By CHIDI O. U. ESIKE

INTRODUCTION

I have always felt that we owe our fellow humans enlightenment about medical conditions that will motivate them, by virtue of our calling in medicine and being knowledgeable authorities in the art and science of it, to take actions that will help prevent diseases where preventable or reduce the risk of getting such diseases where outright prevention is not possible. This reduces the impact, devastation and deadliness of these rather serious diseases. Definitely we, though overburdened in the medical profession by work, are certainly not doing enough in this aspect and may be equally as guilty in not undergoing medical check-ups as the general population even as it is a known fact that common medical information about diseases can prompt somebody to undergo simple medical check-ups which can help greatly to prevent or reduce the risk of getting many diseases and their devastations. This includes the dreaded cancers; yes, even cancers. I have therefore decided to take action by writing about prostate cancer, a devastating cancer of the male that all male folks are at risk of getting, which fortunately the risk of getting it can be reduced if only we can care and take a little action like checking up ourselves medically.

WHY ARE ALL MEN AT RISK OF GETTING PROSTATE CANCER?

This is simply because prostate cancer occurs only in males and all males have prostate. It is, however, not every male that will have prostate cancer. Very unfortunately, we do not know who, in particular, among the male folks that will get it, so every person who is a man, especially those that are of the black race and over 40 years of age, are at risk of getting prostate cancer and should regularly check for it.

But let us first start by knowing about this male organ of the body called prostate.

THE PROSTATE

The prostate is a gland of the male reproductive system that is found only in males. It produces part of the fluid that makes up the semen that is ejaculated during sex. It is the size of a walnut fruit with the normal size measuring about 4cm wide, 3cm long and 2cm when measured from the front to the back. The prostate gland is located just between the urinary bladder (the sac-like structure where urine from the body collects before it is passed out when we go to urinate) in front and the rectum (the lower part of our intestines or gut where faeces is stored before we pass it out during defecation) behind. It is partly surrounding the urethra (the tiny tube that passes from the urinary bladder through the penis through which we urinate). The prostate gland may grow bigger as men get older and may, in fact, grow so big that it may make the passing of urine difficult and/or may at times block the passage of urine completely in which case one will need the help of doctors passing a small caliber rubber or metallic pipe called urinary catheter to enable the person pass urine.

The Prostate gland normally produces a substance called prostate specific antigen, PSA for short. The production of this PSA increases when there is inflammation of the prostate gland, when there is enlargement of the prostate that is not due to cancer (called benign prostatic hyperplasia in medicine) and when prostate cancer occurs. Therefore, simply taking a little blood from the patient, say from a blood vessel in the forearm, can help suspect or have an idea of what is happening in the prostate including the occurrence of prostate cancer.

CANCER

Cancer occurs when cells of a specific part of the body grow and multiply rapidly and uncontrollably to produce abnormal new cells which have the ability to invade surrounding healthy tissues and organs or to distant tissues and organs causing diseases.

PROSTATE CANCER

Prostate cancer occurs when the cells of the prostate gland grow and multiply abnormally to produce abnormal prostrate gland cells that can initially invade the surrounding healthy prostate gland tissue and if not discovered early, will invade distant tissues and organs.

Prostate cancer occurs only in males and it is common and deadly. In fact, in Nigeria, it is the commonest and deadliest male cancer occurring in about every 33 of 100,000 Nigerian men with 16 of them dying. Most of these men die after prolonged illness, pain, suffering, hospitalisation with a lot of money spent and patient’s relations and loved ones going through a lot of avoidable agony and devastation.

RISK FACTORS FOR PROSTATE CANCER

The risk of having prostate cancer is more in black men. This risk increases with increasing age especially from the age of 40 years, and in males whose male relations such as fathers, uncles etc had suffered or are suffering from prostate cancer.

REDUCING THE RISK OF GETTING PROSTATE CANCER

Though it may not be possible to prevent the occurrence of prostate cancer, the risk of one getting it can be reduced and this is the reason for writing this paper so that our men can know and avail themselves of medical check-ups especially from 40 years of age that can help them reduce the risk of getting prostate cancer or discovering it early when cure is possible. Our female folks should encourage the men to go for the screening for prostate cancer as the males should do to the women for cervical and other cancers.

