Men ‘must check’ waterworks

Dr Greg Boustead, the newly appointed chairman of the Prostate Cancer Foundation in the Western Cape

Nearly one in five men will be diagnosed with prostate cancer during their lifetime – and, in South Africa, more than 4000 men are diagnosed with the illness every year. With prostate cancer being the leading cancer in males, it is crucial that men become more informed about the illness and its risks. So says Dr Greg Boustead, the newly appointed chairman of the Prostate Cancer Foundation in the Western Cape.

14 June 2017 – Boustead, who has worked in prostate cancer for the last 17 years and is South Africa’s most experienced robotic surgeon, works as a Urological and Robotic Surgeon at Netcare Chris Barnard Memorial Hospital, Cape Town and Waterfall City Hospital in Midrand.
In his new position with the foundation, he said he would focus on raising awareness of men’s health issues – particularly prostate cancer as the most common cancer in men in South Africa – as well as spearhead fundraising for the foundation in the Western Cape.
“Sadly, many men are unaware of the risks they face with regard to this disease and many men remain undiagnosed or are diagnosed with advanced stages of the disease,” Boustead said.
“With June being Men’s Health Month it is a good time to remind men to take time out to check their health. Men are known to ignore the early warning signs of disease and to visit their doctors less frequently than women.
“Men need to take seriously the need for regular check-ups and that this includes screening for cardiovascular risk factors and mental health.
“Men over 40 should speak to their doctors about screening or prostate cancer, particularly if they have a family history of prostate or breast cancer, which would make them more at risk for prostate cancer. If you are a black African male, you are also at increased risk.”
According to Boustead, general lifestyle measures that can help to decrease prostate and other cancer risk include regular exercise, diets low in animal and saturated fat and antioxidants in the form of fresh fruit and vegetables.
“All men but particularly middle-aged and elderly men should be aware of changes in the ‘waterworks’. If they pass urine more frequently in the day or get up more often at night, their urine flow gets weaker or they have pain or blood on urination they should be checked for prostate enlargement. This may be due to the benign enlarged prostate, but men should also be checked for cancer. Prostate cancer screening using a blood test known as PSA can reduce the risk of prostate cancer death by up to 20%. Targeted screening of men with a PSA blood test at age 50 and again at 60 can detect a significant proportion of prostate cancers.”
Boustead said one of the key aims of the Prostate Cancer Foundation would be to drive ongoing awareness and education programmes and to raise community awareness of the disease, resulting in early detection and more effective treatment of the illness.
Boustead also sees it as a priority to urge business leaders and government to help promote education on all aspects of prostate cancer, including screening, access to early diagnosis and the latest treatments.
Boustead, who was instrumental in introducing robotic-assisted laparoscopic surgery into South Africa believes there is a pressing need for patients and their families for easily accessible, high quality balanced information about their treatment alternatives throughout their cancer journey.

New imaging techniques help diagnosis

Dr Boustead qualified as a urology specialist in South Africa in 1993 and was most recently Clinical Director at the Hertfordshire and South Bedfordshire Urology Cancer Centre in the UK. Dr Boustead has been instrumental in setting up robotic surgery in South Africa and has been doing robotic surgery since 2008. Dr Boustead has a strong research background being a Principal Investigator in 22 clinical trials and has 45 international publications
In 2013, Dr Boustead led a team at Pretoria Urology Hospital that performed the first Da Vinci robotic prostatectomy in SA and, in 2015, he performed the first robotic-assisted cystectomy and total bladder reconstruction in SA. Since then, he has trained and accredited 22 surgeons at Netcare Robotic Centres in Johannesburg and Cape Town,  and at Pretoria Urology Hospital. He currently leads the Netcare Da Vinci Robotic Surgery programme in Johannesburg, Cape Town and Durban.
Robot-assisted laparoscopic prostatectomy (RALP) a rapidly expanding development in surgery where a robotic side cart is attached to the operating instruments and is directly controlled by the surgeon.
The robot assists by providing magnified 3D, 1080 HD visibility, allowing greater control of the miniature instruments and improved precision during the surgery compared to conventional keyhole or open surgery. This results in excellent cancer control, continence and preservation of erectile function where possible.

According to Boustead, the last decade has seen tremendous advances in the diagnosis and treatment of prostate cancer. “New imaging techniques using MRI scans can detect high grade and potentially lethal cancerous areas within the prostate with a high degree of certainty. We can then do targeted biopsies of these areas to confirm this. We have also seen tremendous strides in new drugs for advanced prostate cancer which have improved survival and quality of life for men at a stage of their disease which was previously very hard to treat. “Traditionally we relied on medical or surgical castration to control advanced prostate cancer, but these treatments only work for a variable amount of time. “Now chemotherapy called Docetaxel and Cabazitaxel have shown improvements in survival for prostate cancer sufferers. Most recently drugs like Abiraterone acetate (Zytiga) and Enzalutamide(Xtandi) show excellent survival and quality of life improvements with very low side effect rates. Patients in South Africa have been waiting for approvals and licensing of Xtandi which has finally come through in the last few weeks.”

However, said Boustead, one of the biggest challenges in prostate cancer in South Africa is addressing the disparities in access to screening, early diagnosis and the latest treatment.
“New therapies are expensive even by first world standards, and this is compounded by currency exchange rates. There are however a variety of potential, novel, collaborative Private-Public approaches which can at least start to address these issues. “

The Prostate Cancer Foundation also promotes the continuing education of health care professionals about prostate cancer and supports prostate cancer research dedicated to improving treatment and to finding a cure for prostate cancer.
“Over the next few months I will be engaging corporate business  and local government leaders, the pharmaceutical industry, urologists, oncologists and allied medical associations as well as prominent figures in the community to make them aware of the foundations activities and hopefully gain intellectual and financial support from a diverse population to further the aims and ideals of the Prostate Cancer Foundation,” Boustead said.

by Sue Segar, a Cape Town journalist.

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