Prostate Cancer in Nigeria: The way forward

Ojulari Faridah

About 1 in 9 men will be diagnosed with prostate cancer during their lifetime. Prostate cancer has become a global health challenge because of its rising morbidity and mortality rates in males. It was classified by the World Health Organization (WHO) in 2018 as one of the most common cancer with 1.28 million cases and a 26.6% incidence rate in Africa. Sadly, over 100,000 Nigerians are diagnosed with cancer annually.

According to a research study carried out earlier this year, prostate cancer was the second most frequent cancer diagnosis in men and the fifth leading cause of deaths worldwide. Based on the 2018 estimates of GLOBOCAN, a project of the International Agency for Research on Cancer (IARC), over 1,276,106 new cases of prostate cancer were reported worldwide in 2018 representing 7.1% of all cancer in men. Interestingly, in a trend towards an increase of prostate cancer incidence worldwide up to 2040, it is estimated that death rates will double with 379,005 deaths worldwide and the highest incidence of prostate cancer will be registered in Africa.

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The American Cancer Society defined the prostate as a gland found only in males that makes some of the fluid that is part of semen. The prostate is found below the bladder and in front of the rectum, it is about the size of a walnut and can be much larger in older men. Prostate cancer begins when cells in the prostate gland start to grow out of control. In a recent research study,

it has been found that Western Africa has the fifth-highest risk for prostate cancer mortality in the world and Nigeria has the largest population and economy in this region. How saddening! Prostate cancer for Nigerian men is both the most common and most deadly cancer with 32.8 cases and 16.3 deaths per 100,000 men. This according to the study, is more than double the death rate in North America with an estimated 80% of Nigerians incurable on the diagnosis. Why is this so?

The lack of adequate access to medical care, decreased documentation and reporting o cases are crucial factors contributing to late detection of the disease. In addition, the limited resources for screening and detection of prostate cancer increases the odds of it being detected during the late stages.

Furthermore, the fact that medical care and assistance are not widely accessible in developing countries may give a possible explanation for the high mortality in Nigeria.  Researchers do not know exactly what causes prostate cancer, but they have found risk factors some of which include age and race. About 6 cases in 10 are diagnosed in men who are 65 or older,  and it is rare in men under 40. However, fortunately, the average age of diagnosis is about 66.

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Prostate cancer can be detected early by testing for Prostate Specific Antigen (PSA) levels in a man’s blood. Another way is the Digital Rectal Exam. Early prostate cancer usually causes no symptoms. More advanced prostate cancer can sometimes cause problems during urination, blood in the urine or semen, trouble getting an erection, pain in the hips, back(spine), chest(ribs), weakness or numbness in the legs or feet or even loss of bladder or bowel control from cancer pressing on the spinal cord.

There is no assured way of preventing prostate cancer but there are some measures one can take that might lower ones’ risk of the disease. Research data indicates a dominant role for lifestyle factors in prostate cancer development considering that the out of control growth of the cells takes many decades, lifestyle modification may represent a practicable and cost-effective approach to retard prostate cancer development.

Although the data about the role of specific lifestyle factors nurturing prostate cancer development have often been conflicting, most of the studies clearly show that a diet rich in fruits, vegetables, and antioxidant micronutrients, while food poor in saturated fats may significantly lower the risks of prostate cancer development.

However, not all studies agree totally, but several ones have found a higher risk of prostate cancer in men that their diet contains high calcium content and diary foods. For now, the best advice about activity and diet to possibly lower the risk of prostate cancer is to be physically active, stay at a healthy weight and eat a good amount of fruits and vegetables each day. Also, limiting the amount of calcium in the diet can be helpful. Examples of suitable vegetables include cabbage and broccoli.

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Prostate cancer can be treated with various treatment choices, but sadly, these choices have side effects that are specific to each treatment choice. Luckily, physicians try their best to ensure that you experience minimal side effects from treatment. The inability to control your bladder (Urinary incontinence) and the inability to achieve a full erection (Erectile dysfunction) are the most common side effects of treatment. Side effects depend on factors such as cancer stage, treatment choice and overall health condition.

Before treatment commences, discuss with your doctor about what to expect based on your disease and treatment choice, try to develop a plan to cope with the side effects of your preferred treatment. Treatment choices include surgery, hormone therapy, radiation, immunotherapy, chemotherapy, and bone-related treatments.

The registering of cases play an important role in the advancement of prostate cancer research and care. Therefore, improved data quality and availability of data feedback to health care providers would increase the relevance of analyzing data collected in underdeveloped countries. New research on gene changes connected to prostate cancer is helping scientists understand how prostate cancer develops better.

This could hopefully make it possible to design medicines to target those changes. Scientists have found some substances in tomatoes (lycopene) and soybeans (isoflavones) that might help prevent some prostate cancer. Most men diagnosed with prostate cancer will live a long time but the challenges remain in choosing the best treatments for individuals at all stages of the disease.

With early detection, prompt action, and improved medical care, the story of prostate cancer can be rewritten in Nigeria.


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