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INTERVIEW: Prostate Cancer and the Controversial Debates

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Ghana is said to be among the list of African countries performing poorly in terms of the early detection and management of prostate cancer according to a medical survey by FKN Arthur and co. published in the Journal of Science and Technology Vol. 26(1) 2006.

It is reported that over 80 percent of men diagnosed with the disease in the country do not survive it usually because the cancer grows into an advanced stage before being detected.

Every year, an estimated 921 new cases of prostate cancer are recorded with 758 estimated deaths per year. According to a survey conducted by the Korle-Bu Teaching Hospital, Ghana has also exceeded global prostate limits, as the country records 200 cases out of every 100,000 men as against 170 worldwide.

While the statistics seem to cast a gloomy picture of the country in that regard, the CEO of De Men’s Clinic & Prostate Research Lab, Dr. Raphael Nyarkotey Obu says the situation can be reversed if Ghana adopts a prostate cancer policy for men.

The naturopathic doctor in a recent interview on Radio Univers’ health literacy show, Good Health, told host Jonas Nyabor that Ghana needs to increase awareness on the disease condition and dedicate more time and resources to its research.

 

Below is the interview conducted on the weekly health radio show.

What Is Prostate Cancer?

Prostate cancer is also known as carcinoma of the prostate. This condition is caused when cancer develops in the prostate, a gland in the male reproductive system responsible for producing and secreting alkaline fluids during ejaculation.  The cancer cells may spread from the prostate to other parts of the body, particularly the bones and lymph nodes.

 

What is Ghana’s Position in terms of Prostate Cancer Incidence?

Almost 1,000 men are diagnosed with prostate cancer each year in Ghana. Ghana is among the few countries leading the global incident of Prostate Cancer in the world. Out of 4 men, one black man is likely to have the condition so it has become necessary to raise awareness on prostate cancer. Currently, there is very little research and public education on prostate cancer in the country.

 

What are the Classes of Prostate Cancers?

Prostate cancer is be classified into three. There is the localized or organ confined prostate cancer, it means you have the cancer but its within the. With the second class, that is locally advance prostate cancer, it means that you have the cancer but its broken through the outer capsule of the prostate gland and almost spreading to other parts of the body. The last, Mestatic prostate cancer is far advance with the cancer actually spreading to other parts of the body.

 

What causes Prostate Cancer?

We still don’t know that exact cause of prostate cancer however, like other cancers, it is believed to be as a result of the cell’s exposure to viruses and toxins which triggers unusual or uncontrollable growth and secondly diet, hormones, lifestyle and environmental influences promote the growth and development of the abnormal cells and could be the cause of prostate cancer.

 

What are the risk factors?

The three risk factors that can predispose someone to prostate cancers is age, and also family history, genetics and the third one is race, just being a black man alone, you are predisposed to prostate cancer. Looking critically at the three risk factors especially Age: Aging is not really the cause because I did some work and I realized that in Okinawa, (Southern Japan), they are centenarians, living close to and over 100. At the age of 40 they believe they are children, between 60 and 70 they believe they are adults and at 100 ‘life’ begins, so if its age then the Okinawans should be more prone to cancer but they live a cancer free life so aging is not actually the cause. Family History: When a father or any man in the family has prostate cancer, there is a higher likelihood that the son will also have it. If there is also an issue any cancer most especially breast cancer, you are more prone to getting prostate cancer.

There is a lot of work ongoing especially with regards to the genes. Cancer is multifaceted with so many factors involved.

 

What is the prostate’s main function?

The prostate gland is the powerhouse of every man. It seats underneath the urinary bladder and the nerves that help in erection surrounds the prostate that is why in Ghana most of the men when they hear the word prostate cancer or surgery they are afraid because when the nurse get injured then it means you can become impotent. It produces a fluid called PSA (Prostatic Specific Antigen). When you have sex, the PSA paves way for the sperm to swim into the vagina, canal cavity. It does a lot of work for men. Incontinence can be a result of a problem with the prostate.

