Are we on the verge of a new day in PCa awareness in the Caribbean?

[Shai]

Cultural and religious beliefs, coupled with lack of education about the danger of undiagnosed Prostate Cancer, have made this cureable disease a taboo subject in Caribbean societies. Is this changing?

In an effort to promote awareness about Prostate Cancer diagnosis and treatment, I had the pleasure of meeting two highly motivated, visionary health policy makers from the region. The Honorable Evans Rogers, Health Minister of Anguilla (upper photo) and the Honorable Hensley Daniel, Health Minister of Nevis (lower photo), are committed to improving access to education, early detection and appropriate treament.

Are we on the verge of a new day in PCa awareness in the Caribbean?

[Arnon Krongrad, MD]

There is little doubt. I get calls today that I never got 10 years ago. They have to do with tree-tops programmatic issues in Barbados to research studies in Jamaica to individual risk assessments in Trinidad. I also see more men who are aggressively looking for information.

I think the real problem in the Caribbean is that the countries are so tiny that you don't have critical mass to develop information and care services. As for the former, I think this tool can be extremely useful because geography and population density are not relevant. The question is how to get the word out in a relatively decentralized population (not that it's easy in the US). Speaking with health ministers is a start and what you did is an important step. There is more work to do. But ... I think the audience is receptive and the fatalism that Dr. Consedine describes is probably on the wane.

I wonder if the men in the photos with you would be an informal Caribbean task force advisory board for us and if they would invite their colleagues to the "table." I wonder if they will speak publicly about prostate cancer as a health issue. I know in Antigua the deputy PM became quite the public missionary after his diagnosis. I know that the treatment of Rene Preval in Haiti was very public. It'll be great if your friends would carry the torch without being diagnosed.

[E. Michael D. ("Mike") Scott]

The system (currently under review) we have put in place to provide base information for Kenya and for at least one Caribbean island nation would work for almost any other island (although in a few places we might need French and/or Spanish language versions too).

There is a "chicken and the egg" element to all of this that we need to be aware of. An issue that has to be addressed in any developing environment is whether the health system is actually capable of dealing with a major increase in demand for early prostate cancer detection, not to mention the consequent quality of care for those diagnosed.

[Arnon Krongrad, MD]

This is exactly the issue we have domestically with community-based awareness programs. Access to care in the US is also not uniform. As a friend recently put it, the health systerm in the US is Darwinian. Maybe so and it's not uniquely an American trait.

With that in mind, it may be that under some inspired leadership central care hubs can develop. I have been impressed by the vision articulated by a few of the people I've met over recent months, including the Health Minister of Antigua and the men Shai introduces above. I cannot comment on resources and implementation. Like domestically those remain to be allocated and deployed. But the first step is in place and the vision is right.

[Kathy Meade]

You need to engage Jim Williams. Rather than reinventing the wheel ICC probably has models that you can use. I know one successful model used in the mountains of VA and W VA uses a community center based program for all cancers including prostate. They address issues like lack of access to care and issues of basic needs like availability of food and clothing resources. It is a go to place in the community for all cancer patients, including prostate cancer. This might translate to this environment also.

It is a rose in an empty environment.

[Shai]

Mike,
I would love to hear what you have in mind for Africa. Mind you that while information is a constant, it is consumed in different ways by different societies.

You have correctly pointed out that small Islands have less developed - or non-existent - base of information, professional, technical and facility capabilities to address increase in demand for awareness and the resulting demand for treatment. Nevertheless, my view is that a collaborative approach of skilled professionals in the USA and visionary Caribbean health policy makers can result in better access to information, grass roots involvement in disease detection drives and even in better treatment options.

Having InfoLink co-branded to Ministries of Health, as the nation's PCa information portal, will be a great FIRST STEP in our collaborative mission and the practical needs of our Caribbean friends. Other steps are peer-to-peer (P2P) education and the merger of available infrastructure and imported skills. The Krongrad Institute has taken an active interest in these strategies and is working to implement some, or all of them, in various Caribbean locations (Cayman, Turks and Caicos, Antigua, Dominican Republic, Nevis, Anguilla, etc.).

I summary, I am optimistic that the region is indeed open to an "open discussion" about
Prostate Cancer".