, which are most abnormal.

      In the event there is a second most common pattern, the pathologist must give it a grade of 1 to 5, and then adds the grades for the two most common patterns together to make the Gleason score 3 + 4 = 7. in the event only one pattern is seen, the pathologist must count it two times; Hence, 5 + 5 = 10. A high Gleason score as 10 indicates a high-grade prostate tumor. High-grade tumors are very likely to grow faster, and spread, unlike low-grade tumors. People who are classified as in the category of low-grade, or “low risk ” may never get actual cancer.

  3. DA Native in Texas
    August 8, 2016

    This is a very, very good article. In this day and age there is absolutely o reason why men to be afraid to do this exam. For you gentlemen reading this article I would like to encourage you all to do it. I began doing this at the age of 40, and right now I well over 60 and has been doing it yearly since then. The danger with not doing it early is that sometimes by the time you decide to do it, the cancer has already done so much damage that it’s to late. We need to get away from that fear/phobia of the digital exam. Think of it this way: sometimes when you are diagnosed late you will get a tube inserted in almost all of your crevices. So if you cannot afford to pay for it, whenever there’s a program like the one the good doctor spoke about please go get it done. In closing Dr. Christian your articles very well written and I love reading them. Be blessed and keep up the good work.

  4. Clayton Shillingford
    February 27, 2014

    Good work Sam.. We need more of this kind of education and encouragement from our professionals

  5. CB
    February 24, 2014

    Enjoyed your article as usual…hope to see more of you in Castle Bruce…..the health team is very dynamic….

  6. just saying
    February 24, 2014

    I will definitely ask encourage my brothers to do the test. Thanks doc

  7. CaraW
    February 24, 2014

    How old were you in 1977 that the doctor felt it necessary to perform a DRE?

  8. Don Keyballs
    February 24, 2014

    Thanks for the encouragement Dr.Sam. Though I was always concerned about having a DRE (over 40 yrs old), I’m going to schedule one ASAP.

  9. Anonymous
    February 23, 2014

    I am also at a higher risk because my father died from prostate cancer. I do the DRE once a year and the PSA every six months. I tell myself the good thing about the DRE is that it lasts less than a minute.

    I am due for one in less than a month.

  10. Cocoatea
    February 23, 2014

    Thanks again doc. Men please go get the check up. It might save your life.

  11. Faithful Dominican
    February 22, 2014

    Doctor Sam you are the best writer I have read when it comes to putting medical issues on the table in a manner the common man can understand. “Carpor” means afraid on french patois, right? Well your charming use of medical language has made our understanding of medical hygiene that much easier. Well done. Your father must have been proud that your effort lengthened his life. Keep it up.

  12. Anonymous
    February 22, 2014

    :-D i am definitely getting my men friends to read this. They so carpor! Maybe after this they will say if the doc can do it … then its okay.
    Thanks doc

  13. openmind
    February 22, 2014

    must say as important as this test is,the way we think in Dominica and brand others,you will need grass roots education to convience the men to take it like a man.

Post a Comment

Your email address will not be published. Required fields are marked *

:) :-D :wink: :( 8-O :lol: :-| :cry: 8) :-? :-P :-x :?: :oops: :twisted: :mrgreen: more »

 characters available