Emmanuel Ezeh,44, has heard about prostate cancer but thinks it is just another enigmatic name for a serious ailment that has nothing to do with him.
“It affects the heart, abi?” the Abuja resident asked. “Is it not the same sickness that killed Yar’Adua (former president Musa Yar’Adua)? I don’t know, is it an abnormal growth? Why should I even know about it?”
Prostate cancer, one of the many common types of cancer, is a leading cause of death among, especially black men. Yet many, such as Mr Ezeh, know little about it.
The 44-year-old could not name any symptoms of the ailment.
Men of African descent are twice as likely to die from the disease as white men, reports show. However, it is still quite difficult to accurately describe the burden in Africa due to poor cancer registration systems and awareness.
A 2019 study published in the journal, springerlink, found that the knowledge of prostate cancer and its screening was poor among men in Nigeria.
Men, 40 years and above, should at least go for yearly checkup and screening to monitor the growth of prostate cancer. They need to know the early symptoms of the disease so that they can present every case early for treatment, according to health experts.
Today is World Cancer Day; an international event marked on February 4 to raise awareness of cancer and to encourage its prevention, detection, and treatment.
To mark the day, PREMIUM TIMES spoke to a number of cancer experts on prostate cancer. They explained why the ailment is more susceptible to black men and why awareness is poor.
Men have poor health-seeking behaviour and are very poor at compliance with medical orders, keeping appointments, Henry Ewononu, a public health expert said. The male ego is said to be the reason for this, he added.
He said Nigerian men die needlessly from cancer of the prostate – an ailment which can be prevented if detected early – due to poor awareness.
“In the last one year, men who died from prostate cancer that I know had similar characteristic features: The symptoms were not detected early; they initially had complaints of low back pain; they are in their 60s, and their disease had rapid progression within three-four years before their deaths”, he explained.
The prostate is a walnut-sized gland that is part of the male reproductive system. It is located beneath the urinary bladder and in front of the rectum.
The prostate makes some of the fluid that nourishes and protects sperm cells in the semen. Just behind the prostate are the seminal vesicles, which make most of the fluid for the semen.
Cancer occurs when abnormal cells grow and divide uncontrollably in the prostate and may eventually spread into other tissues.
Often, early-stage prostate cancer has no symptoms or signs, but as it progresses, the ailment can make urinating and ejaculating painful.
Oseremen Aisuodione-Shadrach, a cancer expert, said the best way for men in same age bracket as Mr Ezeh to monitor the prostate is by doing a simple test called PSA once a year.
“Another way is to have a doctor do a digital rectum examination by using the finger to examine the prostate once a year in any black man who is more than 40 years. Once you do that, you are being monitored so that if there are abnormalities in the prostate or you pick an abnormality in the result, it can be treated early. But once it is late, prostate cancer usually has no treatment.
“If a PSA test or DRE indicates that prostate cancer may be present, more monitoring and testing is needed to diagnose prostate cancer. When prostate cancer does cause symptoms or signs, it is usually diagnosed in a later stage.
“These symptoms and signs may include frequent urination, weak or interrupted urine flow or the need to strain to empty the bladder, blood in the urine and blood in the seminal fluid.”
It is not just patients who lack knowledge: doctors too do. Spencer says that general practitioners do not have enough experience with prostate cancer, because so few patients go for prostate check-ups.
Causes of Cancer
An ongoing research, which is trying to find the reasons for the high rate of prostate cancer among black men, has already started linking it to genes and race.
The study, MADCAP (Men of African Descent and Carcinoma of the Prostate), is a five-year study that began in 2015. Its aim is to discover the root of the disease in black men, through the collection and genomic analysis of biosamples for the study.
Mr Aisuodione-Shadrach, the principal investigator of the Abuja site for MADCAP Network study in Nigeria, also shed light on the project and the possible causes of prostate cancer.
Age: The risk of prostate cancer increases with age, especially after age 50. More than 80 per cent of prostate cancers are diagnosed in men who are 65 or older.
Race/ethnicity: Black men have a higher risk of prostate cancer than white men. They are also more likely to develop prostate cancer at an earlier age and to have more aggressive tumours that grow quickly. The exact reasons for these differences are not known and may involve genetic, socioeconomic or other factors.
Family history: Prostate cancer that runs in the family, called familial prostate cancer, occurs about 20 per cent of the time. This type of prostate cancer develops because of a combination of shared genes and shared environmental or lifestyle factors.