Rabii Madi

MD, MBA, FACS, Consultant Urology, Director of Robotic Surgery at Clemenceau Medical Center in Dubai

“Men’s wellness package aims to increase awareness of men’s health overall”

Men’s wellness package at Clemenceau Medical Center in Dubai is an exciting health package for men in order to achieve that goal of increasing awareness about prostate health and overall men’s health. “Hospitals” magazine met with Rabii Madi MD, MBA, FACS Consultant Urology, Director of Robotic Surgery at Clemenceau Medical Center in Dubai, who focused on men’s health in general and the importance of early detection of prostate problems after age 50.

We would like to focus on men’s health on the occasion of International Men’s Day on November 19? What is the main concern?

Actually, what we are looking for in men’s health awareness in November or as it’s known the month of ‘Movember’ is to increase the awareness among men especially when it comes to prostate cancer. As you know, prostate cancer is the most common cancer in men and it affects mostly men above the age of 50. It is estimated that out of 100 men 13 will be diagnosed with prostate cancer and unfortunately three to four will die from it. So it’s very common and it increases with age. It’s important for every man to know about the way we detect prostate cancer and the way we treat it and hopefully some ways of preventing it.

What should be done to help men improve their health?

What we can do is increase the awareness of the diseases that can affect men with age, especially prostate problems that mostly include prostate cancer by knowing what to do to prevent it, when to start screening and what to do to treat it.

Men’s wellness package is an exciting health package for men in Clemenceau Medical Center in Dubai. What does it include? What is its importance?

Men’s wellness package that we have at Clemenceau Medical Center in Dubai is very attractive since we are offering it at a discounted rate just in order to achieve that goal of increasing awareness about prostate health and overall men’s health. So that package includes a visit to see a urologist, PSA blood test that screens for prostate cancer and it includes the male hormone testosterone which is very important in men’s health and wellness.

The package also includes an Ultrasound (KUB) that gives us an idea about the condition of the kidney, the bladder and the prostate.

Let’s focus on male urology concerns. When a man should start visiting a urologist? Should it be done regularly every year?

Men should see a urologist whenever he has any urologic symptoms or sexual problems which might happen at any age whether in men or women. But when it comes to men’s health awareness, a routine visit to the urologist should be done starting at the age of 50 to check his prostate condition and screen it, as well as to check his overall sexual health condition because it is well-known that as men get older, they will be at higher risk of developing prostate cancer or prostate enlargement and erectile dysfunction. We recommend that every man starting at the age of 50 should visit a urologist on a yearly basis even if he does not have any symptoms at all. Men with a family history of prostate cancer need to come earlier starting from age 40. Also, men who see blood in their urine should see a urologist at any age.

What are the most common urological issues affecting men?

The most common urological issues affecting men vary depending on age. For men over the age of 50, we have to keep an eye on three important entities; the benign enlargement of the prostate which is unavoidable for every man and it is part of the aging process and that causes symptoms or troubles in urination such as weak stream, experiencing nocturia which is the need to urinate two or three times during the night and many other symptoms.

The second problem that might happen while aging is prostate cancer which is very common and silent since it can affect men’s health without any symptoms.

The third problem is bladder cancer which is  common among smokers. It presents with blood in urine.

That’s why screening is very important since it leads to early diagnosis and cure as well.

Any man with blood in the urine that he can see or blood in the urine analysis test should see a urologist; of course, there are many health problems that might occur during men’s life and need the intervention of a urologist such as kidney stones, urinary tract infection and of course if he has some sexual dysfunction or low testosterone.

It is well known that prostate abnormalities are normal after the age of 50 such as enlarged prostate which might become a cancer after years if not treated.

Here, I would like to clarify the difference between prostate cancer and prostate enlargement that happens with men which we call “Benign prostatic hyperplasia” (BPH) which is part of the aging process of men and of course it is manifested by some urinary symptoms; this case is usually managed by medication or surgery when these medications did not work. What I want to emphasize is that the enlargement that happens with age is not a risk for prostate cancer. BPH is not transformed into cancer. Those are two separate entities and are not connected to each other.

Prostate cancer can be totally silent and that is what we see in our clinics; many cases do not have any symptoms at all but they have prostate cancer based on the early detection, screening and PSA blood test.

How can men avoid it?

Men cannot totally avoid prostate cancer or even prostate enlargement; unfortunately, it’s not related to any specific factor that we can prevent. Prostate cancer is not directly related to a factor that we can minimize and this is why early screening and detection because it’s asymptomatic. But of course some risk factors such as family history, having a father or brother who suffers from prostate cancer should urge man to start screening before the age of 50 without suffering of any symptoms.

Moreover, having a healthy lifestyle by following a healthy heart diet is good for the heart and the prostate; healthy eating habits is recommended by increasing the consumption of vegetables and fruits and decreasing meat and fatty products. Exercise is also very important.

What are the advanced treatments?

There are different treatments available; here, I would like to emphasize that there is no one-size-fits-all treatment, some patients will react very well with surgery while others need radiation, and maybe we can apply it to other treatment options. This depends on many factors like the patient’s age, his health in general, and how aggressive the prostate cancer is according to the biopsy result. It’s very important to take the decision between the urologist and the patient after diagnosis.

If prostate cancer is diagnosed at an early stage, we have many options to treat it. One of the treatments is just watching it “active surveillance” where we don’t treat cancer but monitor it closely.  The second option is surgery which is the most prescribed procedure and the most curative. The third option is radiation therapy whether external beam or brachytherapy. Ablation is also another option, whether it is through cryoablation or high-intensity focal ablation.

What is the role of robotic surgeries in treating prostate cancer?

Robotic surgery is the most advanced surgical treatment for prostate cancer. As I mentioned earlier, one of the most common ways of treating prostate cancer is surgery, and the most advanced and accurate way is robotic surgery which has been available for more than 17 years and it’s a gold standard for the treatment of prostate cancer in many countries such as the US where more than 90 percent of surgeries for prostate cancer are done by robotic surgery.

I’m lucky to be among the first in the United States who adopted robotic surgery and I have been doing robotic surgeries for prostate cancer for more than 15 years and performed more than two thousand surgeries.

What is the importance of awareness? What should be done to encourage men to visit a urologist regularly?

The importance of awareness is very simple. Prostate cancer is very common and it can be silent at an early stage, so every man should be aware of that silent possibly fatal cancer.

The good thing is that we have easy ways to detect it earlier; thus with early detection comes early treatment which leads to cure.

Prostate cancer awareness is as important as breast cancer awareness in women. Many women are aware of it and every man should be the same at the age of 50 or earlier if there is any family history. PSA blood test and digital rectal examination should be done.

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