With ‘Movember’ awareness month shining the spotlight on men’s health, a urologist from global health system Cleveland Clinic is advising men on important checks and symptoms for three common urological cancers.

“We encourage patients to undergo appropriate kidney, prostate and bladder screenings as the earlier these cancers are diagnosed, the more treatable they are. In general, treatments at an earlier stage are less invasive and the outcomes better. We also advise individuals never to ignore any urological symptoms, but instead to discuss these with a physician, and be sure to mention any family history of

cancers,” says Jihad Kaouk, M.D., a urologist and Director of Robotic Surgery at Cleveland Clinic’s Glickman Urological & Kidney Institute.

“Kidney cancers tend to occur later in life, most commonly from age 60 onwards, although younger people can still develop kidney cancer. Typically, we will screen younger men when they have symptoms, which could include anything abnormal such as blood in the urine, flank pain and fever. However, kidney cancers are usually a silent disease, so from the age of 60 and above, kidney screens should be a routine part of a man’s annual check-up,” Dr. Kaouk says.

A simple abdominal ultrasound can be useful in kidney screening, particularly in people with a family history of kidney disease or who present with symptoms, says Dr. Kaouk. If an abnormality is picked up, for example a mass on the kidney, then a contrast-enhanced MRI or CT scan will confirm a diagnosis and determine the next steps. Dr. Kaouk adds that since kidney cancer usually develops without symptoms, masses are often found incidentally, when a patient is screened for another reason.

“Treatment options for localized kidney masses are usually straightforward with a very high rate of cure if the disease is caught early,” Dr. Kaouk says.

Dr. Kaouk points out that prostate cancer is common to the extent that if all men lived to the age of 90 and beyond, all men would have developed it. “Given this high prevalence, we focus on treating men with aggressive prostate cancer as well as those who develop it at an earlier age,” he says. “For older patients or less aggressive forms of prostate cancer, active surveillance is the preferred approach, with treatment initiated only if necessary.”

“Annual testing for prostate cancer is important for men aged 50 and above. However, if individuals have a first-degree relative who was diagnosed with prostate cancer, they should start screening as early as age 40. In addition to a physical examination, screening is done through a blood test to detect raised levels of a protein called prostate-specific antigen, or PSA. This protein is produced by both cancerous and noncancerous tissue in the prostate, so having a high number doesn’t necessarily mean a person has cancer as there could be many other causes,” Dr. Kaouk says.

If a nodule or bulge is felt during the rectal physical examination, Dr. Kaouk says a biopsy will be taken regardless of the PSA results. “The good news is that the method of taking the biopsy has vastly improved over the years, greatly reducing any risk of infection or bleeding. At Cleveland Clinic, we usually now use a special type of MRI, called multiparametric MRI, which is fused with an ultrasound image, enabling very precise prostate biopsy.”

If the biopsy indicates cancer, Dr. Kaouk says a treatment plan will be formulated based on the classification of how aggressive it is, and taking into account existing comorbidities and life expectancy.

“Bladder cancer can be life-threatening, and it is time sensitive as it can be very aggressive, spreading quickly. Smokers are at particularly high risk for bladder cancer so they need to be extra vigilant. There is no routine bladder cancer test, but patients will be screened if they report symptoms. The most common symptom is blood in the urine. Fortunately, screening is very simple, and conducted through inserting a scope into the bladder to examine it, in addition to urine tests.”

Dr. Kaouk says that if polyps are found in the bladder, they can usually be scraped out. However, if the cancer has advanced significantly, the bladder may have to be removed, which is life-changing.

“Movember is a great opportunity to create awareness of these common cancers found in men, and to encourage them to speak openly to their doctors about any symptoms they experience. Doing so could greatly improve their outcomes or even save their lives,” Dr. Kaouk concludes.

