ABU DHABI // There will be a sharp increase in the number of cases of prostate cancer in the UAE if men do not start being screened for the disease, a leading expert has warned. Caught and treated early, the disease has a cure rate of more than 90 per cent, according to the Prostate Cancer Foundation. Despite it being one of the most common forms of cancer found in men in the UAE, a lingering stigma means it is usually not diagnosed until it is too late.
"The majority of men we see coming to this hospital present with end-stage cancer, when it is not curable," said Dr Waleed Hassen, the chief of the urology department at Tawam Hospital in Al Ain. He called the situation "a travesty". Men between the ages of 25 and 50 make up the largest age group in the UAE, according to census figures, meaning a critical mass are approaching the screening age of 50. Without screening, prostate cancer continues to develop, taking up to 15 years for any symptoms to appear. By then, it is too late.
"Early screening saves lives," said Dr Hassen. "There is no question about it." He has seen men who are paralysed, yet who are visiting a doctor for the first time. When symptoms do occur, they can include not being able to urinate or needing to urinate often, especially at night, erectile dysfunction or frequent pain in the lower back, hips or upper thighs. Unlike many other cancers such as brain tumours or leukaemia, a prostate cancer sufferer usually only starts experiencing symptoms when the cancer spreads from the prostate gland, located in the pelvis, to other parts of the body, often the bones. At that point, treatment is more invasive and complicated.
Recent years have seen major drives in other countries, such as the United States and Britain, to promote awareness of prostate cancer and set up national screening programmes. Yet in the UAE, screening is almost "non-existent", said Dr Hassen. "The reason why it is so important to be screened is because, firstly, we can detect cancers at a much earlier stage when the patients are potentially curable," said Dr Hassen. "And secondly, they are curable with less chance of it affecting their quality of life."
According to the UAE National Cancer Registry, where some but not all hospitals report their figures, there was a 212 per cent increase in the number of men being diagnosed with prostate cancer between 1998 and 2006. The registry showed 16 males were diagnosed in 1998, jumping to 50 in 2006. Dr Hassen is adamant that men above 50 - 45 if there is a family history of the disease - need to get over their embarrassment surrounding this type of cancer. There are two tests used to detect prostate cancer in the absence of symptoms: a blood test to find prostate specific antigen (PSA), a substance produced by the cells of the prostate, and a rectal examination to check whether the prostate is enlarged.
If the cancer is found in early stages, there are modern treatments using minimally invasive surgery available to treat it, said Dr Hassen. This month Daman, the national insurance company in Abu Dhabi, added free annual prostate cancer screening to its plans for all men over the age of 45. "Including the free annual screening in our list of benefits is one thing, but to actually go out in the media stressing on the issue and drawing attention to it is trickier," said Dr Ezzat Ajami, the company's network director. "Internationally, prostate cancer is a touchy subject and in this region it is probably even more so."
munderwood@thenational.ae