Prostate cancer is the third most common male cancer in Hong Kong. Every year over one thousand men are diagnosed with prostate cancer, and about 200 die from the disease. Prostatectomy is an effective treatment for prostate cancer with up to 80-90% of patients having a progression free survival (PFS) period of 10 years. However, about 10% of patients can suffer from surgical side-effects such as incontinence. While special procedures can help improve the condition, these procedures are often expensive and unaffordable to many.

 

Incontinence can affect one’s daily and sexual life. As a result, patients with incontinence problems will often feel anxious and have low self-esteem. They are likely to isolate themselves from families and friends and may even feel worthless. Dr CHAN Wai-hay, Consultant in Surgery, Queen Elizabeth Hospital pointed out, “To avoid embarrassment, patients often prefer to stay home, which further impairs their social and daily functions.” 

 

Some patients try to deal with the problem in their own way. For example, some install urinary drainage bags, while others use toilet paper and cotton to make diapers. However, as their skin is in constant contact with their urine, it often results in serious skin problems or infection. In extreme cases, some even opt to tie rubber bands around their penis to avoid urine leakage. This blocks the blood supply to the genital organ and can lead to serious consequences. These methods are not effective in improving the condition and will often worsen the situation.

 

The artificial urinary sphincter (AUS) and the male sling, are both effective in the treatment of incontinence and can significantly improve patients’ quality of life. Over 10,000 patients worldwide have received these surgeries over the past three decades. However, they are not common in Hong Kong. During the past 11 years, more than 10 operations were performed in public hospitals, most of which were performed at Queen Elizabeth Hospital. 

 

Dr HO Lap-Yin, Associate Consultant in Surgery, Queen Elizabeth Hospital, shared his clinical experience, “The cost of this procedure is definitely quite high. AUS costs around HK$70,000, whereas the male sling costs around HK$30,000. Not everyone can afford such fees. For this reason, some patients prefer to suffer the inconvenience and distress caused by incontinence rather than pay for the surgery."

 

In view of the complications faced by prostate cancer patients, Hong Kong Cancer Fund, in collaboration with Queen Elizabeth Hospital, has launched a one-year surgery subsidy scheme for urinary continent devices, which aims to help prostate cancer patients that have incontinence as a result of a prostatectomy. 

 

Mrs. Sally Lo, Founder and Chief Executive of Hong Kong Cancer Fund said, “We are committed to helping make life better for people touched by cancer and increasing a cancer patient’s quality of life is an important part of this commitment. When we learned of the needs of these prostate cancer patients and how we can make a difference to their lives we immediately agreed to the funding of HK$1.15 million for the pilot scheme. Our collaboration with Queen Elizabeth Hospital will help those with financial difficulty to receive proper post-surgical care and improve their well-being.” 

 

The scheme will allow prostate cancer patients to receive the procedure one year after prostatectomy to help improve their condition. Physicians will perform thorough examinations to rule out incontinence due to other causes (i.e. other diseases or drugs). Medical social workers will then assess the patients’ financial status and those eligible will receive subsidy for the surgery.