Video: Prostate Health Booklet, PSA Guidelines
Minister of Health Kim Wilson, BHB CEO Scott Pearman, and Dr. Jonathan Makanjoula introduced the Integrated Care in Bermuda: Understanding Prostate Health booklet.
Minister of Health Kim Wilson said, “I’m very pleased to be launching the Integrated Care in Bermuda: Understanding Prostate Health booklet today.
“This booklet is one of the recommended deliverables from an extensive piece of collaborative work on the integrated care pathway for prostate cancer.
“It has followed a similar process to the integrated cancer care pathway completed for breast cancer, and it is just as important.
“While breast cancer is the number one cancer affecting women in Bermuda, prostate cancer is the number one cancer affecting men. In fact, it makes up 33% of cancer diagnoses in men in Bermuda with over 50 new cases identified in Bermuda each year. Why it needs our attention now is that mortality rates in Bermuda for prostate cancer are twice that compared to the OECD average.
“It is critical we understand and improve our care pathways for prostate cancer so we can deliver the most effective screening and the best, most efficient treatment for men who are diagnosed.
“Our goal is to also improve outcomes and share information about what can be done to understand and reduce the risks of developing prostate cancer so men and their families can make well informed decisions about their health.
“The integrated pathway work for prostate cancer is led by Bermuda Hospitals Board’s consultant urologist and founder of the Daily Male charity Dr Jonathan Makanjoula in partnership with patients, local urologists and oncologists, clinical specialists and primary care representatives.
“It is one of a number of integrated care pathways BHB is working on under the leadership of BHB CEO Scott Pearman, and others that are being led by the Ministry of Health.
“I very much want to extend the gratitude of the Bermuda community for all the patients and healthcare providers who have worked on this pathway and thank you for helping to protect and improve the outcomes for the men in all our families.”
CEO Scott Pearman said, “Thank you, Minister Wilson.
“I am extremely proud to being able to hold a copy of the Integrated Care in Bermuda: Understanding Prostate Health today and share more about the work being done to develop effective integrated care pathways to improve healthcare screening, treatments and outcomes for the people of Bermuda.
“Bermuda Hospitals Board wants to see the best possible outcomes for its community.
“This integrated prostate cancer pathway follows on from similar work completed for breast cancer that has seen improvements in the pathway for women. We are also working with Johns Hopkins on pathways for trauma and burns care, which we hope will also improve the efficiency and effective of our trauma and burns response.
“As the honourable minister has noted, it was important to do prostate cancer as the number one cancer diagnosis in men in Bermuda. Our plan is to next complete a similar integrated care pathway for colon and lung cancer. The central purpose of the cancer pathways is about making a difference in the lives of people in Bermuda. We want to make screening more effective and available, to catch cancers as early as possible when there is the best chance of a full recovery. We also want to raise awareness about risks and prevention, and to improve the care pathway for men diagnosed with prostate cancer so that we can improve outcomes and save lives.
“It is BHB’s vision to pursue excellence through improvement, and at BHB we believe that improvements require listening to and understanding the patient experience. It also requires working in partnership with fellow providers and other experts to ensure a coordinated and collaborate pathway can be developed that reduces duplication, avoids delays and keeps the patient at the heart of all we do.
“So today I’m proud to see this work is progressing and making a difference and thank all those who have been involved in developing the pathways. Concrete improvements are being made to help save more lives. I would now like to hand over to BHB’s consultant urologist Dr Jonathan Makanjoula who is also the founder of the DailyMale charity.”
Consultant Urologist/Founder DailyMale Dr Jonathan Makanjuola said, “Thank you, Minister Wilson and Mr Pearman.
“The work on the prostate cancer integrated pathway started in just as I was starting at BHB in 2022 and it was great timing. This process has been a great way to look at what can be improved to improve screening and get men diagnosed and treated as soon as possible. An early diagnosis makes such a big difference to outcomes, and as the honourable minister has noted, mortality rates for men with prostate cancer in Bermuda are twice the OECD average.
“The state of Bermuda’s prostate cancer pathway was first mapped in 2022, revealing key opportunities to improve the pathway, notably in early detection, standardisation of care and patient support. The pathway has already been updated since then and I would specifically like to thank the following individual got validating the pathway and guidelines. Dr Fosker from the Bermuda Cancer & Health Centre for helping validate the pathway. Dr. Michael E. Czerwinski, Consultant Urologist, Island Urology Services. Dr. Michael E. Brooks, Consultant Urological Surgeon, Dynamic Urology Services. Dr. Jeff MacLeod and Dr. Adil Ladak, Island Health Services FPG. Dr. Kyjuan H. Brown, President, Bermuda Medical Doctors Association and Dr. Ayoola Oyinloye, Director of Population Health Innovation and Strategy, Bermuda Health Council
“One of the improvements I am most proud of is the improved access to free screening for men through the DailyMale mobile screening unit. We are going out into the community to make it as easy as possible for men to get assessed. The original 2022 map has already been updated to include an additional urologist as a new service provider for the island, and the DailyMale clinics as a new entry point to the pathway. Since the DailyMale started in February 2022 we have screened over 250 men with no insurance and to date picked up 10 cases of advanced prostate cancer, and facilitating treatment both at BHB and Bermuda Cancer & Health Centre.
“That being said I am proud to announce we have van and partnership with BHB the DailyMale had purchased and are shipping in Bermuda’s first mobile screening van. With donations from business and individual in Bermuda we have raised over $200,000 to build and import a fully function mobile clinic. This mobile clinic will enhance our capabilities and enable us to travel across the island offering free screening and healthcare to those with limited or no insurance.
“This work has also enabled us to develop standardised PSA screening guidelines. Why is this important? Because previously each physician was using different guidelines from different countries, leading to inconsistent care between service providers. With the input of local urologists, oncologists and other key stakeholders, who participated in a workshop to discuss screening guidelines, we now have Bermuda-specific screening guidelines will help us standardise care and improve early detection and we are sharing them with you today.
“This early phase of work also identified a low understanding of prostate cancer in the community and limited support for patients diagnosed with prostate cancer. Conversations with stakeholders helped identify what information was needed helping us develop the content, and the final booklet was then reviewed for feedback. The result is the prostate health guide we are publishing today. It is a resource for men in the community to improve the understanding of prostate health and support those with prostate-related conditions.
“The message I’d like to leave you with today is that when detected early, most prostate issues, including cancer, are highly treatable, and men have a range of options to regain their health and peace of mind.
“So please read this guide if you are a man or to share with the men in your life.
“My hope is that this information will empower you to take charge of your prostate health and encourage you to make screenings a regular part of your wellness routine. Together, by staying informed and proactive, we can make a big difference in men’s health in Bermuda.”
The full PSA Guidelines poster follows below [PDF here]:
The full Prostate Care Booklet follows below [PDF here]:
This is critical. Because of the fear of the finger exam the easiest way around it is two fold:
1. Immediately activate your annual exam on your birth day. Go every year. Once you get the routine, there is no fear because you have a relationship with your doctor. He doesn’t really want to do it either.
2. It is so simple. Once on your side count to 10. You change up and come out. Easy. What’s the big deal? You won’t feel like you were forced to go and all fear and uneasiness etc would have gone.
The dreaded ‘DRE’ has almost completely been replaced by a PSA test that is now part of the routine ‘annual checkup’ blood tests. More than likely your GP will only do a DRE now if he wants to eliminate any uncertainties if a questionable number comes up on the PSA results.