With ‘Movember’ awareness month shining the spotlight on men’s health, a urologist from global health system Cleveland Clinic is advising men on important checks and symptoms for three common urological cancers. “We encourage patients to undergo appropriate kidney, prostate and bladder screenings as the earlier these cancers are diagnosed, the more treatable they are. In general, treatments at an earlier stage are less invasive and the outcomes better. We also advise individuals never to ignore any urological symptoms, but instead to discuss these with a physician, and be sure to mention any family history of cancers,” says Jihad Kaouk, M.D., a urologist and Director of Robotic Surgery at Cleveland Clinic’s Glickman Urological & Kidney Institute. “Kidney cancers tend to occur later in life, most commonly from age 60 onwards, although younger people can still develop kidney cancer. Typically, we will screen younger men when they have symptoms, which could include anything abnormal such as blood in the urine, flank pain and fever. However, kidney cancers are usually a silent disease, so from the age of 60 and above, kidney screens should be a routine part of a man’s annual check-up,” Dr. Kaouk says. A simple abdominal ultrasound can be useful in kidney screening, particularly in people with a family history of kidney disease or who present with symptoms, says Dr. Kaouk. If an abnormality is picked up, for example a mass on the kidney, then a contrast-enhanced MRI or CT scan will confirm a diagnosis and determine the next steps. Dr. Kaouk adds that since kidney cancer usually develops without symptoms, masses are often found incidentally, when a patient is screened for another reason. “Treatment options for localized kidney masses are usually straightforward with a very high rate of cure if the disease is caught early,” Dr. Kaouk says. Dr. Kaouk points out that prostate cancer is common to the extent that if all men lived to the age of 90 and beyond, all men would have developed it. “Given this high prevalence, we focus on treating men with aggressive prostate cancer as well as those who develop it at an earlier age,” he says. “For older patients or less aggressive forms of prostate cancer, active surveillance is the preferred approach, with treatment initiated only if necessary.” “Annual testing for prostate cancer is important for men aged 50 and above. However, if individuals have a first-degree relative who was diagnosed with prostate cancer, they should start screening as early as age 40. In addition to a physical examination, screening is done through a blood test to detect raised levels of a protein called prostate-specific antigen, or PSA. This protein is produced by both cancerous and noncancerous tissue in the prostate, so having a high number doesn’t necessarily mean a person has cancer as there could be many other causes,” Dr. Kaouk says. If a nodule or bulge is felt during the rectal physical examination, Dr. Kaouk says a biopsy will be taken regardless of the PSA results. “The good news is that the method of taking the biopsy has vastly improved over the years, greatly reducing any risk of infection or bleeding. At Cleveland Clinic, we usually now use a special type of MRI, called multiparametric MRI, which is fused with an ultrasound image, enabling very precise prostate biopsy.” If the biopsy indicates cancer, Dr. Kaouk says a treatment plan will be formulated based on the classification of how aggressive it is, and taking into account existing comorbidities and life expectancy. “Bladder cancer can be life-threatening, and it is time sensitive as it can be very aggressive, spreading quickly. Smokers are at particularly high risk for bladder cancer so they need to be extra vigilant. There is no routine bladder cancer test, but patients will be screened if they report symptoms. The most common symptom is blood in the urine. Fortunately, screening is very simple, and conducted through inserting a scope into the bladder to examine it, in addition to urine tests.” Dr. Kaouk says that if polyps are found in the bladder, they can usually be scraped out. However, if the cancer has advanced significantly, the bladder may have to be removed, which is life-changing. “Movember is a great opportunity to create awareness of these common cancers found in men, and to encourage them to speak openly to their doctors about any symptoms they experience. Doing so could greatly improve their outcomes or even save their lives,” Dr. Kaouk concludes.

With early screening and ongoing advances in treatment options, there is no reason for lung cancer to maintain its reputation as one of the deadliest cancers, according to an expert from global health system Cleveland Clinic.

“This is a very exciting time in the field of lung cancer treatment, says Khaled Hassan, MD. MS, a medical oncologist specializing in lung cancer at Cleveland Clinic. “In addition to advances in surgery and radiation, the past two decades have seen major developments in systemic therapy, with immunotherapy, targeted therapy, and antibody-based treatments introduced alongside the traditional chemotherapy options.”

Dr. Hassan welcomes the opportunity for people to discuss lung cancer openly and to encourage at-risk individuals to be screened. He says, “We need to share the message that the earlier we catch the disease, the more treatable it is, and even if it is caught in its later stages, there are many new effective treatment options to explore now.”

Focusing on the importance of regular screenings, Dr. Hassan says research indicates that lung cancer death rates could be reduced by up to 20% if individuals aged 50 to 80 with a 20 pack-year smoking history, and who are currently smoking or have given up in the past 15 years, are screened annually using a low-dose CT scan.

Dr. Hassan is quick to point out, however, that non-smokers and younger individuals can also get lung cancer, which is usually driven by specific gene mutations, as opposed to the cumulative damage to DNA caused by smoking.

Medical advances

According to Dr. Hassan, the advances in medical oncology over the past two decades mean that treatment is now far more personalized than it was in the past. Rather than analyzing the cancer from a histological perspective, experts now analyze the disease at a molecular level, looking for specific DNA mutations that are driving the cancer, and that can be targeted with specific drugs.

At facilities such as Cleveland Clinic, a multidisciplinary team will handle lung cancer cases, with medical and radiation oncologists, thoracic surgeons, pulmonologists, radiologists, pathologist and other lung cancer experts working together to create a treatment plan for the best possible patient outcomes.

