Dr. Taha Ibrahim, hospital director for Al Noor Hospital, is concerned that a screening programme for prostate cancer might not be cost-effective.
Dr. Taha Ibrahim, hospital director for Al Noor Hospital, is concerned that a screening programme for prostate cancer might not be cost-effective.

Calls for prostate cancer screening



Some experts say there is no need for a national screening programme for prostate cancer - although almost half of patients begin treatment at a stage when the chance of survival is slim.

The latest health authority figures showed that in 2010, 41 per cent of patients were either found to have the disease or began treatment at stage four, when the five-year survival rate drops to about 30 per cent.

Yet many doctors believe national screening is not necessary, said Dr Jalaa Taher, section head of cancer control and prevention at the Heath Authority-Abu Dhabi.

"All patients should report any symptoms early," said Dr Taher. "Doctors should also screen people but we still don't recommend a national screening programme."

Some patients in whom the condition is diagnosed at an early stage refuse treatment because of side-effects, which can include impotence and incontinence.

"They only agree to take treatment when the cancer had started to metastasise [spread to other parts of the body]," said Dr Taher.

According to Cancer Research UK, the five-year survival rate for men found to have the disease at stage one or two is almost 100 per cent. This falls to between 70 and 80 per cent at stage three.

Thanks to new technology, which is still under trial in the UK, side-effects may eventually disappear.

According to the most recent Lancet Oncology journal, a 41-patient study found that ultrasound treatment could reduce the risk of impotence and incontinence.

But while more is being done to improve treatment, doctors must still keep a close eye on high-risk patients, said Dr Taher.

Men older than 50 who show symptoms - such as an inability to urinate or an increase in nocturnal urination - should automatically be screened using PSA, the prostate specific antigen blood test.

Screening includes a clinical exam, a rectal sonogram and the PSA test. The last can be done annually.

in 2008 the national health insurance company, Daman, made annual screenings free for men aged 45 and older.

In 2010, 53 men - a third of them Emiratis - were found to have prostate cancer, and there were seven deaths last year. This is the most recent data available.

Despite the lack of a national screening programme, the incidence of prostate cancer in the UAE is low, said Dr Taher.

"All the well-respected health authorities don't recommend conducting screening programmes," he said. "But as it is included in Thiqa [the insurance programme for UAE nationals], if they want to have it, or if there is some history of it in their family, they can get it done.

"We have different kinds of cancer, so why don't we screen for all of them? We screen according to the progression of the disease."

A screening programme would not be cost-effective, said Dr Taha Ibrahim, the hospital director of Al Noor Hospital. "Prostate cancer in this area is not that high. Because of that, there is no stimulus for an active screening programme."

But others disagree, such as Dr Waleed Hassen, the chair of Tawam Hospital's urology department and an assistant professor of urology for Johns Hopkins Medical Institutions.

An unpublished 21-month study from Tawam, which the doctor conducted two years ago, revealed that 41 cases out of 98 tested positive for prostate cancer. "These were cases that were detected by screening and did not include cases that were referred to the hospital," said Dr Hassen. "The [Haad] data is inaccurate … it is a matter of under-reporting."

The Haad data, which came from Tawam, accounted for roughly 80 per cent of cases, said Dr Taher.

When asked about a national screening programme, Dr Hassen believes that "there is no question that more should be done".

His research also showed that the prevalence of the disease was probably comparable to other countries and not as low as some experts think.

"We found a much higher rate of aggressive [forms of the] disease," said Dr Hassen. "We [found] tumours that were potentially lethal."

The Haad data revealed that prostate cancer is the fourth most common form of the disease among men in the UAE. It is the most common form of the disease among men in the UK, US and Australia, and the tenth-leading cause of death among men with cancer.

Most cases worldwide are in men older than 50, although the youngest patient in the UAE, in 2010, was 45.

"This is a young population, like most of the Middle East, so you do not expect a huge amount of numbers," said Dr Hassen. "As the population gets older, we are going to see more cases and the medical establishment needs to be prepared.

‘Being tested saved my life’

Ali, who has lived in the Emirates for 36 years, was alerted to the need to be examined by a conversation about a mutual friend who had been told he had the disease.

“I was speaking to my friend and he said to me, ‘He [the mutual friend] is 60 and he never went, all this time, to get the test.’ He could not believe it.

“I said to him, ‘I’m 62 and I haven’t done the test either.’ He told me to go do it, so I did.”

The visit saved his life. His doctor diagnosed stage-one prostate cancer.

Ali was given the all-clear several years ago but still has check-ups. He said it was the responsibility of doctors to tell men about the importance of screening.

“They say anybody over the age of 40 should start doing the tests,” he said. “When I went to my doctor he said I should have had this test a long time ago.

"It seems that my [previous] doctors were at fault because they should have asked me. Doctors should really advise their patients."
* Zaineb Al Hassani

Know before you go
  • Jebel Akhdar is a two-hour drive from Muscat airport or a six-hour drive from Dubai. It’s impossible to visit by car unless you have a 4x4. Phone ahead to the hotel to arrange a transfer.
  • If you’re driving, make sure your insurance covers Oman.
  • By air: Budget airlines Air Arabia, Flydubai and SalamAir offer direct routes to Muscat from the UAE.
  • Tourists from the Emirates (UAE nationals not included) must apply for an Omani visa online before arrival at evisa.rop.gov.om. The process typically takes several days.
  • Flash floods are probable due to the terrain and a lack of drainage. Always check the weather before venturing into any canyons or other remote areas and identify a plan of escape that includes high ground, shelter and parking where your car won’t be overtaken by sudden downpours.

 

The Old Slave and the Mastiff

Patrick Chamoiseau

Translated from the French and Creole by Linda Coverdale

HAJJAN
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The Penguin

Starring: Colin Farrell, Cristin Milioti, Rhenzy Feliz

Creator: Lauren LeFranc

Rating: 4/5

UAE rugby in numbers

5 - Year sponsorship deal between Hesco and Jebel Ali Dragons

700 - Dubai Hurricanes had more than 700 playing members last season between their mini and youth, men's and women's teams

Dh600,000 - Dubai Exiles' budget for pitch and court hire next season, for their rugby, netball and cricket teams

Dh1.8m - Dubai Hurricanes' overall budget for next season

Dh2.8m - Dubai Exiles’ overall budget for next season

THE BIO

Born: Mukalla, Yemen, 1979

Education: UAE University, Al Ain

Family: Married with two daughters: Asayel, 7, and Sara, 6

Favourite piece of music: Horse Dance by Naseer Shamma

Favourite book: Science and geology

Favourite place to travel to: Washington DC

Best advice you’ve ever been given: If you have a dream, you have to believe it, then you will see it.

What is graphene?

Graphene is extracted from graphite and is made up of pure carbon.

It is 200 times more resistant than steel and five times lighter than aluminum.

It conducts electricity better than any other material at room temperature.

It is thought that graphene could boost the useful life of batteries by 10 per cent.

Graphene can also detect cancer cells in the early stages of the disease.

The material was first discovered when Andre Geim and Konstantin Novoselov were 'playing' with graphite at the University of Manchester in 2004.


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