By Sola Ogundipe

Prostate cancer is a public
health concern among black
men worldwide, and it is the second most common cause of cancer deaths in men, but Britain could start screening middle-aged men for prostate cancer within three to five years according to one of the UK’s leading experts on the disease who said technological advances mean a national breast cancer-style strategy may finally be possible.

At present, there is no national screening programme for the disease, which is Nigeria’s second deadliest cancer and Britain’s third.

Professor Ros Eeles, a world-leading voice in the field of oncogenetic at the Institute of Cancer Research in the UK, hopes that advances in both genetics and imaging would progress towards this goal.

“We’re probably looking at getting close to a tailored screening programme in the next three to five years,” she said.

According to the International Agency for Research on Cancer (IARC), in Nigeria, prostate cancer constitutes about 1 in 3 of all male cancers.

Around 50,000 men in the UK are told they have the disease each year and one in eight will be diagnosed in their lifetime.

At the moment, men usually only find out they have prostate cancer when they start displaying symptoms—usually when they start finding it difficult to urinate or get a hot burning sensation.

They then request a PSA blood test, which they are eligible for over the age of 50. The PSA test is a blood test used primarily to screen for prostate cancer.

The test measures the amount of prostate-specific antigen (PSA) in your blood. PSA is a protein produced by both cancerous and noncancerous tissue in the prostate, a small gland that sits below the bladder in men.
But this is far from accurate, missing many aggressive cancers and picking up too many cancers that would not cause problems if they had not been detected.

Because of this, PSA levels have never been deemed accurate enough for a screening programme. Experts say this is the key reason that annual prostate cancer deaths are still on the rise.

Prostate cancer usually develops slowly, so there may be no signs someone has it for many years.

If the cancer is at an early stage and not causing symptoms, a policy of ‘watchful waiting’ or ‘active surveillance may be adopted.

Some patients can be cured if the disease is treated in the early stages. But if it is diagnosed at a later stage when it has spread, then it becomes terminal and treatment revolves around relieving symptoms.
Millions of men are put off seeking a diagnosis because of the known side effects from treatment, including erectile dysfunction.

Tests for prostate cancer are haphazard, with accurate tools only just beginning to emerge. There is no national prostate screening programme as for years the tests have been too inaccurate. Doctors struggle to distinguish between aggressive and less serious tumours, making it hard to decide on treatment.

Men over 50 are eligible for a PSA blood test which gives doctors a rough idea of whether a patient is at risk. But it is unreliable.

Patients who get a positive result are usually given a biopsy which is also not foolproof.

Scientists are unsure as to what causes prostate cancer, but age, obesity and a lack of exercise are known risks. It is estimated that one-third of the cases of prostate cancer can be prevented and another third can be cured if detected early through screening.

Even though there has not been a consensus as regards guidelines for prostate cancer screening, large population studies have shown increased survival benefits in the early treatment of prostate cancer following the screening.

There is also evidence that the recent decline in cancer mortality in several countries was as a result of screening and early detection.