By Ogechukwu Agwu
Not much attention is given to prostate cancer, but the truth is, prostate cancer is to men what breast cancer is to women, it is the most common cancer after skin cancer in men. Also known as carcinoma of the prostate, it is the development of cancer in the prostate. The condition is highly treatable.
It is regarded as a slow growing disease and the majority of men with low grade prostate cancer live for many years without symptoms and without it spreading and becoming life-threatening.
Only men have a prostate. It is a small gland that sits below the bladder near the rectum. It surrounds the urethra, the passage in the penis through which urine and semen pass. Only men have a prostate. It is a small gland that sits below the bladder near the rectum.
The prostate gland is part of the male reproductive system. It produces most of the fluid that makes up semen that enriches sperm. The prostate needs the male hormone testosterone to grow and develop.
The prostate is often described as being the size of a walnut and it is normal for it to grow as men age. Sometimes this can cause problems, such as difficulty urinating. These problems are common in older men and not always symptoms or signs of cancer.
When the cancer starts, the cells in the prostate gland begins to grow uncontrollably and abnormally, these abnormal cells can continue to multiply in an uncontrolled way and sometimes spread outside the prostate into nearby or distant parts of the body
According to a source, there are different kinds of prostate cancer, they include; sarcomas, small cell carcinomas, neuroendocrine tumors, transitional cell carcinomas and adenocarcinomas. Of all these kinds of prostate cancer the most popular one is the adenocarcinomas, it is very rare to suffer the other kinds of prostate.
Studies have shown that men have 1 in 7 chances of developing cancer at some point during their lifetime, according to the American Cancer Society’s estimates that there are about 161,360 new cases of prostate cancer and that there are likely to be 26,730 deaths from prostate.
One in seven men will be diagnosed with prostate cancer during his lifetime. About 6 cases in 10 are diagnosed in men aged 65 or older and it is rare before age 40. The average age at the time of diagnosis is about 66.
It is the third leading cause of cancer death in America men, behind lung cancer and colorectal cancer. Prostate cancer like all cancer can be managed if detected early, more than 29 million men in American are living with prostate cancer.
Across the United Kingdom, prostate cancer is the most common cancer in men, 1 in 8 men will get prostate cancer in their lifetime. Over 47,000 men are diagnosed with prostate cancer every year that’s about 130 men every day.
Every hour one man dies from prostate cancer, that’s more than 11,000 men every year and over 330,000 men are living with prostate cancer.
In Scotland, more than 3,000 men are diagnosed with prostate cancer yearly and every day at least 2 men die from prostate cancer and over 900 men die from prostate cancer every year.
In England, almost 40,000 men are diagnosed with prostate cancer every year in England, more than 9,500 men die from the disease and every hour one man die from it. In Wales, more than 2,500 men are diagnosed with prostate cancer every year , more than 600 men die every year from the disease. In North Ireland, more than 1,000 men are diagnosed with prostate cancer every year and 200 men die from the disease.
In 1997, the disease has an estimated hospital prevalence of 127 per 100,000 in Lagos, Nigeria was reported. A recent published data from South-Western Nigeria also reported a hospital prevalence rate of 182.5 per 100,000 male admissions in the hospital, however the true burden of the disease in Nigeria isn’t known.
Risk factors
There is no known cause of this cancer but there are certain factors that predisposes one to having prostate cancer. According to Dr. Kenneth Omemma, they include: age, race/ethnicity, family history, geography and genetics (gene changes) have a greater effect whereas the factors with lesser effects are diet, obesity, smoking, chemical exposures, inflammation of the prostate, vasectomy, and sexually transmitted diseases.
Studies have shown that the chances of having prostate cancer rise as one grows older; it is particular among older men, men in their 50’s. Statistics estimates that 6 in 10 cases of prostate are found in men older than 65.
“If the man is of the African- American descendant or Carribean, he is likely going to . Prostate cancer occurs more often in African-American men and in Caribbean men of African ancestry than in men of other races. African-American men are also more than twice as likely to die of prostate cancer than white men. Prostate cancer occurs less often in Asian-American and Hispanic/Latino men than in non-Hispanic whites. The reasons for these racial and ethnic differences are not clear.”
