Among the various cancers that plague the male folk, prostrate cancer is the most common and aggressive. And unfortunately, black men are more at risk of the disease than any other race, according to health experts. Indeed, grim statistics in Nigeria show that the disease is the number one cancer killer of Nigerian men. “In Nigeria, prostate cancer has a mortality rate of over eighty percent (80%)! A recent report by World Health Organization (WHO) shows that within a period of four years, deaths from prostate cancer in Nigeria increased by almost 100 per cent. The report showed that prostrate cancer now kills 26 Nigerian men every day (up from 14 men every day),” disclosed Dr Abia Nzelu, Executive Secretary, Committee Encouraging Corporate Philanthropy (CECP), Nigeria.
On the link between prostrate cancer and race, she stated: “Prostrate cancer occurs more often in Africans. It also occurs at an earlier age in blacks and is more aggressive in blacks. Therefore, all Nigerian men are at increased risk of prostrate cancer!”
On why black men are more prone to the disease than other races particularly whites, Dr Matthew Ogwah, a health care practitioner said: “I believe genetic factors may be part of the reason. Some genes have been identified in black men that are associated with an increased risk of prostate cancer and with high grade tumors. There’s also the socioeconomic issue- a black man in a developing nation like Nigeria with inadequate facilities to tackle serious health challenges like cancer, stands a poorer chance of survival from cancer than say an American, who probably has health insurance and better healthcare facilities for screening, treatment and cure. Nonetheless, I believe more research needs to be done in this field to determine the wide prevalent rate between black male and other races.”
On what the prostrate is, she stated: “The prostate is a gland that is found only in males. It is located in front of the rectum (last part of the large intestine leading to the anus) and below the urinary bladder (where urine is stored). The size of the prostate varies with age. In younger men, it is about the size of a kolanut, but it can be much larger in older men. It is responsible for the production of some of the semen (the fluid that carries and nourishes the sperm). Prostate Cancer is cancer that occurs in the prostate gland. Cancer begins when cells in a part of the body start to grow out of control. Cells are the building blocks of the body.”
Risk factors
One of the major risk factors according to health experts is age. “Prostrate cancer is more common among elderly men, say from 65 years of age. It’s rare among men below 40. The risk increases with age, from 50 years and above,” said Dr Matthew Ogwah.
“There are modifiable (can be changed) and non-modifiable (cannot be changed) risk factors,” explained Dr Nzelu. The major non-modifiable risk factors, she added include age, race and family history of prostate cancer.
“On the age factor, the chances of having prostate cancer rises rapidly after age 50.
As for the family history, having a father or brother with prostrate cancer more than doubles one’s risk. The risk is higher for men who have a brother with the disease than for those with an affected father. Men with several affected relatives have a much higher risk, particularly if their relatives were young at the time the cancer was found,” stated the medical practitioner.
The modifiable risk factors, she noted include lifestyle and diet. “People that eat a lot of red meat tend to have higher rate of prostrate cancer than those that eat lots of fish, vegetables and the likes. Also weight can also increase one’s risk, people that are over weight have more high risk than those with moderate weight. Lack of exercise (inactivity), is another risk factor. People that don’t exercise have high risk of prostrate cancer; even if you are trim, and you don’t exercise, your risk of prostrate cancer increases. Other factors are smoking and people with diabetes. People living with diabetics are at higher risk and are more likely to die of prostrate cancer than other people. However, risk factors do not tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors,” she said.
So, what are the symptoms, she was asked. “These could be summarized into three: urinary symptoms, sexual symptoms and pain symptoms. The urinary symptoms include difficulty in passing urine, poor urine flow, bloody urine, frequent passage of urine especially at night and inability to hold urine. Prostate cancer can also cause a man to have trouble getting an erection (impotence) or painful ejaculation. It may also cause pain in the hips, back (spine), chest (ribs), or other areas when the cancer spreads to the bones. So, that arthritis might just be prostate cancer!
“Other symptoms include weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord.
