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What to know about prostate cancer

Prostate cancer is the leading cause of cancer deaths in Nigerian men, and the third leading cause of cancer deaths in Nigeria after breast and…

Prostate cancer is the leading cause of cancer deaths in Nigerian men, and the third leading cause of cancer deaths in Nigeria after breast and cervical cancer.

According to the GLOBOCAN 2021 Report, Nigeria has the highest number of deaths from prostate cancer with 8, 382 (58.5%) deaths out of the 14,334 deaths recorded globally in 2020.

The Medicaid Cancer Foundation said  13,0781 new prostate cancer cases are recorded annually.

“For Nigerian men, prostate cancer is both the most common and most deadly cancer with 32·8 cases and 16·3 deaths per 100,000 men. Prostate cancer is to men what breast cancer or cervical cancer is to women. It has the potential to grow and spread quickly, yet, awareness amongst men and the general population towards screening low,” Chief Executive Officer of the foundation, Dr  Zainab Shinkafi-Bagudu, said.

However, medical experts say early presentation for diagnosis and care could help prevent, and improve the survival rate for the disease.

Prostate cancer is the growth of tumours in the prostate gland. Only men have a prostate which is a walnut-sized gland between the rectum and the penis and creates a fluid to be mixed with sperm to create semen.

Symptoms of prostate cancer include trouble urinating, decreased force in the stream of urine, blood in semen, discomfort in the pelvic area, bone pain as well as erectile dysfunction.

Findings reveal that a large number of Nigerian men who were diagnosed of prostate cancer, presented late at stages III or IV, when the prostate cancer has spread to other vital organs of the body.

Daily Trust reports that there is still a lot of ignorance about the disease and inadequate treatment facilities and equipment across the country. Lack of finances for proper treatment also leaves patients and their families suffering untold hardships.

“When prostate cancer is detected and managed early, people usually respond to treatment. It is very important to go for screening to detect it, especially as one approaches the age of 40,” Dr Habib Muhammad of the Radiotherapy unit, Lagos University Teaching Hospital (LUTH), said.

He said any good public or private laboratory could conduct a test to detect prostate cancer, adding that an easy test to do is Prostate-Specific Antigen (PSA) where blood samples are taken from a man at the laboratory. Other tests like digital examination, ultrasound of the pelvis to see the nature of the prostate can be done, he said.

Dr  Zainab Shinkafi-Bagudu said, “Early detection saves lives. Almost 100% of men diagnosed with prostate cancer in early stages are still alive, five years after diagnosis.”

The Executive Director, Project Pink Blue, a cancer organisation focused on cancer awareness, screening and support services, Runcie C.W. Chidebe, said the burden of prostate cancer in Nigeria is huge and the country continues to lose mentors and older people to this disease.

He said, “Once prostate cancer hits a man in a family, the entire home is affected. The burden is so huge that it drains everyone around the patient – psychologically, financially and otherwise. There is an increasing burden of cancer phobia among family members of any man who has been diagnosed of prostate cancer; families who lost someone to prostate cancer become afraid and continue to see any symptom of any illness as cancer.”

He said low awareness and unavailability of a national screening programme has been a factor for late diagnosis of prostate cancer in the country.

“To reduce the burden of prostate cancer, I would like to see a Nigeria where once a man is 40 years old and above, he is mandated to run a prostate-specific antigen (PSA) test at every visit in any hospital,” he said.

 

 “This way, we can catch abnormal PSA levels on time and tackle prostate cancer at early stages. What we have in Nigeria is opportunistic screenings, a situation where non-governmental organizations, churches and other organizations host medical outreaches and men are screened randomly and possibly present some abnormalities,” he said.

He said the prostate cancer incidence is increasing and the awareness on the disease is really low, “hence there is a need for conscious actions to create awareness and save our men from prostate cancer in Nigeria.”

Risk factors

Prof Omokhoa Adeleye, Professor of Public Health and Community Medicine at the University of Benin Teaching Hospital, Benin City said the risk factors for prostate cancer are black race, being above 40 years, positive family history and high-fat diet.

Adeleye, who is also the consultant for  LAPO Community Campaign for Cancer Control, said other risk factors are high serum androgen (sex hormones) levels and prolonged sexual abstinence in middle-aged adults.

Dr Muhammad explained that “As you age, the likelihood of prostate cancer also increases. It is commoner among blacks and family history also increases the chances.”

A Consultant Urologist at Enugu State University Teaching Hospital, Parklane, Enugu, Dr Bun Eze Eze, explained that since only men have prostate glands, that factor predisposes a man to the illness

He said age is another risk factor. “In Nigeria, majority of patients we diagnose are people usually over 60 years or over 70 years old. So the longer a man lives, the more likely he’s going to have prostate cancer.”

He said the disease tends to run a more aggressive cause in blacks than in whites, adding that another important risk factor is genetics or hereditary factors. “The fact that you have a relation who has had prostate cancer increases your risk of having it.”

He added that people who eat more of vegetables and fruits tend to be less obese and have less risk for prostate cancer than people who eat more animal protein such as beef, red meat – who are usually more obese than the general population.

Patients’ experiences

A 60-year-old patient, Ameh Thomas (not his real name) said he was shocked when he was diagnosed of advanced prostate cancer. He said he noticed a little swelling in his pelvic area and went to the hospital and was told that the cancer was stage four.

 He said a lot of treatments were commenced to save his life.

Another patient, 64, said he felt back pain and decreased force in the flow of his urine before he was diagnosed with prostate cancer. He has been on treatment for four years. He added that the cost of treatments has been taking a toll on him and his family.

Isa Ahmed 73 on the other hand said, “I used to hear when people talk about prostate cancer. I didn’t know what it was until the experience I had recently. I woke up one early morning and discovered that I had pains in my lower abdomen. I did not take it very seriously until I was pressed.

“I find it very difficult to pass out urine. When I tried to force it out I started passing out blood and it was accompanied by severe pain in my pelvic region. I went to a hospital and a series of test and scans were conducted. I was diagnosed with prostate cancer. I was put on drugs and surgery recommended for me.”

Another prostate cancer survivor, Onukwo Emmanuel, 52,  said he underwent surgery for prostate cancer and is now undergoing chemotherapy (treatment that uses drugs to kill cancer cells). He said he lost two friends to the disease.

Prof Omokhoa Adeleye said treatment for prostate cancer includes psychological support,  and prostatectomy (a surgical procedure for the partial or complete removal of the prostate), and radiotherapy (a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumours)  during the early stage of the disease.

He said treatment during the late stage is hormone therapy and bilateral orchidectomy (removal of both of the testicles) plus internal fixation if pathological fracture occurs.

He added that screening primarily PSA level tests could help prevent the disease while secondary methods are digital rectal examination, ultrasonography and high-risk individuals need immediate screening and follow-up.

 

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