It is mostly common in North America, northwestern Europe, Australia, and on Caribbean islands. It is less common in Asia, Africa, Central America, and South America.
According to the American Cancer Society, the reason for this is not clear. More intensive screening in some developed countries probably accounts for at least part of this difference, but other factors such as lifestyle differences (diet, etc.) are likely to be important as well. For example, Asian Americans have a lower risk of prostate cancer than white Americans, but their risk is higher than that of men of similar backgrounds living in Asia.
Prostate cancer seems to run in some families, according to Omemma, “studies suggest that in some cases there may be an inherited or genetic factor. Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease. (The risk is higher for men who have a brother with the disease than for those who have a father with it.) The risk is much higher for men with several affected relatives, particularly if their relatives were young when the cancer was found.
“However there are some cases of prostate cancer that occurs in men without family history.”
Several inherited gene changes also seem to raise prostate cancer risk, but they probably account for only a small percentage of cases overall.
The exact role of diet in prostate cancer is not clear, but several factors have been studied. Men who eat a lot of red meat or high-fat dairy products appear to have a slightly higher chance of getting prostate cancer. These men also tend to eat fewer fruits and vegetables. Doctors aren’t sure which of these factors is responsible for raising the risk.
Some studies have suggested that men who consume a lot of calcium (through food or supplements) may have a higher risk of developing prostate cancer. Dairy foods (which are often high in calcium) might also increase risk. But most studies have not found such a link with the levels of calcium found in the average diet, and it’s important to note that calcium is known to have other important health benefits.
Just like diet, obesity is also another factor that put men at risk of getting prostate cancer, it also does not seem to increase the overall risk of getting prostate cancer.
Some studies have found that obese men have a lower risk of getting a low-grade (less dangerous) form of the disease, but a higher risk of getting more aggressive prostate cancer. The reasons for this are not clear. Lifestyle habit like smoking has also being linked to getting prostate cancer.
Signs and symptoms
Majority of the signs and symptoms are related to urination and they include; difficulty in urinating, blood in the urine ( hematuria), pain in the pelvis or pain at the back when urinating, frequent urination, increased urination at night, difficulty starting and maintaining a steady steam of urine, dysuria (painful urination)
Screening
The objective of prostate cancer screening is to decrease morbidity or mortality from the disease. Omemma opines “that prostate cancer screening may reduce mortality from the disease almost by half but with a substantial risk of over diagnosis.”
Statistics by the World Health Organisation shows that in Nigeria within a period of four years there has been an increase in death rate among men caused by prostate cancer. This statistics shows that prostate cancer kills 26 men daily. This figure is quite alarming and the key to preventing death by cancer is to get screened and tested.
Diagnosis
A doctor will usually do a blood test and/or physical examination to check the health of the prostate. If your test shows that you may be at risk of prostate cancer, the next step is a biopsy. The doctor may decide to do a blood test or a digital rectal examination or both.
Blood test (Prostate Specific Antigen (PSA) test): The result shows whether there is an increase in this specific protein. Depending on the result, you might need further investigation by a specialist. A high PSA test result does not necessarily mean cancer. Prostate diseases other than cancer can also cause a higher than normal PSA level.
Digital Rectal Examination (DRE): Because of where the prostate is located, the doctor inserts a gloved, lubricated finger into the rectum to check the size of the prostate and assess if there are any abnormalities. A normal DRE result does not rule out prostate cancer.
Prevention
There is no evidence that the following protective factors can stop prostate cancer from developing, but they can improve your overall health and possibly reduce the risk of prostate cancer:
Diet: Eat meals that are nutritious. Refer to the Australian Guide to Healthy Eating. What is good for the heart is good for the prostate.
Physical activity/exercise: There is some evidence to show that physical activity and regular exercise can be protective factors for cancer. Try to exercise at least 30 minutes of a day.
More commitment to prevention and early detection is desperately needed in order to complement improved treatment and address the alarming rise in cancer burden globally.