Prostate Cancer and Nigerian Men

On Prostate Cancer and Nigerian Men 

By Motolani Ogunsanya, B. Pharm., PhD 

One out of seven men reading this will be diagnosed with prostate cancer in their lifetime. Prostate cancer is one of the most highly diagnosed cancers and the leading cause of cancer deaths among men in Nigeria. Similar to the rates seen in Black men from other populations, Nigerian men present with a higher stage and grade of prostate cancer and often the more aggressive ones.

Prostate cancer screening still remains the best available method of detecting prostate cancer early. There are two tests that are used to detect prostate cancer: the prostate-specific antigen (PSA) and the digital rectal examination (DRE) test. The PSA test measures the level of PSA, a protein produced by cells of the prostate gland, in the blood. The DRE test involves checking (or palpating) the surface of the prostate gland for bumps, hard spots, and any other abnormalities.

Some of the risk factors for prostate cancer include increasing age, being male, positive family history of prostate cancer, ethnicity (being Black or African), and lifestyle (poor diet and lack of exercise). Prostate cancer may not produce symptoms in its early stages.  As a result, you may look healthy or even feel fine, and not know that there is a problem. If signs and symptoms are present, they may include:  – blood in the urine;  – the need to urinate frequently, especially at night;  – weak or interrupted urine flow;  – pain or a burning feeling while urinating;  – inability to urinate; and  – regular pain in the lower back, pelvis, or upper thighs.

When detected early, prostate cancer can be treated in time, and the chances of surviving are higher. If your risks are high already, a simple test can reduce the burden of complicated (palliative) treatment and the toll it takes on you and your loved one. However, prostate cancer screening rates are low among Nigerian men. There are many speculated reasons for this, which are not uncommon with Black men from other parts of the world. First, the practice of seeking proactive, preventative health measures, such as prostate cancer screening is not a common practice among men, especially Nigerian men. Low level of awareness about prostate cancer and its risk factors are also some of the speculated reasons for low screening rates. The invasiveness of the test (especially the DRE) has been reported to be a deterrent to undergoing screening. 

Prostate cancer screening is not also without its disadvantages. The tests are not always specific enough to detect prostate cancer. As a result, this can result in over-diagnosis especially of cancers that may not have led to clinical problems if they had been left untouched. In addition, the use of aggressive therapy on such cancers is associated with unnecessary risks of urinary, sexual and bowel dysfunction, which have been shown to significantly impact quality of life. Other factors include fatality, masculinity, and stigma. Men have been reported to visit their doctors less than women, and are often embarrassed to discuss their health issues. Statistically, one out of four men did not visit a doctor in the past twelve months. As a result, prostate cancer is often diagnosed at later stages, when the odds of survival are low. The good news, however, is that if detected early, prostate cancer is often treatable and curable. 

So, who should get tested?

- From age 50 onwards, discuss having a prostate checkup with your doctor.
- If there is a family history of prostate cancer, then a checkup should form part of your general checkup from age 40.
- Any time you experience any urinary symptoms, get a checkup.

Unfortunately, cancer, especially, prostate cancer still remains heavily stigmatized in Nigeria. To achieve a healthier nation, we need to begin to talk more comfortably about reducing the stigma associated with cancer. It does not bode us well to keep suffering in silence, especially when help is often around the corner. It’s November - prostate cancer month, and I’d like to use this as a medium to promote prostate health. While prostate cancer screening is not for everyone, it is essential to discuss your risk factors and susceptibility to this disease with your doctor. I would also like to urge the women (mothers, daughter, sisters, aunts, cousins, nieces, etc.) in these men’s lives to talk to them and remind them to get their yearly examinations done and also assess their prostate cancer risk.
For peace of mind, yours and your loved ones’, the first step to preventing prostate cancer deaths is early detection. This begins by first talking to your doctor. 

Dr. Ogunsanya, an Associate Professor, writes for LJSCF from Oklahoma University. She is passionate about cancer advocacy and reducing cancer incidence rates. Dr. Ogunsanya's research focuses on health economics and outcomes research using mixed methodologies. Her research interests primarily involve understanding health behaviors among underserved, minority groups and the use of patient-reported outcomes to capture disease burden in patients with rare diseases, cancer, and other disease conditions. Additional research interests include examining quality of life through theoretical frameworks and large-scale retrospective database analyses.

Website: http://bit.do/drmog

LinkedIn: https://www.linkedin.com/in/motolani/

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