By Dr. Ayotunde Olutunde
This is a gland that is part of the male reproductive system. It is located just below the bladder and in front of the rectum. It is about the size of a walnut (<30g) and surrounds the urethra (the tube that empties urine from the bladder). As a man ages, the prostate tends to increase in size.
What is Prostate Cancer?
This is a malignant tumour (growth) that consists of cells from the prostate gland. Prostate cancer is the most common form of cancer among men, especially African-Americans. The burden of prostate cancer in Nigerian men is also worrisome. It is one of the leading causes of cancer death among men of all races.
Causes and Risk Factors
The cause of Prostate Cancer is unknown. However, it is not thought to be related to Benign Prostatic Hyperplasia (BPH).
High Risk
- African-American Men.
- Men who are older than 60 years.
- Men who have a father or brother with prostate cancer.
Other people at risk
- Men who abuse alcohol.
- Farmers.
- Men who eat diet-high in fat, especially animal fat.
- Tyre plant workers.
- Painters.
- Men who have been exposed to cadmium.
Presenting Features
In the early stages, Prostate Cancer often causes no symptoms for many years. Occasionally, the doctor may first feel a hard nodule during a routine digital (done with the finger rectal examination). Rarely, in more advanced cases, the cancer may enlarge and press on the urethra giving the following:
- Delayed or slow start of urinary stream.
- Dribbling or leakage of urine, most often after urinating.
- Slow urinary stream.
- Straining when urinating, or not being able to empty out all of the urine.
- Blood in the urine or semen.
- Bone pain or tenderness, most often in the lower back and pelvic bones (only when the cancer has spread).
Please note that other disease conditions of the prostate can give the above symptoms.
A rectal exam may show a large prostate or a hard, irregular surface.
As a result of the availability of a simple, reproducible and relatively accurate blood test known as prostate-specific antigen (PSA) prostate cancer can be detected early before the onset of symptoms.
Thus you do not have to wait to see any of the presenting features before seeking a doctor. The PSA level is usually higher than 4mg/ml in people with prostate cancer than in people without the cancer.
It is recommended that men aged 40 years and above should have a regular PSA check.
Prostate cancer is diagnosed from the results of a biopsy of the prostate gland.
Treatment
The treatment options include surgery, radiation therapy and chemotherapy (including hormonal therapy). However, the treatment is individualized based on what is known about your type of cancer and your risk factors.
Outlook
The outcome varies greatly. It is mostly affected by whether the cancer has spread outside the prostate gland and how abnormal the cancer cells are (the Gleason score) at the time of diagnosis.
Many patients with prostate cancer that has not spread can be cured. Even for patients who cannot be cured, hormone treatment can extend their lives.
Prevention
There is no known way to prevent prostate cancer, but researchers are trying to find ways. At present, one can hope only to prevent the progression of the cancer by making early diagnosis and then attempting to cure the disease.
Conclusion
Prostate cancer is a leading cause of death from cancer in Nigerian men. While the causes of prostate cancer are still unknown, some risk factors for the disease, such as advancing age and a family history of prostate cancer have been identified. Prostate cancer is often initially suspected because of an abnormal PSA blood test or a hard lump felt on the prostate gland during a routine digital rectal examination.
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