 

What are the symptoms of Prostate Cancer?

About 40% of prostate cancer is asymptomatic. It is difficult to identify the warning signs. In fact there are a lot of men going up and doing with prostate cancer but they are not aware of it. The warnings signs are not specific. You may have problem with frequency of urination, passing urine during sleep, straining to urinate, dribbling of urine, and incomplete voiding after passing and so on. At the advance stage, you may experience spinal compression and sometimes blood in urine and pelvic pains. The other aspect that affects men a lot is the loss of their libido. These symptoms are not exclusive to prostate cancer, they could be as a result of other diseases. Not all men will experience these symptoms, some may experience nothing at all.

 

How can an individual get to know their status without symptoms?

That is one of the challenges with the black community. We present cases to hospitals very late. It is very difficult to detect because people may live with prostate cancer without any hurting signs. This is one reason why in Ghana, lots of people present prostate cancer to hospitals late.

 

How is Prostate Cancer diagnosed in medical facilities?

Screening is one of the hotly debated areas in the prostate world today because one of the arguments is that, because the disease itself is low growing and some men can live with the disease all their life without any hurtful effect on them, it is believed that once the persons knows his status, he will be subjected to radical treatment and may affect quality of life. However, in my personal opinion, it should be diagnosed. One means used for diagnosis is the PSA test.

The PSA should not be used alone as a tool for prostate cancer screening because what men must know is that Prostate cancer screening is not a straight forward screening. There are other techniques and tools being used in detecting prostate cancer such as the Multiparametric MRI which is coming up but the PSA test yet again is more common and widely accepted.

We use the Ultrasound and the PSA test to monitor if the PSA goes up we go for the Biopsy for find out if the growth is cancerous.

 

When is it important for one to screen for Prostate Cancer?

For men of African descent especially West Africa, screening at the age of 40 is important. If there is a family history, we advocate for genetic testing which comes with very high cost. It may cost up to 1,000 pounds (approx. GHS 4,000).

So the PSA test is still the best marker we still have. The price can be as low as GHS40 depending on the medical facility.

 

Treatment/Management of Prostate Cancer

This is one of the most controversial area in prostate cancer treatment. There is the hormone therapy introduced but the American Cancer Society came out to say the therapy does not cure cancer. With the various treatments that are out so far, none is superior. The stage of the cancer will determine the treatment option for the condition. For instance, the organ confined prostate cancer can be treated with surgery, radiotherapy, hormone therapy or cryotheraphy.

For Ghana, an interdisciplinary approach must be used in cancer management. Over 70% shift to tradition medicine due to sometimes ‘one-sided 100% guarantee’ of cure. This is not a good sign especially as some natural medicines may prove to be rather detrimental.

 

Are there side effects of these treatments?

Treating prostate cancer may result in a change in the sex life of affected men. About 76% of men subjected to prostate cancer treatment may experience temporal or permanent erectile dysfunction. There are lots of supports afterwards.

The cancer journey is a long journey and so patients need deep insight into the condition through access to Urologists, Psychologists, Nutritionists and so on probably at the same facility to know of what is expected of them to live longer in spite of the condition.

 

Living with/How can Prostate Cancer be Prevented?

Since its known that diet is a contributory factor to cancer so taking practicing good dieting helps prevent the condition. The intake of tomato juice cuts down the risk of developing the disease by 30% and prevents disease progression in people living with it. If you are diagnosed with prostate cancer, regular intake of fruits and vegetables is helpful as well as reduction in the intake of dairy products and meat. Fatty fishes such as Salmon are very good for persons diagnosed with prostate cancer due to their rich Omega 3 nutrient. Regular exercising and finally prayer is key.

Persons living with the condition are advised to join support groups.

 

This text was curled from Dr. Raphael Obu’s interview on Radio Univers’ Good Health radio show on Wednesday January 7, 2015.

WATCH THE VIDEO BELOW:

By: Jonas Nyabor/Ghana Health Nest

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