September is designated as Prostate Cancer Awareness Month aimed at: Increasing public awareness of the importance of prostate health; providing easily accessible prostate cancer screenings; Educating about risk factors and symptoms of prostate cancer; and Advocating for further research on prostate cancer. It is therefore pertinent for us to focus our attention on prostate cancer at this time.
To start with, let’s examine what the prostate and prostate cancer mean.
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.
Prostate cancer 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 Prostate cancer now kills 26 Nigerian men every day (up from 14 men every day).
This increase is evident from frequent reports in the media of prominent Nigerians that have died of the disease in recent times. Within the space of three months, prostate cancer killed a former Deputy Senate President (May, 2014); the Aare Musulumi of Yorubaland and Aare of Ibadanland (June, 2014); a former Secretary General of the Organization of the Petroleum Exporting Countries (OPEC) (July, 2014); the President General of the Urhobo Progress Union and first Governor of Kebbi State (August, 2014) and the father of one of Nigeria’s most celebrated musical icons (August, 2014). The Nigerian media has never reported such a rapid succession of prostate cancer deaths of prominent personalities in the past! Although most of the 26 Nigerian men who die of prostate cancer daily are unknown and unsung by the general public, each of them is someone’s beloved and precious husband, father, uncle or friend. May their Souls Rest in Peace!
The Nigerian prostate cancer statistics is alarming and outrageous, given the fact that prostate cancer is curable if detected early. For instance, 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, US President Ronald Reagan, Joint Chiefs of Staff U.S. Army General Colin Powell among others.
What is responsible for the high mortality rate of prostate cancer in our country? The answer is not far -fetched- lack of awareness and inadequate infrastructure and manpower for cancer prevention and treatment in Nigeria.
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.
A risk factor is anything that affects your 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). The major non-modifiable risk factors include: age, race and family history of prostate cancer.
Age- The chance of having prostate cancer rises rapidly after age 50.
Family history- 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.
Race- 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!
Other non- modifiable risk factors include: Length of Your Fingers; Hair Loss (Balding); The Gender of Your Kids; and Your Height. Details are available at the blog page of www.cecpng.org and facebook.com/cecpnigeria.
The modifiable risk factors include: Diet, Obesity, Smoking, Workplace exposures as well as Sexual Activity.
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.
Obesity- Men who are obese (very overweight) have a higher risk of getting more aggressive prostate cancer.
Smoking- smoking has been linked to a possible small increase in the risk of death from prostate cancer.
Workplace – There is evidence that firefighters are exposed to toxic combustion products that may increase their risk.
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.
SIGNS AND SYMPTOMS
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. 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).
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.”
An excellent way of providing easily accessible prostate cancer screenings would be the deployment of Mobile Cancer Centres (MCC) which would take holistic health promotion to the grassroots of Nigeria. The campaign to actualize this (“the BIG WAR against Cancer in Nigeria”) is the present focus of the Committee Encouraging Corporate Philanthropy (CECP-Nigeria). An MCC is NOT the same as a Mobile Mammogram. Rather, it is a clinic on wheels, in which screening, follow-up and treatment (including surgeries), can take place. It includes facilities for mammography, sonology, colonoscopy, colposcopy and cryotherapy, as well as a surgical theatre. It is also equipped with a laboratory for screening against certain cancers like prostate, colon and bladder cancer and other common diseases which are known to increase the risk of cancer. These include malaria, diabetes, hepatitis, kidney disease, hypertension and HIV/AIDS. Thus the MCC would tackle the double burden of disease i.e. Communicable & Non-Communicable. Each MCC costs $600,000.
The Collaborative Research- USA Network of Mobile Clinics aptly summarized the value of mobile health care thus: “The mobile clinic sector is an untapped resource for helping the nation reduce health disparities while improving care, improving health and saving healthcare costs.” As mentioned in a previous article, there are over 2000 mobile health units in the United States of America, in addition to over 1500 Comprehensive Cancer Centres and a National Cancer Institute (NCI).
All hands needs to be on deck in order to stem the cancer menace in our dear nation. Dr. Paul Kleihues, Director of the International Agency for Research on Cancer (IARC) and co-editor of the World Cancer Report 2012 said “We can make a difference by taking action today. We have the opportunity to stem this increase. This report calls on Governments, health practitioners and the general public to take urgent action. Action now can prevent one third of cancers, cure another third, and provide good, palliative care to the remaining third who need it.”
Anyone may contribute towards the Mobile Cancer Centre project by giving via ATM or online at www.quickteller.com using the code ‘777526’ (see donation page of www.cecpng.org or contact firstname.lastname@example.org).
Individuals, families or organizations who donate a mobile unit, could have them branded in their name. There is no better legacy than to be remembered by posterity as one who brought life and health to the community. Equally, a great way of immortalizing our departed loved ones would be to use their death from cancer as a spring board for saving lives by donating an MCC in their memory. Nigeria desperately needs people of goodwill like Sir Dorab Tata the former Chairman of the Tata Group who revolutionized cancer care in India. He did this by establishing the first Indian Comprehensive Cancer Centre in 1941, following the treatment of his wife for blood cancer in England (See previous article in the Guardian Newspaper of 30th and 31st of December, 2013).
To mark Prostate Cancer Awareness Month, there shall be FREE PROSTATE CANCER SCREENING at the National Cancer Prevention Programme (NCPP) centre at 30 Ishaga Road, Surulere, Lagos. This will hold on Saturdays September 13th and 20th, 2014 from 2 pm each day. The NCPP is a non-governmental initiative and the technical partner of the CECP-Nigeria.
Interested participants should register by sending their full name, email address and preferred date of attendance as an sms to the short code: 44777 from any of the major mobile networks.
As a closing food for thought we should reflect on the fact that one out of every three persons alive would be diagnosed of cancer. Therefore, it is in our enlightened self-interest to support the BIG WAR against Cancer in every way we can. Our very own survival is at stake! Let’s ACT! Attack Cancer Together! For together we can!!
To learn more, tune into Nigeria Info 99.3FM every Friday at 8 am as we demystify cancer.
© 2014 Committee Encouraging Corporate Philanthropy (CECP- Nigeria)