If you are wondering as a man why you must regularly do your prostate screening once you turn 40 years of age, then you have to read what Dr Segun Sanni the Coordinator, Health Services THE DOZY MMUOBUOSI FOUNDATION said in this conversation with Healthstyleplus during the Health Clinic awareness programme by Journalists Estate Residents Development Association, JERDA, Arepo, Ogun State where over 300 men benefitted from the free prostate cancer screening programme of the Foundation.
“Every man above 40 years of age must regularly screen his prostate gland for early detection of risk factors that predispose men to the dreaded prostate cancer” says, Dr. Sanni.
What is the function of the Prostate?
The male genitalia, the penis, can be seen, and the urinary bladder can be felt when you’re pressed and wants to pass urine. The prostate, however, is nestled somewhere between the two organs.
“Imagine the back of the penis and the area that opens into the anus, imagine the urinary tract that ends into the bladder, on top of this is a tiny gland that looks like a small fruit at the base of the bladder wrapped around the opening where the urethra passes into the penis, that is where the gland grows”, Sanni explained. You can only feel it, but cannot see it.
The prostate is that male organ located just below the bladder and right in front of the rectum. It is enclosed within the body and is about the size of a walnut. The prostate gland surrounds the urethra which is responsible for emptying urine from the bladder and functions as the organ which produces the fluid that makes up part of the sperm called seminal fluid. The prostate is the organ which produces the fluid that makes up part of the sperm called seminal fluid. The prostate gland is a very important part of the reproductive system in a male.
How Common Is prostate cancer in Nigeria?
“Interestingly, prostate cancer is quite common than what people think especially as it becomes traumatic, says Dr Sanni.
According to Sanni, “From available Literature and from recent statistics, prostate cancer is seen in every one out of six men in Nigeria even as there is no accurate data for the incidence of prostate cancer in the country.
“Many who have certain prostate diseases could go on to develop cancers in their lifetime. You see, as we age, a lot of men will start having urinary symptoms but for cultural reasons, they wouldn’t speak out about their experiences so that help could come early enough”.
Sanni noted that many men only go to the hospital when the prostate starts having symptoms and by then, it could have become too late, “the prostate might have even become cancerous”, the Physician pointed out.
Why Do Regular Prostate Screening?
The Dozy Mmuobuosi Foundation is involved in creating mass awareness that every man above 40 years must regularly screen his prostate. The aim of our prostate cancer screening programme is to encourage as many men pick up early risk factors and nib prostate cancer in the bud at its onset, explained Dr Sanni.
Prostate cancer is initially non-aggressive cancer.
That means, it is a slowly and quietly insidious growth and can give a window period of up to six years before it shows and become aggressive. By the time it becomes symptomatic, it becomes very aggressive, especially among blacks.
And even when you are able to diagnose it correctly, the treatment leaves lots of morbidity and mortality.
Morbidity in the sense that, even if successfully treated, you might not go without side effects that might be unpleasant such as fertility, the ability to procreate or even having an erection and so on. This is why our campaign slogan is “diagnose early, catch it early, it is totally treatable”, Sanni noted.
The Prostate Cancer Screening/Examination:
The doctor examines the man through the back with a gloved lubricated finger. He carefully inserts the finger pointing towards the front to feel the small gland.
He takes note of certain things – because he is used to what a normal gland feels like, the doctor takes note if the gland is enlarged, if it feels different, he takes note of the size, shape and whether it is nodular or not, if it is hard, moves freely or has become attached. Even without all these, if the prostate has started to become enlarged these are some of the things will see.
This Examination is called the digital rectal examination. We use it in addition to the blood test that we call Prostate Specific Antigen (PSA). The PSA will tell you when the Prostate is getting enlarged or if there is the presence of a substance that is cancerous.
The PSA is a blood test which indicates the presence of an enlargement or inflammation or cancerous cells or abnormalities in the cells.
At The Dozy Mmuobuosi Foundation, we use both the PSA and Digital Rectal Examination together because the PSA alone is not enough for good outcomes in a thorough prostate screening exercise.