To determine the most appropriate treatment, physicians consider three factors, says Dr. Hassan. “First, we will first identify the type of lung cancer and the molecular characteristics of the disease. Next, we will take into account the stage of the cancer – ranging from stage 1, which is localized, to stage 4, where the cancer has metastasized, or spread. Third, we will consider the current health and circumstances of patients, for example, whether they are fit for surgery.”

If the disease is caught early, at stage 1, and the patient is otherwise healthy, removal of the tumors by surgery is the preferred option, says Dr. Hassan, as this offers the best chance of removing all cancer cells so the cancer will not recur. He says surgery will be curative in around 80% of stage 1 patients. If the patient is not able or willing to undergo surgery, a form of targeted radiation such as stereotactic body radiation therapy would most likely be given.

For lung cancer in stages 2 and 3, surgery or radiation would be followed by systemic therapy, which has seen major advances in the past two decades, says Dr. Hassan. In stage 4, as the cancer has spread to other organs, surgery or radiation would not play a role, and treatment would be in the form of systemic therapy.

Regarding the advances in systemic therapy, Dr. Hassan says that chemotherapy was the gold standard treatment for many years, but three breakthroughs have greatly increased treatment options. The first came in the early 2000s, when experts found that many lung cancers are driven by specific genetic mutations. As these mutations were identified, oral drugs targeting each were developed, and more drugs continue to be developed as more mutations are identified.

The second breakthrough came with the development of immunotherapy drugs in the mid-2010s. These are well-tolerated with fewer risks and side effects compared to chemotherapy, for example, since they leverage the body’s own immune system to fight the cancer. “In very simple terms, cancerous cells normally ‘hide’ from the immune system, but the immunotherapy drugs work to make them identifiable and accessible, so that they can be eradicated,” Dr. Hassan says.

Antibody-drug conjugates (ADCs) represent the third breakthrough. Here, antibodies with chemotherapy drugs attached to them circulate in the blood and bind to specific receptors in cancer cells. Once attached, they release the chemotherapy into the cell to destroy it. The benefit of this approach is that it targets only the cancer cells rather than exposing the entire body to a course of chemotherapy.

Dr. Hassan points out that while these new treatments, alongside regular screening, can help to reduce cancer death rates significantly, prevention is still key. “It is well documented that many cases of lung cancer arise from years of tobacco use. Encouraging individuals to quit or never take up any tobacco habit, including cigarettes, chewing tobacco, shisha, and vaping, would substantially reduce lung cancer incidence and death,” he concludes.

