Prostate cancer is currently the leading cause of male specific cancer deaths in men. It’s the 3rd highest cancer cause death of men after Lung and Colorectal cancers. It’s the commonest cancer in black men accounting for 40% of cancer deaths according to 2011-2012 Cancer facts and figures for African Americans. And guess what? It is also one of the CURABLE cancers (yes, eradication totally, like you would malaria or appendicitis), if caught early (the all-so-popular caveat with cancers). So the key is to know when it’s lurking in the shadows and turn up the lights suddenly on it!
What is a Prostate?
The prostate is a small almond shaped gland located just beneath the urinary bladder in males. It’s an organ of fertility as its sole purpose is to produce fluids that add bulk to semen and supply sperm cells with adequate nutrition to remain healthy. It has two equal halves split in the ‘midline’ by the urethra as it journeys from the urinary bladder to exterior via the penis. Being a very glandular organ, it undergoes a lot of changes in its life time in response to testosterone, age and environmental stimuli just like the female breast. And as we’ve seen with the female breast, sometimes in the course of this constant state of flux, some cells escape regulation and become autonomous with resultant aberrant growth. Just like rebellious kids. Also the prostate is known to increase in size with increasing age and this enlargement is more prominent in black men than any other ethnicity and starts about the age of 40. The reason for this is probably the 15% increase in testosterone observed in black men over other ethnicities or the preponderance for a high fat diet by this ethnic group in addition to an interplay of these and environmental factors such as Smoking, low Selenium and Chromium diet and an established family history.
What are the Symptoms?
It is not uncommon for a man over the age of 40 to have some symptoms such as; difficulty in commencing urination, dribbling at the end of urination, feeling of incomplete emptying of bladder, poor stream, as these could be features of a harmless enlargement of the Prostate ( Benign Prostatic hyperplasia). Unfortunately these are also the features of an enlargement due to a malignancy (cancer), especially in its early stages. Thus it is the Urologist who decides which it is. These symptoms are brought about by the enlargement of the gland in the part of it that straddles the urethra and thus compresses this urethra as it enlarges. This is the commonest site of prostatic enlargement, however, 47% of Prostate cancers are diagnosed following an elevated PSA blood test in men who are completely asymptomatic, as the enlargement could be occurring at one corner of the gland or the other. Most enlargements (regardless of site) are usually accompanied by an increase in the blood levels of a prostate specific antigen, the widely acclaimed PSA.
It is reasonable thus, to suggest that every man over the age of 40 should have a PSA measurement and get the subsequent result interpreted by a Urologist (a Surgeon who specialises in the treatment of surgical problems of the urinary system and male reproductive tract).
Prevention is better than cure
Other important life style changes would include, cutting down smoking steadily towards zero, increasing intake of fruits and vegetables, Vitamins A, C and E as sources of anti-oxidants, assiduously working towards an active lifestyle and a low fat diet (bearing in mind that 1gm of fat provides us with 9kcal and 1gm of alcohol provides us with 8 and all excess calories are converted to fat in the body).
Factors like family genetics and being a quintessential black brother cannot be amended and we have to work around it and glean of its immense advantages thereof.
In terms of treatment of Prostatic cancer, there are many treatment options available from near total passivity to radical surgery, radiotherapy and hormonal therapy. Treatment offered depends a great deal on the stage of the disease. Prognosis varies as widely. Early detection of prostate cancer which is still confined to the gland with no evidence of microscopic spread ( metastases or lymphovascular invasion) gives the best chance at cure with one treatment modality which could be Surgical removal of the gland or Focussed radiotherapy (destruction of tumour cells via a directed beam of radiation) .
This article seeks to sensitize black men on the absolute necessity on keeping an eye on the prostate as one would a young fledgling child and resolve not to ‘spare the rod’ to avoid untoward consequences.
Chinekwu Ofong is a Nigerian born and bred Medic with a keen interest in the Health of Africans.