Team:TEC-Costa Rica/HP/Gold

Integrated Human Practice
What do men know about their prostate?

For our Integrated Human Practice, we decided to ask ourselves why men didn’t have their prostate checked for prostate cancer. By doing this, we were able to decide for the best possible way of detecting this illness in a way that most men would find friendly enough.

Take a look to this introductory video!

Surveys and Interviews

We started by doing field research on how many men had been checked for prostate cancer. For this, we created a questionnaire which was applied both via web and face-to-face. The questions of the interview are as follow:

  1. Age

  2. Gender

  3. Have you undergone a prostate cancer diagnosis test?

  4. If not, why?

  5. Why don’t men get tested for prostate cancer?

  6. Considering a new diagnostic test using urine, would you rather buy it in a pharmacy or take it in a hospital?

Figure 1. Age groups of our interviewees.

Figure 1. Age groups of our interviewees.

Figure 2. Gender proportion.

Figure 2. Gender proportion.


First, we got a sample of 393 people, who we asked the questionnaire. Figure 1 shows the age composition of the people who answered our questions. Figure 2 shows that most of the people interviewed are men. Figure 3. shows a vast majority of men have not been tested for prostate cancer in any way. Figure 4 shows the reasons men give for not being checked for the illness.

Figure 3. Question 3.

Figure 3. Question 3.

Figure 4. Reasons why interviewees haven’t been checked for prostate cancer.

Figure 4. Reasons why interviewees haven’t been checked for prostate cancer.


With this questions, we found out that most men younger than 40 don’t consider important to get checked for prostate cancer, since it is the main reason given for not being tested. Another important limitation is the access of men to health services, either because of difficulty to take time to do it because of work, or for geographical reasons. Yet, when asked why men don’t like to be tested (Figure 5), a huge majority points out it is because the traditional test (Digital Rectal Exam) is very invasive, and frightens men. Some of the interviewees even told us men aren’t necessarily afraid of the test but of the opinion other people may have of them.
So, we see, this issue goes beyond medical reasons to the cultural conformation of the Costa Rican man, where getting touched, even for medical reasons, is mocked of, relating it to homosexuality or weakness.

Figure 5. Reasons why most men don’t get checked for prostate cancer.

Figure 5. Reasons why most men don’t get checked for prostate cancer.


Since most of the people didn’t get checked for prostate cancer because of the detection method commonly used, we proposed two different systems for the detection of the disease. First, we proposed a system present in health centers (clinics, hospitals), where men could go, give a urine sample, and then get the results by a doctor. We thought most men would prefer this over our second option, which was to go to a pharmacy and get a device like a pregnancy test that gave you the result anywhere. Surprisingly, most men (Figure 6) preferred the “pregnancy-test”-like device, because they would get the results faster and wouldn’t have to spare time in visiting a doctor.

http://2016.igem.org/wiki/images/b/b5/T--TEC-Costa_Rica--prostal_hp_integrated_survey6.png

Figure 6. Preferred device.

Meetings

Beside from this interviews we had different meetings with representatives of several renowned pharmaceutical, biotechnological and medical companies in our country. We were trying to collect technical and professional criteria and opinions about our project.


First we had the opportunity to explain our project to Pfizer Latin America and Caribbean representatives. We discussed about the importance of generating non-invasive diagnosis systems and how the project we propose will appear as a way to reduce the mortality of prostate cancer, through early diagnosis. This same topic was developed at the seminary “Biología Sintética para Tomadores de Decisiones en Biotecnología” or “Synthetic Biology for Decision Makers in Biotechnology” organized by IICA (Instituto Interamericano de Cooperación para la Agricultura). At these seminary we also had the opportunity to meet iGEM representatives Ana Sifuentes (iGEM Junior Fellow) and Camilo Chávez (iGEM 2016 participant from Edinburgh, Overgraduate).


We assisted to meetings with ILSI (International Life Sciences Institute) and Lisan Laboratories representatives; we talked about the impact of Synthetic Biology. Also we explained our project and asked for some recommendations.


Then we meet some doctors from Hospital Clínica Bíblica. This conversation was focused on the possibility of detecting prostate cancer by sensing a biomarker in urine samples.


We talked with SPERATUM investigators and developers; this is a microARN cancer therapeutics company raised in our country (the first of its class). The main point discussed was whether to design our product as “pregnancy-test”-like device or as a kit for laboratories to undergo the examination of urine samples. SPERATUM advised to select the kit for laboratories as the way for commercializing the product, these because “realizing that you have prostate cancer, alone in the bathroom of your house, will probably generate a psychological and emotional shock”.

Conclusion

The information obtained by the analysis of the survey results and the opinion of the different experts we talked with, showed that even though the best option may be the design a kit for laboratories, men (users) rather to undergo the test by themselves. This human practice helped us understand better the problem behind our project, and also to propose our solution: Prostal, a cell-free system available in pharmacies that will allow men to keep a strict record of their health in an easy, fast, accessible, and non-invasive way.