“Alarming” is how consultant urologist Dr Marie Brown describes the number of men, in two years, who’ve turned up at the St Ann’s Bay Hospital with advanced stage prostate cancer or at high risk of having the disease.

She said that since joining the hospital’s team in 2022, they’ve conducted 626 prostate biopsies up to October 2024. Of that number, 437 patients had a high prostate-specific antigen (PSA) of 8 ng/ml or above. She noted that 140 had a low PSA, while only 49 patients had a negative result.

Prostate cancer is the uncontrolled growth of cells in the prostate. Prostate-specific antigen is a protein produced by prostate cells. A high PSA level indicates an elevated amount of prostate-specific antigen in the blood, which may be a sign of prostate cancer or other prostate-related issues. A level above 4.0 ng/ml is generally considered abnormal.

Dr Brown told the Jamaica Observer that prior to her arrival in 2022, St Ann’s Bay Hospital did not have a urologist. And, through working with patients, she’s found that many men opted against getting their prostate checked because they did not want to travel to Kingston or other areas to conduct the exam.

She added that for some of the men who made the journey to the capital city to get their exams done, they ended up missing follow-up sessions due to the coronavirus pandemic and did not return for treatment.

However, with prostate cancer screenings now more accessible in St Ann, on a weekly basis, the consultant urologist sees 50 to 70 patients in the clinic for prostate-related issues — and 80 per cent of them have advanced features.

“We have different levels of treatment for people with prostate cancer, and a lot of what I am seeing are people who have already what we call significantly elevated PSA or their imaging shows that the cancer is no longer just confined to the prostate alone, but it has gone to either lymph nodes or the bone,” said Dr Brown.

“We don’t have the exact numbers [for advanced cases], but even when I was in Kingston I didn’t have this experience. You would see it every now and again, but for me it is like almost a weekly occurrence here in St Ann,” she said.

The consultant urologist stated that the men’s ages range from 40 to 80 years old.

“There are also these advanced cases where they may have paraplegia, where, because of spread to the bone, the nerves in the spinal cord have either compressed or been invaded by a tumour, and as a result of that they’re unable to walk, or they will end up in kidney failure because of obstruction of the kidneys,” she told the Sunday Observer.

Dr Brown said that the team at St Ann’s Bay Hospital, in collaboration with the Ministry of Health and other stakeholders, have been working to address the issue and increase education among men about prostate cancer and the importance of screenings.

She said that the hospital started its annual men’s fair in 2022, with a team of medical professionals conducting digital rectal examinations (DRE) and PSA tests for 162 men. The following year, the numbers increased to 251 men, and in 2024 they provided the services to 317 men.

The 2025 Men’s Health Fair will be held on Sunday, May 25 at Turtle River Park in Ocho Rios, St Ann, from 9:00 am to 5:00 pm, offering free prostate tests and other examinations. Cari-Med Group Limited and Apotex, a Canadian pharmaceutical corporation, have donated $1 million towards the purchase of 200 PSA screening kits.

Individuals who cannot attend the health fair can get screened for free at Jamaica Cancer Society locations in St Ann and St Mary in September, when the country observes Prostate Cancer Awareness Month, she added.

Dr Brown said that with the health fair, added resources, and public education, many men have become compliant.

“In terms of the advanced cases that we have to give hormonal injections every week, if I have 50 people in clinic, 25 are for hormonal injections. If I have 60 to 70, we have about 30 to 40 of those being hormonal injection people, and they have been compliant. Every three months they’re going to show up, they’re going to do their PSAs, and you can see the relief on their face when you say, ‘Yes, your PSA is heading in the right direction,’ ‘It is decreasing,’ or ‘Your PSA is maintaining its low level,’ ” she told the Sunday Observer.

However, she added that the work continues to get others on board with prostate cancer testing and eliminating the stigma associated with the DRE in Jamaica.

The procedure involves a health-care professional inserting a gloved, lubricated finger into the rectum to check for abnormalities.

Dr Brown said that while she has seen where the stigma has reduced, there are some men who require more information and assurance before they are willing to get tested.

“Some people will actually give the impression that this is a horrible test and they should not do it, and then men listen to other men, mostly, so that restricts how much they will actually do for themselves. But I think as more men are coming out, I am hoping that in another couple of years, this whole stigma that is attached would actually be out the door,” she said.

The urologist warned that a refusal to get tested will put men at a greater risk of having advanced prostate cancer.

“It will be more costly financially, affect their well-being and their ability to earn and take care of their family. The idea that follow-up and frequent checks are only for females, that is no longer a thing,” Dr Brown said, as she urged men to get tested.