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Saturday, 7 March 2015

Prostate cancer: The myths, the facts


   Blessing Ekum











If there is any disease that has baffled the medical world in recent times, it is cancer. And while medical science is making leaps in understanding the disease and finding treatments and hopefully a cure, this disease is still shrouded in mystery and is a subject of myths and superstitions among the public. As with every other health condition, ignorance is not bliss and this is why several campaigns have been designed for awareness on this debilitating condition.
The month of March is prostate cancer awareness month and the goal is to raise awareness of this disease by encouraging its prevention, detection and treatment. Every man has a prostate but very few men know anything about it and symptoms they could look out for that indicate a problem with it. According to Mr. Emmanuel Ikawo of the Department of Biochemistry, University of Lagos, Lagos, prostate cancer is the most common cancer in Nigerian males, having overtaken liver cancer. He adds that it accounts for between six and 20 per cent of all cancers and its incidence is increasing. More so, current data from most parts of the country show it to be the third most common cancer. Given these statistics, Dr Femi Olaleye, Medical Director, Optimal Cancer Care Foundation, Lagos, sheds light on this form of cancer and provides information on facts about it, its prevention and  treatment.
Myth 1: Only old men can have prostate cancer.
Fact:  What is the definition of old men? Men above age 70?  Majority of deaths from prostate cancer occur in men below age 70.  So this is NOT true.
Myth 2: Infrequent sex turns the prostate cancerous
 Fact: Although the prostate is involved in reproduction as the organ that is primarily responsible for the male ejaculation of semen and production of the seminal fluid, there is no truth to the connection of infrequent sex making the prostate cancerous. A study of eunuchs (castrated males)  has confirmed this fact, as they do not suffer from prostate cancer. In fact, the opposite has been shown to increase the risk – high levels of testosterones predispose black people to prostate cancer compared to white people who generally have lower levels of the male hormone.
Myth 3: Vasectomies cause prostate cancer.
 Fact: Vasectomy is a form of male sterilisation that involves blocking off the Vas Deferens (the tube that transports sperm cells from the testes to the prostate). This procedure does not affect the prostate in any way and therefore does not increase the risk of prostate cancer. So this is FALSE.
Myth 4: Prostate cancer doesn’t run in my family so I’m not at risk
 Fact: The risk of positive family history leading to prostate cancer is only between five and 10 per cent. In essence, there is a 90 to 95 per cent possibility to have prostate cancer in a man that does not have positive family history.
 Myth 5: No symptoms means no cancer.
Fact: Majority of patients with prostate cancer do not exhibit symptoms in the early stages of the disease.
The three common symptoms of prostate cancer are:
Frequency of urination — this happens in probably a quarter of patients with prostate problems
Difficulty in passing urine — this happens in only about 15 per cent  of patients
Blood in the urine — this happens in about five to 10 per cent of patients.
 So, it is possible for a patient not to have any symptoms by the time the diagnosis is made through series of screening and diagnostic tests.
 Myth 6: Prostate cancer is infectious
Fact: This is NOT true. Neither is it contagious. The causes of prostate cancer are largely unknown but no infective organisms have been implicated.
Myth 7: I must have prostate cancer because I can’t pee against a wall from three metres away
Fact: This is NOT true. A man can have difficulty in his flow of urine due to a benign (non-cancerous) enlargement of the prostate commonly seen in elderly males. This could be responsible for the inability to pee against a wall from three metres.
 Myth 8: Once you have prostate cancer, you will die of the disease.
 Fact: Prostate cancer is the number one cancer killer of men in Nigeria but recent studies have shown that majority of men with prostate cancer actually die with the disease rather than from the disease as the average Nigerian male has to contend with other risks to his life such as hypertensive heart disease, cardiac arrest, kidney and liver problems, diabetes and road traffic accidents. Men who detect prostate cancer early can actually survive for a very long time and do not necessarily die from the cancer.
A good example is the recent announcement that Professor Wole Soyinka is a survivor and this is simply due to the fact that the disease was detected very early through screening, rather than waiting for symptoms to develop.
Myth 9: Treatment for prostate cancer always causes impotence or incontinence.
There may be some truth here as one of the post-operative complications of prostatectomy (surgical removal of a diseased prostate) is incontinence but this is usually transient and a temporary problem that is easily managed with passing of urinary catheters for a short period after the operation.
What then can men do to lower the risk of having this form of cancer?
Dr Olaleye says, “It is clear that the chances of developing prostate cancer increase in men over 40. Detecting prostate cancer at its early stages can save lives. Men between 50 and 70 years with no family history of prostate cancer; men between 40 and 70 with a family history of prostate cancer all need to go for screening.
“Lack of awareness, inadequate infrastructure and manpower for cancer prevention and treatment are issues our country Nigeria has to deal with before it can successfully address prostate cancer for positive results. 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.
“ We cannot prevent the cancer but we can prevent men from dying from the cancer through early detection and prompt treatment.”

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