Experts proffer measures for reducing the risk of prostate cancer which is fast becoming a leading cause of male deaths in Nigeria
Prostate cancer, also known as carcinoma of the prostate which results from an enlarged prostate that makes it difficult for a patient to urinate, is fast becoming a leading cause of male deaths in Nigeria. Prostate cancer is peculiar to men aged 50 years and above.
In Nigeria, prostate cancer has a mortality rate of over 80 per cent. A recent report by the World Health Organisation (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 Prostate cancer now kills 26 Nigerian men every day (up from 14 men daily).
According to Dr. Abia Nzelu, Executive Secretary of the Committee Encouraging Corporate Philanthropy (CECP-Nigeria), prostate cancer develops in the prostate gland of the male reproductive system. 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).
Dr. Nzelu says that Prostate Cancer begins when cells in a part of the body start to grow out of control. Since cells are the building blocks of the body, the tumour will grow slowly but there could be aggressive cases. He describes the prostate cancer mortality rate in Nigeria which is over 80 per cent as alarming and outrageous, given the fact that prostate cancer is curable if detected early. He recalls that Nelson Mandela, the late South African President 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. According to Dr. Abia, one interesting thing about Mandela’s case was that all aspects of his treatment and diagnosis took place in South Africa. He identified other well-known personalities who survived prostate cancer as Archbishop Desmond Tutu of South Africa, Emperor Akihito of Japan, former US President Ronald Reagan, Joint Chiefs of Staff US Army General Colin Powell.
Dr. Nzelu believes that some of the factors responsible for the high mortality rate of prostate cancer in Nigeria include lack of awareness as well as inadequate infrastructure and manpower for cancer prevention and treatment in Nigeria. He explains that in order 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.
According to him, the risk factor is anything that affects a man’s chance of getting a disease. The risk factors of prostate cancer could be classified as modifiable (can be changed) and non-modifiable (cannot be changed). Dr Nzelu says the major non-modifiable risk factors include: age, race and family history of prostate cancer.
In terms of age, he says, the chances of having prostate cancer rises rapidly after age 50.
Family history is also a risk factor because having a father or brother with prostate 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,” Dr Nzelu says.
In terms of race, the Executive Secretary of CECP-Nigeria reveals that prostate 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 prostate cancer,” he cautions. Other non-modifiable risk factors include: Length of a person’s fingers; hair loss (balding); the gender of a person’s children and his height.
However, the modifiable risk factors include: diet, obesity, smoking, workplace exposures as well as sexual activity.Dr Nzelu says that in terms of diet, men who eat a lot of red meat or high-fat dairy products appear to have a slightly higher chance of getting prostate cancer. Similarly, men who are obese (very overweight) have a higher risk of getting more aggressive prostate cancer. Smoking has equally been linked to a possible small increase in the risk of death from prostate cancer. In terms of workplace, experts say there is evidence that fire-fighters are exposed to toxic combustion products that may increase their risk.
However, Dr Nzelu explains that risk factors do not tell us everything because 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. “Therefore, every man should be aware of the symptoms of prostate cancer. These could be summarized into three viz: 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,” he says.
He notes that prostate cancer can also cause a man to have trouble getting an erection (impotence) or painful ejaculation, pain in the hips, back (spine), chest (ribs), or other areas from cancer spread to bones. 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.
He explains that although there are other diseases that can also cause many of these same symptoms, it is important for men having such symptoms to see the doctor if they 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.
Anthonia Sowunmi, Consultant Radiologist and Oncologist at the Lagos University Teaching Hospital explains that one of the problems in tackling prostate cancer in Nigeria is the fact that most patients report to the hospital when the disease has reached advanced stages. The patients often waited until they found it difficult to urinate and the doctors would be at a loss on what to do.
She believes that in order to reduce the mortality rate of prostate cancer in Nigeria, there is urgent need to make prostate cancer screening widely available and accessible to all Nigerian men.
By Chris Ajaero