The Tribune

By Dr Greggory Pinto

I became a urologist with the aim of improving the quality of lives of Bahamian men, women and children. Bahamian men are unfortunately notoriously poor at addressing their own health needs. Prostate cancer will strike one in six Bahamian men in their lifetime. The Bahamas has the 14th highest per capita prostate cancer incidence in the world. At least 80 Bahamian men died of prostate cancer in 2019 and more than 200 Bahamian men were diagnosed with prostate cancer that same year. Bahamian men have all the risk factors for an aggressive form of prostate cancer, in being a nation of predominantly men of African ancestry, having a high rate of obesity and have a high incidence of BRCA gene mutations.

Bahamian black men often have prostate cancer on average six to seven years earlier than men of other racial persuasions.

Prostate cancer has an almost 100 percent cancer specific survival rate at five years and 96 percent cancer specific survival rate at 10 years, if the disease is diagnosed and treated at an early stage. Early diagnosis is key in the fight against needless prostate cancer related deaths in the Bahamas.

Knowledge is imperative if we are going to stop unnecessary prostate cancer deaths in our Bahamas.

Emphasising the importance of men’s health awareness not only attempts to save lives but also tries to improve the quality of the lives of men.

Erectile dysfunction is a taboo topic that Bahamian men are timid speaking about and they are every reluctant to seek the consult of a urologist regarding their erectile dysfunction, which may take the form of premature ejaculation or the inability to achieve and maintain a good quality erection. The possible causes of erectile dysfunction are multiple, which may include an impaired penile blood or nerve supply, low testosterone, performance anxiety, side effects of medications or undiagnosed/poorly controlled diabetes and/or high blood pressure. You can always rise again. The first step in recovering erectile function is seeking the comprehensive, compassionate and confidential consult of a urologist.

Men’s health awareness focuses on many vital health topics including the management of erectile dysfunction but also includes all major topics related to the good health of Bahamian men.

These topics include any urinary issues, male infertility, kidney stones, chronic pelvic pain, circumcision, vasectomies, blood in the urine, cancers of the prostate, kidneys, bladder and penis, hypertension, heart disease and diabetes mellitus.

As a urologist the most pressing issues Bahamian man may face concerning their health include:

Benign prostate hyperplasia

The other prostate problem, non-cancerous BPH, is the enlargement of the prostate that almost every Bahamian man will face if he is blessed with advanced age. BPH can cause symptoms such as a weak urinary stream, frequent day and nighttime urination, urinary urgency, incomplete bladder emptying, recurrent urinary tract infections and even urinary incontinence/leak.

Far too many Bahamian endure a poor night sleep because of frequent urination and they have their urinary problems control their lives and rob them often of their happiness. BPH can be managed very successfully with medications or minimally invasive urological procedures. Bahamian taxi drivers should not have to suffer the indignity of driving around with a container in which they urinate because they will never make it to even pulling over to the side of the road to urinate. Bahamian teachers should not very afraid to drink a glass of water because they can’t teach a class without having to frequently urinate. Bahamian men in general do not need to live their lives sleep deprived because they are waking up five times in the night to urinate. Bahamian men from every walk of life are suffering needlessly with urinary problems and they are unaware that they can regain control of their bladder and their happiness with the aid of a urologist.

Hypertension

Hypertension is the medical term for high blood pressure, and it is well known to be a silent killer, with no symptoms of uncontrolled blood pressure until often irreversible damage has already been done to various bodily organs.

Long standing hypertension could leave to erectile dysfunction, kidney failure, cardiac failure and stroke, among multiple other devastating health consequences. Sudden acute spikes in blood pressure could also be fatal or lead to severe medical morbidities.

Many Bahamian men are at risk for developing high blood pressure because of poor lifestyle choices, an unhealthy diet, an inactive sedentary existence and obesity.

It is far too common an occurrence for Bahamian men to choose to not be complaint with prescribed high blood pressure medication.

Proper control of hypertension could prevent serious negative health issues and lead to greater longevity.

Heart disease

Heart disease is one of the leading causes of death for Bahamian men. Heart disease is a broad medical term that includes the various cardiovascular disease conditions such as angina, atherosclerosis, coronary heart disease, congestive cardiac failure and cardiac arrhythmias.

Heart disease is truly a silent killer with few to no symptoms until the disease has advanced.

Many Bahamian men have risk factors for cardiovascular disease. Annual or bi-annual health physicals, compliance with prescribed medications, regular exercise, healthy, well-balanced diet and not smoking nicotine products could all significantly reduce the likelihood of developing heart disease.

Erectile dysfunction is often an early warning sign of heart disease as 70 percent of men with erectile dysfunction have or will develop some element of heart disease.

Diabetes

The Bahamas has one of the highest incidences of diabetes in not just the region but the world. One in seven Bahamian men have diabetes or are prediabetic.

Diabetes is the seventh leading cause of death in the United States.

Poorly controlled diabetes could potentially lead to devastating health consequences such as infected diabetic foot, diabetic retinopathy affected eyes, diabetic peripheral neuropathy, diabetic cystopathy leading to impaired ability to empty the bladder, amongst many other negative health consequences.

Diabetics have a four times increased risk of developing erectile dysfunction and erectile dysfunction presents on average 15 years earlier in diabetics when compared to non-diabetics.

Annual health physicals are essential for men so that silent non communicable diseases can be detected early and managed effectively. Bahamian men should be screened for type 2 diabetes starting at age 40 years old, and even at an earlier age if there is a family history of diabetes, a history of hypertension, obesity or a history of high cholesterol.

Screening for colorectal cancer should happen in all men 45 years old and older.

Bahamian men need to realize that they may unknowingly suffer silently with no symptoms from common health disorders such as prostate cancer, hypertension, diabetes, heart disease and colorectal cancer.

If you have not had an annual physical in the past one year then please do so as having annual physicals and taking appropriate health care actions, may potentially add years to your life and improve the quality of health for the years that you do live.

Bahamian men are often afraid to talk about their health

Bahamian men are definitely reluctant to speak about erectile dysfunction because they often feel that they are a failure and less than a man when faced with erectile dysfunction. Almost every man faces erectile dysfunction is his lifetime and the real tragedy is suffering needlessly in silence when you are not alone and with the aid of a urologist, you will always rise again.

Bahamian men are often afraid to talk about urinary issues such as a weak urinary stream or urinary incontinence/leak or frequent nighttime urination because they have a great fear that these urinary problems are prostate cancer related.

The reality is the statistically speaking, benign prostate cancer is far more prevalent than prostate cancer.

Prostate cancer should also not be feared because early diagnosis can lead to an almost 100 percent cure rate.

Older men are usually more proactive about their health when compared to younger men

I find that Bahamian men of all ages are very reluctant to seek management for any health issues, however, with knowledge comes greater understanding and an improved willingness to seek help.

For example, waking up to urinate several times a night is not an inevitable part of getting older and a poor quality erection that is difficult to maintain is also not an inevitable part of being middle aged or older.

At least 20 percent of men younger than 30 years old have faced erectile problems.

Prostate cancer is a very curable cancer, that has an excellent cure rate and there are many curative treatments available.

Bahamian women often pressure the men in their lives to seek medical assistance.

Bahamian men need to take a greater responsibility in maintaining a healthy, long life.

A little knowledge may very well save your life or the life of someone you love.

Bahamian are suffering in silence and despair with dozens of urological ailments that can be treated.

Improve your quality of life and add years to your life.

You can always rise again if you have erectile dysfunction.

You can always regain control of your bladder and your happiness instead of continuing to have urinary issues negatively control your life.