Bougainvillea: First prostate cancer surgery done

PRESS RELEASE: The Bougainvillea Clinic, a private hospital in Road Town, has successfully carried out a procedure called radioactive seed implantation, also known as brachytherapy, on three patients with early-stage prostate cancer.

The operation was done on January 6 which is the first time treatment for prostate cancer has been performed in the British Virgin Islands.

The three patients, two from BVI and one form a neighbouring island, underwent the procedure.

The procedure lasted about an hour and 20 minutes each. The patients were all discharged a few hours after the surgery.

All three patients expressed satisfaction with the fact that the service could be performed here in BVI – at home for the BVI patients and close to home for the other.

Urological surgeon Dr Dwayne Thwaites, who practices in several of the Leeward Islands, sees patients with problems related to the prostate, bladder, kidneys, and other parts of the urinary and genital system at Bougainvillea Clinic once or twice per month.

With Dr Thwaites, the Bougainvillea Clinic was able to arrange for a team of radiation therapy specialists from 21^st Century Oncology Inc in Florida, United States to come to BVI to perform the complex treatment at our clinic.

The team which was led by radiation oncologist Dr Christopher Chen included a radiation physicist, a radiation therapist, and an administrative personnel.

General anesthesia was administered by Dr Craig Stoutt, thus ensuring that the patients felt no pain during the procedure. The Bougainvillea Clinic also acknowledged the involvement of several nurses and other support staff at the medical facility.

Prostate cancer is the leading cancer for men in the USA. It is followed by lung cancer and then colorectal cancer. Prostate cancer is more common in black men than in whites and tends to occur at a younger age in black men.

In the Caribbean, prostate cancer is by far the most common, followed by cancer of the colon and rectum.

Fortunately, most prostate cancers are relatively slow-growing. Most of these cancers are diagnosed in men in their 60s, with a significant percentage of blacks diagnosed in their 40s and 50s, when the cancers tend to be more aggressive.

Not all patients with prostate cancer need active treatment. Persons diagnosed over the age of say 80 are often more likely to die of other conditions than from prostate cancer and may not need treatment.

Managing prostate cancer depends on how early it is diagnosed and the level of aggressiveness of the cancer determined by the Gleason Score when the biopsy is examined under the microscope.

Only two forms of treatment can cure cancer of the prostate; surgery for complete removal of the cancerous gland, when cancer is confined to the gland; and radiation therapy which kills cancer cells.

It may be given by radioactive seed implants into the gland for early cancer that is confined to the gland; or by external beam radiation to the pelvic area for later stage cancer that has spread outside of the gland but is still confined to the local pelvic area.

All of these treatments have significant side effects such as urinary incontinence and erectile dysfunction which usually show up immediately after surgery in 25 to 50 percent of cases treated by whatever form of surgery, but tend to improve over the ensuing months .

Two and five years after treatment, men in the prostatectomy group were significantly more likely than those in the radiation group to report urinary leakage and erectile dysfunction.

But the problems increased in both groups over time, and 15 years after treatment, the likelihood of having these side effects was similar between the two groups.

At 15 years, almost all the men reported having erection problems – 87 percent in the prostatectomy group and 93.9 percent in the radiation group.

When we consider that prostate cancer tends to be slow-growing in most cases and that treatment carries risk of very significant complications. There should be no rush to treat very early cancer.

Watchful waiting may be selected as an option with repeated prostate-specific antigen (PSA) and prostate biopsy procedures to follow the activity of the cancer.

With increasing PSA and perhaps a change in level of aggressiveness, a decision to treat is likely to be made and the choice will be either surgery or brachytherapy; both treatments having similar cure rates but different side effect profile.

Both options of radical prostatectomy and brachytherapy are now available here in BVI at the Bougainvillea Clinic.

Bougainvillea Clinic thanked all persons involved in making this treatment a reality in the BVI.

It however offered special thanks go to the Customs department, Immigration, and Labour department, for their help in getting the radioactive seeds and the treatment team into the island.