Doctors in new call for UAE-wide cancer screening programme

Prostate cancer is the fourth most common cause of cancer deaths in men, but if diagnosed and treated early the disease has a cure rate of about 90 per cent.

Dr Mohsen El Mekresh speaks to a patient in his examination room at Mafraq Hospital. Christopher Pike / The National

ABU DHABI // Doctors have renewed calls for a national screening programme for prostate cancer.

It is the fourth most common cause of cancer deaths in men in this country, but if diagnosed and treated early the disease has a cure rate of about 90 per cent.

As Prostate Cancer Awareness Month begins, doctors say there should be routine testing in the UAE, as there is in many western countries.

"In some developed countries there is such a programme and we need to see this in the UAE," said Dr Faribroz Bagher, head of the urology department at Dubai Hospital and a board member of the Emirates Urology Society. "We are pushing the importance of prostate screening but of course this will take time."

Dr Bagher believes every man over the age of 50 should be screened for the disease.

Men with a family history of prostate cancer should be screened after the age of 40, he said. Early detection was vital in saving lives and a national screening drive was an important part of this.

"The screening is important because unfortunately those who have prostate cancer in its early stages do not really show any signs or symptoms," he said. "So maybe you have prostate cancer and you do not know. By the time you have symptoms of prostate cancer it is often too late to treat."

Dr Bagher said the prostate could be removed if the condition were caught early, and there was a high chance of eradicating the disease for good. However, when symptoms begin to show at more advanced stages, often the prostate has become enlarged, meaning this operation is not viable, or the cancer has spread.

Symptoms include urinating frequently, slow urinal flow, painful urination, blood in urine or semen and sometime pain in the lower back or side.

"The value is early detection," said Prof Mohsen El Mekresh, a German expatriate professor of urology at Mafraq Hospital in Abu Dhabi who has worked in the UAE for four years.

"Survival rate at five years is 99 per cent for those who have cancer early detected, still in the gland itself.

"If you have late diagnosis or if the tumour goes out of the gland, the five-year survival will be only 31 per cent. So screening means early detection, early diagnosis, early treatment and higher five-year survival."

Under the screening programme, men undergo an annual prostate-specific antigen, or PSA, test, a blood test that can detect cancer at an early stage.

Professor El Mekresh said some men die of prostate cancer because they are not checked regularly and it is picked up at a late stage, when the tumour has spread.

"I hope like in western countries it should be mandatory to have PSA screening to save lives," he said. The urology department at Mafraq Hospital is working with Emirates Medical Association - through Emirates Urological Society - to try to start a national screening programme.

His department has also been visiting companies with many male staff over the age of 50.

Dr Waleed Hassen, chief of urology at Tawam Hospital, said there had been some controversy over national screening programmes in the West because the test cannot differentiate between a cancer that will lead to death and one that may not affect the patient.

"There is a balance between over-diagnosis and under-diagnosis which we still need to work out," he said.

Surgery carries the risk of impotence and incontinence.

However, said Dr Hassen, in the UAE, where there is "little in the way of screening", many men have advanced stages of the cancer, which carries a high mortality rate.

Dr Hassen believes there should be a screening programme, but in a controlled manner rather than random testing.

While there is a lack of data to show how many men have the disease, Dr Hassen said it represents a "significant number of morbidity and mortality in the country".