Afraid of the finger 54-y-o who dodged prostate screening for years now worried as symptoms emerge

For years, Errol Bennett feared a doctor’s finger more than prostate cancer, but following months of concerning symptoms, though worried, he is still not ready to get screened.

“A the finger business. Mi nah lie to you. Mi just never comfortable with the idea of nobody, man or woman, putting dem finger inna mi bottom,” Bennett told THE STAR. “Mi know is a doctor and is them work, but mentally as a man? Mi just cya get past that.”

Bennett has not been diagnosed with prostate cancer and his symptoms may be caused by several other conditions. But after years of avoiding prostate screening, they are hard to ignore.

“Before, mi did afraid of the finger. Now mi afraid of what them might find,” he said.

For more than a year, Bennett said he has noticed changes in his urinary habits. He now wakes two or three times during the night to urinate, sometimes struggles to begin urinating, and has noticed that his stream is weaker. At times, even after using the bathroom, he feels as though his bladder has not completely emptied. Then came another change in the bedroom.

“Mi couldn’t perform like how mi normally perform. Sometimes mi couldn’t get an erection at all, and that start bother me because mi know that wasn’t normal for me,” he said. “But instead of going to the doctor, mi keep telling myself seh maybe is stress.”

For Bennett, however, the reluctance to be screened goes beyond fear of physical discomfort. It is tangled up in ideas about masculinity and sexuality.

“Is just how we grow. From you a youth, certain things a ‘b****man thing’. Man supposed to tough. Nobody supposed to touch you certain places,” he said.

Bennett said jokes among men have helped reinforce those attitudes. A man admitting that he had undergone a digital rectal examination (DRE), he said, could quickly become the subject of questions about whether he had “enjoyed it”.

“Mi wouldn’t seh mi believe it (the examination) can make you gay. But mi used to look pon it like, why would a straight man willingly allow another man fi do that?” he said. “Looking back now, mi can see seh that don’t really make sense because is a medical examination.”

Consultant urological surgeon Dr William Aiken said apprehension surrounding the DRE remains a barrier for some Jamaican men, but insisted it is a perceived discomfort. He told THE STAR that patients later told him, “‘Doc, if I had known it was this painless and this quick, I would have done this a long time ago.’”

More concerning, Aiken said, is the tendency for men to wait until something feels wrong before considering prostate cancer.

“There are absolutely no signs when it is early,” he said. “A man will have prostate cancer and it is growing inside of him and he will have absolutely no signs. So unless he goes and screens for the presence of the cancer, he won’t know.”

By the time symptoms develop, Aiken warned, the disease may already be advanced or metastatic. He recommends that men begin prostate cancer screening at age 40, and stressed that men who are unwilling to undergo a rectal examination should not allow that fear to stop them from approaching a doctor altogether. Initial screening, he explained, includes a prostate-specific antigen blood test and the rectal examination.

“If a man only wants to do the blood test, we not gonna turn him away,” Aiken said. “We do the blood test. We just simply explain that the test is compromised by not doing everything.”

Another fear among some men, he said, is that prostate cancer treatment inevitably results in impotence or incontinence. While both are potential complications, Aiken said advances in treatment mean these outcomes are not inevitable. Ironically, delaying diagnosis until the disease becomes advanced can leave a man facing more serious consequences.

For Bennett, there was another factor that helped him justify staying away from screening – he considered himself healthy. He regularly consumed bush remedies, including sarsaparilla and guinea hen weed, as part of what he considered a naturally healthy lifestyle.

“So me nuh see how cancer woulda reach me,” he said. He now acknowledges: “Sometimes you feel like once you don’t know, you alright.”