However, there are other diseases that can also cause many of these same symptoms. For example, trouble passing urine is much more often caused by benign prostatic hyperplasia (BPH) than cancer. Still, it is important to tell your doctor if you have any of these problems so that the cause could be found and treated. On the other hand, early prostate cancer does not usually show any symptoms, making detection difficult. For this reason, men over 50 (and black men over 40) should go for yearly prostate checks. Screening can be done with a blood test called prostate-specific antigen (PSA) and/ or a digital rectal exam (DRE).”
To Dr Idowu Ogunkoya, symptoms begin with waist pain and difficulty in urination. “It starts with waist pain. Then when the prostate is really fully blown up, to pee will be difficult and painful because the urethra is completely blocked. That is because of the pressure between the bladder and the prostate and the pressure on the urethra which is the hole where the urine passes through. So once it has blocked like that, the individual cannot pee and that is where the problem starts,” he said.
He advised the eating of fresh foods such as vegetables to prevent prostrate and other cancers. “Cancer can be prevented by eating fresh foods such as vegetables and things that contain vitamin E and B which are anti-oxidants that prevents it. As a matter of fact, if we eat right, cancer can be prevented.
We didn’t use to have cancer in Africa when we were eating fresh foods. It is a result of eating over processed foods,” he said.
Screening, early detection is essential
Just like in most other cancers, Dr Nzelu noted that early detection through screening could help in prostrate cancer prevention, treatment and cure. “Regular screening is the key to prevention of prostrate cancer and other types of cancer,” she stated, adding that, “prostrate cancer can be picked up at an early stage if men do their screening every year to check their (PAS) or Prostrate Specific Antigens-it is protein that is produced by men. The protein is supposed to be less than 4mg/L in men; when it becomes prostrate cancer, its elevated. When a man does his PAS check regularly, he would be able to notice when the PAS increases and take proper action.”
Dr Nzelu noted that the nation’s prostate cancer statistics was alarming and outrageous, given the fact that prostate cancer is curable if detected early. “For instance, the late freedom fighter and former South African President, Nelson Mandela was diagnosed with early-stage prostate cancer at the age of 83. He underwent seven weeks of out-patient radiotherapy and made a full recovery. He lived until the age of 95 and was cancer-free until the end. Moreover, all aspects of his treatment and diagnosis took place in South Africa. Other well-known personalities who survived prostate cancer include Archbishop Desmond Tutu of South Africa, Emperor Akihito of Japan, former US President Ronald Reagan, Joint Chiefs of Staff U.S. Army General Colin Powell among others.”
She blamed the high mortality rate of prostate cancer in the country on lack of awareness, inadequate infrastructure and manpower for cancer prevention and treatment in Nigeria. As she noted:
“To improve prostate cancer survivorship, it is important for every man to know his risk of prostate cancer as well as the signs and symptoms. There is urgent need to make prostate cancer screening widely available and accessible to all Nigerian men. According to the World Health Organization, “We cannot treat our way out of the cancer problem. More commitment to prevention and early detection is desperately needed in order to complement improved treatments and address the alarming rise in cancer burden globally.”
She pointed out that to beat the cancer scourge involves everyone, not just the government alone. “Government has a lot to do, but the thing about cancer prevention in general is that it involves every one, not just the government. For instance, in America the fight against cancer started from private sectors, some doctors, supported by business men. American Cancer Society started with advocacy and research, that is why they now have so much improvement in cancer survival-ship, so that out of every three American with cancer, only one will die and the target is that this will be the last century for cancer.
“So the government and private individuals can do a lot and one way to be involved is by supporting what CECP in collaboration with the Nigeria Stock Exchange (NSE) is doing, to ensure that we have these mobile cancer centres, going round in the community, because we need to have an organised system of doing things to make it happen.”
For treatment, Ogwah stated: “It involves drugs, hormone therapy, chemotherapy and other forms of treatment which basically depend on the stage of the disease whether it’s in early stage or has reached advanced stage.”