With early screening and ongoing advances in treatment options, there is no reason for lung cancer to maintain its reputation as one of the deadliest cancers, according to an expert from global health system Cleveland Clinic. “This is a very exciting time in the field of lung cancer treatment, says Khaled Hassan, MD. MS, a medical oncologist specializing in lung cancer at Cleveland Clinic. “In addition to advances in surgery and radiation, the past two decades have seen major developments in systemic therapy, with immunotherapy, targeted therapy, and antibody-based treatments introduced alongside the traditional chemotherapy options.” Dr. Hassan welcomes the opportunity for people to discuss lung cancer openly and to encourage at-risk individuals to be screened. He says, “We need to share the message that the earlier we catch the disease, the more treatable it is, and even if it is caught in its later stages, there are many new effective treatment options to explore now.” Focusing on the importance of regular screenings, Dr. Hassan says research indicates that lung cancer death rates could be reduced by up to 20% if individuals aged 50 to 80 with a 20 pack-year smoking history, and who are currently smoking or have given up in the past 15 years, are screened annually using a low-dose CT scan. Dr. Hassan is quick to point out, however, that non-smokers and younger individuals can also get lung cancer, which is usually driven by specific gene mutations, as opposed to the cumulative damage to DNA caused by smoking. Medical advances According to Dr. Hassan, the advances in medical oncology over the past two decades mean that treatment is now far more personalized than it was in the past. Rather than analyzing the cancer from a histological perspective, experts now analyze the disease at a molecular level, looking for specific DNA mutations that are driving the cancer, and that can be targeted with specific drugs. At facilities such as Cleveland Clinic, a multidisciplinary team will handle lung cancer cases, with medical and radiation oncologists, thoracic surgeons, pulmonologists, radiologists, pathologist and other lung cancer experts working together to create a treatment plan for the best possible patient outcomes. To determine the most appropriate treatment, physicians consider three factors, says Dr. Hassan. “First, we will first identify the type of lung cancer and the molecular characteristics of the disease. Next, we will take into account the stage of the cancer – ranging from stage 1, which is localized, to stage 4, where the cancer has metastasized, or spread. Third, we will consider the current health and circumstances of patients, for example, whether they are fit for surgery.” If the disease is caught early, at stage 1, and the patient is otherwise healthy, removal of the tumors by surgery is the preferred option, says Dr. Hassan, as this offers the best chance of removing all cancer cells so the cancer will not recur. He says surgery will be curative in around 80% of stage 1 patients. If the patient is not able or willing to undergo surgery, a form of targeted radiation such as stereotactic body radiation therapy would most likely be given. For lung cancer in stages 2 and 3, surgery or radiation would be followed by systemic therapy, which has seen major advances in the past two decades, says Dr. Hassan. In stage 4, as the cancer has spread to other organs, surgery or radiation would not play a role, and treatment would be in the form of systemic therapy. Regarding the advances in systemic therapy, Dr. Hassan says that chemotherapy was the gold standard treatment for many years, but three breakthroughs have greatly increased treatment options. The first came in the early 2000s, when experts found that many lung cancers are driven by specific genetic mutations. As these mutations were identified, oral drugs targeting each were developed, and more drugs continue to be developed as more mutations are identified. The second breakthrough came with the development of immunotherapy drugs in the mid-2010s. These are well-tolerated with fewer risks and side effects compared to chemotherapy, for example, since they leverage the body’s own immune system to fight the cancer. “In very simple terms, cancerous cells normally ‘hide’ from the immune system, but the immunotherapy drugs work to make them identifiable and accessible, so that they can be eradicated,” Dr. Hassan says. Antibody-drug conjugates (ADCs) represent the third breakthrough. Here, antibodies with chemotherapy drugs attached to them circulate in the blood and bind to specific receptors in cancer cells. Once attached, they release the chemotherapy into the cell to destroy it. The benefit of this approach is that it targets only the cancer cells rather than exposing the entire body to a course of chemotherapy. Dr. Hassan points out that while these new treatments, alongside regular screening, can help to reduce cancer death rates significantly, prevention is still key. “It is well documented that many cases of lung cancer arise from years of tobacco use. Encouraging individuals to quit or never take up any tobacco habit, including cigarettes, chewing tobacco, shisha, and vaping, would substantially reduce lung cancer incidence and death,” he concludes.

The month of October was a blessing for the patients and staff at PMH Oncology Centre and the Sister Sister Breast Cancer Group. Rubis Bahamas Limited provided free breakfast each Tuesday for the month of October as a giveback for the company’s internal cancer awareness month.

Each year, Rubis recognizes October as cancer awareness month. “Cancer is the leading cause of death worldwide” according to the World Health Organization (W.H.O.). Rubis aims to educate its employees, bring awareness to the public, encourage early detection, and show empathy as well as help those in the fight against cancer.

Sister Sister Breast Cancer Group, a leading non-profit organization supporting cancer patients, pioneered the initiative of a weekly ‘teatime’ at PMH Oncology Centre. However, due to COVID-19 the weekly ‘teatime’ paused and only returned twice a month. This allowed Rubis to step in, give Sister Sister Breast Cancer Group a break and bring the initiative back on track for the entire month of October.

For the five Tuesdays in October, Rubis provided a hot catered breakfast with fruits, tea and hot chocolate for 60 patients and caregivers. Each week, Rubis departments; Sales & Marketing, Operations, Finance, Aviation, Administration, and IT, alternated to serve the patients and staff. In addition, each department was responsible for putting together weekly gift bags for the cancer patients that included a motivational note, branded hot & cold tumbler and bag. The last note from Administration and IT read “You are not alone, and we are here to support you on this journey”.

“Corporate responsibility has always been paramount in our organization” says Rubis Bahamas Limited Managing Director, Raymond Samuels. “Each year the Marketing Department looks for new and unique ways to involve Team Rubis as a group to educate or give back. Cancer has undoubtedly impacted every family in the Bahamas and Rubis continues to show its support by being a gold sponsor for The Cancer Society of The Bahamas major fundraiser.”