Generally, the risk of getting prostate cancer can be reduced by stopping or quitting smoking, maintaining healthy lifestyles such as avoiding obesity (avoiding too much weight), reducing our body weights if we are obese, maintaining ideal body weights for our heights, exercising regularly, avoiding sedentary lifestyles, keeping physically active, eating healthy diets with whole grains, lots of fruits and vegetables and avoiding excess sugar, fats, sweetened and processed foods, etc.

The more specific way of reducing the risk of getting prostate cancer is by screening for it. Screening for disease, by the way, is looking for the disease when it has not started and before it starts manifesting its symptoms. This is important because by the time diseases, especially cancers, start manifesting their symptoms, they would have established themselves and may have invaded surrounding tissues or other more distant tissues, thus making cure difficult or impossible.

The risk of getting prostate cancer can be reduced by screening for it. To do this, one goes to his doctor who will screen for prostate cancer by first asking the person some relevant questions, examining the person physically including performing a rectal examination and sending him for prostate specific antigen (PSA) test. One may go for the PSA test alone, though.

To do the rectal examination (I hope we remember the rectum which I said above is the lower part of the gut or intestine where faeces is stored that is behind the prostate), the doctor will ask the person to lie down on the examination bed or couch and will position the person in a particular position with the patient facing away from the doctor. After telling the person what he wants to do, he, the doctor, will gently insert a gloved, lubricated finger into the anus of the person and check how the prostate is. There are things he will feel and he will suspect some abnormalities in the prostate including suspecting prostate cancer.

Having performed the rectal examination to assess the prostrate, the doctor will continue his screening for prostate cancer by sending the person for PROSTATE SPECIFIC ANTIGEN (PSA) test. Prostate Specific Antigen is a substance normally produced by the prostate so there is a normal value of it in the blood. However, the quantity of PSA in the blood is increased when there is prostate cancer. PSA level in the blood also increases when there is inflammation of the prostate or when there is enlargement of the prostate that is not due to cancer (called benign prostatic hyperplasia in medicine). So, it is not every increase in the quantity of PSA that is due to prostate cancer but your doctor, if he or she is not a Urologist, will likely send you to a specialist doctor in this area called a Urologist who will be able to know if the increase in your PSA is due to cancer of the prostate or not.

If the PSA value in the blood is increased, one may be sent for further tests like ultrasound, magnetic resonance imaging (MRI), CT scan, etc, to know the exact cause of the high PSA. The person may also be taken to the operating theater and bits of any suspicious looking part(s) of the prostate (called a biopsy) are taken and sent for a special test called histology. When these pieces of prostate tissues are analysed, it will be shown if it is prostate cancer that the person has or not and the person will be treated accordingly.

If after the examination, the prostate feels normal and the PSA level is within normal limit, that means that the person most likely does not have prostate cancer. It is usually a good practice to carry out medical check-ups including checking for prostate cancer at regular intervals of say yearly. This is because with the whole lot of activities going on in the body at the cellular level, a new prostate cancer may develop with in the interval of the test. Again, there is the small chance that an early onset prostate cancer may be missed for some reasons in the previous testing. This will most likely be discovered in subsequent testing.

Prostate cancer though a disease that can kill after causing prolonged and severe agony to affected men can be completely cured if discovered early or the risk of occurrence reduced by simple and relatively inexpensive medical check-ups. AVOID PROCASTINATION. GO FOR A MEDICAL CHECK-UP NOW.

REFERENCES

Elima Jedy-Agba et al. Cancer incidence in Nigeria: a report from population-based cancer Registers. Cancer Epidemiol 2012, Oct

Oluwarotimi SN, Adekoyejo AP, Anunobi CC, Oluwayemi A, Ima-Obong AE et al. Prevalence of prostate cancer at authopsy in Nigeria – A preliminary report. The prostate, 2021, 18 (9):553 – 559.

Prostate cancer screening, National Cancer Center Institute. Cancer.good/types

•Chidi O. U. Esike, an Associate Professor, is a medical expert.

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