Why prostate cancer affects black men more

By Chioma Obinna

WHEN the call for regular screening for prostate cancer for men above 40 years of age become almost an everyday song in the lips of Nigerian medical experts many people did not see it as an important call.  Some even made jest of it while some see it as an avenue for doctors to make more money. Unfortunately, today statistics available have shown that more Nigerian men are coming down with prostate cancer.

Prostate Cancer is cancer that occurs in the prostate gland. Cancer begins when cells in a part of the body start to grow out of control. Cells are the building blocks of the body. It is now the number one cancer killer of Nigerian men and has a mortality rate of over 80 percent.

Prostate in blackmen

PROSTATE CANCER SCREENING

However, the call for regular screening for prostate cancer may have been justified as studies have shown that in reality there are a number of differences in how prostate cancer impacts black men compared to men of other racial and ethnic backgrounds.

According to experts, black men are 60 percent more likely than white men to be diagnosed with prostate cancer during their lifetime, and are more than twice as likely to die from the disease.

Black men are also diagnosed at a younger age (about 3 years younger on average) and are more likely to have “high grade” tumours – the kind of tumours that grow rapidly, spread to other parts of the body, and often cause death.

“Having a father or brother with prostate cancer more than doubles one’s risk. The risk is higher for men who have a brother with the disease than for those with an affected father.

The modifiable risk factors include diet, obesity, smoking, workplace exposures and sexual activity. Men who eat a lot of red meat or high-fat dairy products appear to have a slightly higher chance of getting prostate cancer. Men who are obese have a higher risk of getting more aggressive prostate cancer. Smoking has been linked to a possible small increase in the risk of death from prostate cancer. There is evidence that fire fighters are exposed to toxic combustion products that may increase their risk.

According to a health practitioner, Dr Matthew Ogwah, black men may be more prone to the disease due to genetic factors. “Some genes have been identified in black men that are associated with an increased risk of prostate cancer and with high grade tumours.

There’s also the socioeconomic issue- a black man in a developing nation like Nigeria with inadequate facilities to tackle serious health challenges like cancer, stands a poorer chance of survival from cancer than say an American, who probably has health insurance and better healthcare  facilities for screening, treatment and cure.

People that eat a lot of red meat tend to have higher rate of prostrate cancer than those that eat lots of fish, vegetables and the likes. Also weight can also increase one’s risk, people that are over weight have more high risk than those with moderate weight. Lack of exercise (inactivity), is another risk factor. People that don’t exercise have high risk of prostrate cancer; even if you are trim, and you don’t exercise, your risk of prostrate cancer increases. Other factors are smoking and people with diabetes.

People living with diabetics are at higher risk and are more likely to die of prostrate cancer than other people. However, risk factors do not tell us everything. Many people with one or more risk factors never get cancer, while others who get cancer may have had few or no known risk factors,” she said.

So, what are the symptoms, she was asked. “These could be summarized into three: urinary symptoms, sexual symptoms and pain symptoms. The urinary symptoms include difficulty in passing urine, poor urine flow, bloody urine, frequent passage of urine especially at night and inability to hold urine. Prostate cancer can also cause a man to have trouble getting an erection (impotence) or painful ejaculation.

It may also cause pain in the hips, back (spine), chest (ribs), or other areas when the cancer spreads to the bones. So, that arthritis might just be prostate cancer! “Other symptoms include weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord.

However, there are other diseases that can also cause many of these same symptoms. For example, trouble passing urine is much more often caused by benign prostatic hyperplasia (BPH) than cancer. Still, it is important to tell your doctor if you have any of these problems so that the cause could be found and treated.

On the other hand, early prostate cancer does not usually show any symptoms, making detection difficult. For this reason, men over 50 (and black men over 40) should go for yearly prostate checks. Screening can be done with a blood test called prostate-specific antigen (PSA) and/ or a digital rectal exam (DRE).”

According to Ogwah, symptoms begin with waist pain and difficulty in urination. it starts with waist pain. Then when the prostate is really fully blown up, to pee will be difficult and painful because the urethra is completely blocked. That is because of the pressure between the bladder and the prostate and the pressure on the urethra which is the hole where the urine passes through. So once it has blocked like that, the individual cannot pee and that is where the problem starts.”

He advised the eating of fresh foods such as vegetables to prevent prostrate and other cancers. “Cancer can be prevented by eating fresh foods such as vegetables and things that contain vitamin E and B which are anti-oxidants that prevents it. As a matter of fact, if we eat right, cancer can be prevented. We didn’t use to have cancer in Africa when we were eating fresh foods. It is a result of eating over processed foods,” he said.

Screening, early detection is essential

Just like in most other cancers, early detection through screening could help in prostrate cancer prevention, treatment and cure. “Regular screening is the key to prevention of prostrate cancer and other types of cancer. Prostrate cancer can be picked up at an early stage if men do their screening every year to check their (PAS) or Prostrate Specific Antigens-it is protein that is produced by men.

The protein is supposed to be less than 4mg/L in men; when it becomes prostrate cancer, its elevated. When a man does his PAS check regularly, he would be able to notice when the PAS increases and take proper action.

s