ONE of the country's leading oncologists is warning general practitioners to desist from using only the results of a transrectal ultrasound to diagnose prostate cancer.
Dr William Aiken, consultant urologist at the University Hospital of the West Indies, is also urging general practitioners to immediately refer a cancer patient to the urologist once an abnormal PSA (prostate-specific antigen) level is detected or if they suspect that the patient has cancer, and to end the long wait.
Transrectal ultrasound is a procedure used in the diagnosis of prostate cancer after an abnormal PSA is detected in a patient.
But Dr Aikens said: "In the evaluation of men with prostate cancer, a transrectal ultrasound must always be combined with a biopsy, because the inherent characteristics of an ultrasound cannot differentiate between the prostate cancer and the absence of the cancer."
"You cannot send a patient to do a ultrasound alone without a biopsy to determine whether or not they have prostate cancer," he said. "And unfortunately, I have seen patients who have been told that they are fine on the basis of a normal ultrasound and there PSA continues to rise and they are referred late."
Dr Aiken, who was speaking yesterday at Prostate Cancer Medical Symposium at the Jamaica Pegasus hotel in Kingston, said that the practice is very widespread and should be discontinued, as it has legal medical consequences and adverse consequences for the patients.
The symposium was hosted by the Jamaica Cancer Society and the Jamaica Urological Society as a part of activities for Prostate Cancer Awareness month and in observance of Prostate Cancer Awareness Day.
Dr Aiken complained that he and some of his colleagues were seeing an increase in the number of patients being referred late when they should have been immediately referred to a urologist, once their PSA levels were abnormal or they were suspected of having cancer.
"I don't know whether it is the economic environment in which we are working, but unfortunately there is a trend that we are seeing, and other urologists can attest to this, where general practitioners are holding on to the patients with abnormal PSA and keeping them and in many cases referring them late," he said.
Said the Dr Aiken: "I have several patients in my practice who have been sent to me by general practitioners and they have nicely documented in their letters where the PSA was abnormal from three, four, five, six years ago and they watched those patients and they kept doing those PSA, sometimes it is on the insistence of the patient why they are referred to the urologist."
However, one general practitioner yesterday rejected Dr Aiken's claim.
Dr Seni Ononuju, said she did not share the view that general practitioners hold on to their patient. Based on her own experience, the Nigerian-born doctor said, the patients were sometimes to be blamed for failing to visit the urologist when they were referred. Many refused to go on their own.
"I have referred many of my patients, and years later when I see them and asked, if they went, they say, 'Doctor, I didn't feel sick so I didn't go'," she said.
Furthermore, Dr Ononuju said: "I could not imagine that any doctor, because of economic situation, would play down on the illness of a patient that you know and if a doctor does that, it means he is not going with the oath that we have taken, that all times to do our best for the patients and I think we should correct those ideas."