There might be certain growth that may not necessarily be associated with the PSA level and would not be seen using PSA. At the same time, you might have someone with PSA that is increasing but might not have an enlarged gland because with age the PSA starts to increase.
On the other hand, an increased PSA level might also not necessarily be a problem since PSA increases with age only it shouldn’t get to a particular level/measurement at a certain age like 40 years old having the antigen level of a 55-year-old child be of concern.
So the two tests are what a doctor will take together to advise on further investigations that will determine if someone is at risk of developing prostate cancer or not.
So for those who are reluctant to go through regular prostate screening for cultural or religious reasons, what we do is to tell them how serious the condition could be if allowed to develop. Prostate cancer is the greatest killer among men aged 45 and above in Nigeria and that alone should get one thinking.
How Is Genetics a factor In prostate cancer?
Genetics plays a very important factor because it has to do with family history. History of a brother, a father or uncle or grandfather who has had cancer specifically, prostate cancer and not any other type of cancers.
We have a set of questions in our form and when we administer the questionnaire we take such cognizant history into consideration when talking to our clients. We don’t overlook the history of prostate enlargement as well.
However, prostate cancer is familial and genetic. Genetics in that it is more common among blacks than other races. If one has a positive family history, the chances of one developing cancer is high.
A family history is like having an association; it is not necessarily that the person will develop prostate cancer. There is no cause and effect to prostate cancer.
Prevention of Prostate Cancer Is Key:
No hard and fast rule but like every other cancer, a healthy lifestyle is key- such as eating well, not overindulging in alcohol and one must be engaged in exercise among others.
These are what we have in control-not genetic or family history and even at that you still find people developing cancer. That is why screening is critical. However, with a positive lifestyle and regular prostate screening, one can pick the disease early and can be treated. The early treatment leaves one the option of nipping the disease in the bud before it becomes debilitating.
What type of treatment options are available?
With the kind of screening method we offer at The Dozy Mmuobuosi Foundation, it helps to detect those with high risks of developing cancers, our reagents are very sensitive and we do ultrasounds for those that are suspicious and we refer such persons to see a Urologist who might now decide to do a prostate biopsy for histopathologist to determine whether it is cancerous and then the urologist sits with the patient to detect treatment options available at the early stages.
Are there symptoms to reveal prostate cancer?
I won’t be discussing symptoms because there are arrays of symptoms almost 6-8 that can be seen and only one or two cannot point to cancers. But generally, there are obstructive and irritative symptoms with 6-8 signs to each of these which we can see. It is the urologist who can break down the signs.
The benefit of Early Detection:
Every man must regularly screen his prostate as early detection of prostate cancer starts with screening.
This is what The Dozy Mmuobuosi Foundation does. When an individual is picked up with predisposing risk factors, he is at a very big chance of early treatment and good outcomes to recover from developing cancers that could kill him.
Not going through regular prostate screening means playing a game of chance with life- A game of roulette or ludo.
Co-Morbidity effects of Prostate Diseases left untreated:
Benign Prostate Hypephlaxia – BPH or enlargement of the prostate is a co-morbidity condition of the prostate. This may not become cancerous but as it grows, it will start giving some symptoms. Yet, you find people managing this condition on their own. However, if left unattended would affect the quality of life, urine dripping and incontinence and then one will develop body odour and of course, that will affect the quality of social lifestyle.
One could equally end up with urine retention which is also a bad one and myriads of complications that are unpalatable.
Can Prostate Diseases be found in men below 40?
One could have different reasons for developing Prostatitis which is very different and has other causes. But developing prostate enlargement and cancers is associated with older men. That explains why most prostate screening starts from age of 45 years though we start for men in our project at 40. The reason being that when the curve says it is better to screen 45year old and above we want to see if there are indications for men below 45 and since we started, we have found not a couple of men below 45 with a significantly high level of PSA for their age, They may not develop the prostate disease, but to be on a safe side, we asked them to see Urologist. Though it is very rare we do not say never in medicine.
Nonetheless, it is rare to have someone below 40 years having prostate enlargement or developing cancers; quite unusual.