The month of October was a blessing for the patients and staff at PMH Oncology Centre and the Sister Sister Breast Cancer Group. Rubis Bahamas Limited provided free breakfast each Tuesday for the month of October as a giveback for the company’s internal cancer awareness month. Each year, Rubis recognizes October as cancer awareness month. “Cancer is the leading cause of death worldwide” according to the World Health Organization (W.H.O.). Rubis aims to educate its employees, bring awareness to the public, encourage early detection, and show empathy as well as help those in the fight against cancer. Sister Sister Breast Cancer Group, a leading non-profit organization supporting cancer patients, pioneered the initiative of a weekly ‘teatime’ at PMH Oncology Centre. However, due to COVID-19 the weekly ‘teatime’ paused and only returned twice a month. This allowed Rubis to step in, give Sister Sister Breast Cancer Group a break and bring the initiative back on track for the entire month of October. For the five Tuesdays in October, Rubis provided a hot catered breakfast with fruits, tea and hot chocolate for 60 patients and caregivers. Each week, Rubis departments; Sales & Marketing, Operations, Finance, Aviation, Administration, and IT, alternated to serve the patients and staff. In addition, each department was responsible for putting together weekly gift bags for the cancer patients that included a motivational note, branded hot & cold tumbler and bag. The last note from Administration and IT read “You are not alone, and we are here to support you on this journey”. “Corporate responsibility has always been paramount in our organization” says Rubis Bahamas Limited Managing Director, Raymond Samuels. “Each year the Marketing Department looks for new and unique ways to involve Team Rubis as a group to educate or give back. Cancer has undoubtedly impacted every family in the Bahamas and Rubis continues to show its support by being a gold sponsor for The Cancer Society of The Bahamas major fundraiser.”

The Ministry's attention has been drawn to social media posts and online publications being circulated that have sought to discredit and defame the work of the National Health Insurance Authority (NHIA) and its leadership. The content shared is inaccurate and viewed as an ineffective attempt to distract from our dedicated efforts to improve healthcare services throughout The Bahamas.

The National Health Insurance Authority is a Bahamian success story and serves as a model in the region for what is possible in transforming a nation’s healthcare system using a patient-centered approach, in pursuit of the mandate to expand access to affordable, quality healthcare services.

The success of NHIA can be attributed to successive, competent leadership from the Board of Directors and executives from its inception which continues today under the current Managing Director, Mrs. Christy Butler, who was appointed in March 2021.

As the Minister of Health and Wellness, the Hon. Dr. Michael R. Darville, stated, “ I take pride in reporting that since its inception in 2017, the NHIA has seen remarkable growth. The program has extended its reach to the Family Islands, including Cat Island, Grand Bahama, Abaco, Long Island, and Eleuthera. With over 160,000 beneficiaries enrolled, supported by 87 facilities and 140 providers. I extend heartfelt gratitude to our stakeholders and partners for helping us achieve these milestones. The successful launch and adoption of the Electronic Health Record within NHIA’s provider network reflects its commitment to technological advancements.”

Minister Darville further expressed, “I am deeply committed to improving the healthcare system in The Bahamas and encourage the public to seek information from trusted and official sources. NHIA's leadership team and Board of Directors have my complete support and confidence and I applaud the work of team in its role in the transformation of the Bahamian healthcare sector.”

The Ministry of Health and Wellness remains dedicated to advancing the path towards better health and well-being of the people of The Bahamas and is optimistic about further expanding and improving the National Health Insurance Program.

The Ministry's attention has been drawn to social media posts and online publications being circulated that have sought to discredit and defame the work of the National Health Insurance Authority (NHIA) and its leadership. The content shared is inaccurate and viewed as an ineffective attempt to distract from our dedicated efforts to improve healthcare services throughout The Bahamas. The National Health Insurance Authority is a Bahamian success story and serves as a model in the region for what is possible in transforming a nation’s healthcare system using a patient-centered approach, in pursuit of the mandate to expand access to affordable, quality healthcare services. The success of NHIA can be attributed to successive, competent leadership from the Board of Directors and executives from its inception which continues today under the current Managing Director, Mrs. Christy Butler, who was appointed in March 2021. As the Minister of Health and Wellness, the Hon. Dr. Michael R. Darville, stated, “ I take pride in reporting that since its inception in 2017, the NHIA has seen remarkable growth. The program has extended its reach to the Family Islands, including Cat Island, Grand Bahama, Abaco, Long Island, and Eleuthera. With over 160,000 beneficiaries enrolled, supported by 87 facilities and 140 providers. I extend heartfelt gratitude to our stakeholders and partners for helping us achieve these milestones. The successful launch and adoption of the Electronic Health Record within NHIA’s provider network reflects its commitment to technological advancements.” Minister Darville further expressed, “I am deeply committed to improving the healthcare system in The Bahamas and encourage the public to seek information from trusted and official sources. NHIA's leadership team and Board of Directors have my complete support and confidence and I applaud the work of team in its role in the transformation of the Bahamian healthcare sector.” The Ministry of Health and Wellness remains dedicated to advancing the path towards better health and well-being of the people of The Bahamas and is optimistic about further expanding and improving the National Health Insurance Program.