Prostate Cancer daigram

Pastor Gbadebo is one of the most pleasant people I have ever met. He is truly a man of God and has the fortitude to face the biggest battle of his life. Recently, he was diagnosed with widespread prostate cancer. He now has the mother of all battles: the battle to live.
Sometime ago, in the now distant past, Pastor had a prostate examination performed. He was then asked to go for a blood test to check the function of the prostate gland. The test is called PSA or prostate specific antigen, for long. This test measures what the prostate is doing and a high number indicates a hard working or cancerous prostate gland. Cancer cells are actively dividing and so producing a lot of PSA, as high as (50 – 1000). The normal level should be less than 10. Unfortunately, the good pastor ignored the advice and did not perform the test.

We met when he suddenly lost all power in the legs and could no longer walk. The tests show that he had prostate cancer that had now spread all over his body, and into the bones of his back causing pressure on the nerves supplying his legs. So, the cancer is no longer limited to the prostate from where it originated; it has spread all over his body, as cancer often does.

The prostate gland
The gland is at the base of the bladder in men. It word prostate comes from the Greek word prostates, literally "one who stands before", "protector", "guardian”. It secretes chemicals useful in ejaculation, movement of sperms and manliness. It is an important organ but it can develop cancer as much as any other organ in the body. Women do not have a prostate gland per se.

Prostate enlargement
Prostate gland enlargement is a common condition as men get older. Also called benign prostatic hyperplasia (BPH) and prostatic hypertrophy, prostate gland enlargement can cause irritating problems when passing urine. In some people, it causes pain, bleeding or difficulty in passing urine. Some people pass small amounts of urine frequently, and often will wake up several times over the night to pass urine. Untreated prostate gland enlargement can block the flow of urine out of the bladder and can cause bladder, urinary tract or kidney problems. There are several effective treatments for prostate gland enlargement. In deciding the best option for you, you and your doctor will consider your particular symptoms, the size of your prostate, other health problems you may have and your preferences. Your choices may also depend on what treatments are available in your area. Treatments for prostate gland enlargement include medications, lifestyle changes and surgery.

Prostate cancer
Prostate cancer, a disease of older men, is on the increase and it is now killing younger people in Nigeria. The men affected are often in their early fifties and vibrant active members of the society. The cancer is also usually discovered late, making treatment rather difficult. It is better prevented or at least discovered before it spreads out of the prostate gland. It often spreads to the bones of the spine and therefore increases the risk of paralysis due to pressure on the nerves. It can also spread to the lungs and the head causing damage that leads often leads to death in these vital parts of the body.

Prevention is better than cure
Cancer of the prostate occurs in middle aged and older men. Doctors usually advice men over 40 years of age to have their prostate examined regularly and to have a PSA test performed once in a while. All this, to ensure the prostate remains healthy. Also, to pick up abnormal signs as soon as possible. In this way the problem can be duly investigated and effective remedy offered. Prostate cancer is the most common cause of death from cancer in men over age 75. It is rarely found in men younger than 40.
Those who are at a higher risk of prostate cancer include but are not restricted to: Farmers, painters, men who have a father or brother with prostate cancer, men who drink too much alcohol and those who eat too much animal fat. Prostate cancer is less common in people who do not eat meat (vegetarians) and those who eat fish.

Who should be screened and how often?
Men over the age of 40 years should go and see their own general practitioner or a urologist (doctors specialised in problems of the kidneys, bladder, prostate and all other parts of the urinary tract) for a prostate examination. The doctor may put a finger up the bottom to feel the contours and the relative size of the prostate gland. The doctor can tell if the gland feels smooth and normal or if it feels irregular and bumpy. An irregular gland may signify cancer. Secondly, the doctor will order the blood test (PSA). The result of both the finger examination and the PSA are useful in making a diagnosis. It is advisable for men over the age of 40 years to have the examinations performed every 2-3 years and longer period in between, if all remains well.

Treatment of prostate cancer
This depends on the stage of the cancer and the person affected. The options include surgery to remove the cancer in the prostate gland and medications to suppress the activity of the male sex hormones. These chemicals (the hormones) feed the cancer so blocking their effect leads to control of the cancer. Other treatments include various types of radiation treatment. The specialist will determine what is best for the individual patient.

So, what do you want to do?
Are you over 40 years of age? Have you had your prostate checked? Have you had your PSA done? Do you know any man who is above 40? Is he your husband, father, brother or son? Has he had his prostate checked? So, what do you want to do? Sit back and let prostate cancer claim another life? Or find a specialist quickly?

•Ogungbo is a consultant neurosurgeon at Cedarcrest Hospital, Abuja