Men Above 50 Should Go For Pros­trate Screen­ing

The Guardian (Nigeria) - - HEALTH - By Paul Adun­woke

AS to­day marks aware­ness week for pros­trate can­cer, men above 50 have been ad­vised to go for screen­ing with­out de­lay, even if they are with­out symp­toms. Screen­ing process en­tails a rec­tal ex­am­i­na­tion of the prostate by a doc­tor, prefer­ably an urol­o­gist, a prostate-spe­cific anti­gen (PSA) test and a prostate scan, which should be un­der­taken yearly.

Med­i­cal ex­perts say the ben­e­fit of this is that can­cer de­tected early by this method is po­ten­tially cur­able. The high ac­cept­abil­ity and prac­tice of prostate can­cer screen­ing is the rea­son for im­proved sur­vival and low death rates from prostate can­cer in the West­ern world.

Un­for­tu­nately, how­ever, many Nige­ri­ans are yet to em­brace screen­ing for can­cers gen­er­ally, in­clud­ing prostate can­cer. They wait un­til there is pres­ence of symp­toms for months or even years, by which time the can­cer has spread to other or­gans in the body and is po­ten­tially in­cur­able. Late pre­sen­ta­tion and, there­fore, late di­ag­no­sis is the main rea­son mor­tal­ity from prostate can­cer is still very high in the coun­try.

Since prostate can­cer is not to­tally pre­ventable, the mes­sage be­ing preached is early de­tec­tion, which is only pos­si­ble through screen­ing.

Dr. Ru­fus Wale Oje­w­ola, a Con­sul­tant urol­o­gist, Depart­ment of Surgery, La­gos Univer­sity Teach­ing Hos­pi­tal (LUTH), and a lec­turer in Surgery, Col­lege of Medicine of Univer­sity of La­gos (CMUL), said the prostate is an ac­ces­sory or­gan of re­pro­duc­tion found be­low the blad­der in men. Prostate can­cer is when can­cer de­vel­ops from the prostate or­gan. He said: “Prostate can­cer is the com­mon­est can­cer in adult males. About one in 36 men will de­velop the can­cer in their life time, while one in six af­flicted men will die of the dis­ease. Prostate can­cer can be ag­gres­sive and lead to death, but can also be slow grow­ing in which case, pa­tients can live long and die of other dis­eases or causes like com­pli­ca­tions of di­a­betes, hy­per­ten­sion, lung dis­eases or even road traf­fic ac­ci­dents or old age.”

He ex­plained that the risk of de­vel­op­ing prostate can­cer in­creases with age.

“The peak in­ci­dence is in the sixth and sev­enth decades of life. It was rarely di­ag­nosed in men be­low 50 in the past, but this has changed as younger men are in­creas­ingly be­ing af­flicted now,” he ex­plained. “We now di­ag­nose prostate can­cer in men around 40 years. This is what we call age mi­gra­tion in can­cer, and is not pe­cu­liar to prostate can­cer alone. For ex­am­ple, breast can­cers are be­ing di­ag­nosed in­creas­ingly in teenagers now. There is a racial pre­dis­po­si­tion to prostate can­cer, as it is an es­tab­lished fact that the dis­ease is com­moner and more ag­gres­sive in blacks than whites. Men should also know that prostate can­cer is cur­able, if de­tected at the early stage.”

Oje­w­ola said man­i­fes­ta­tion of prostate can­cer de­pends on the stage at di­ag­no­sis. In the very early stage, it might not man­i­fest with any symp­tom.

He said: “It is only dis­cov­ered dur­ing screen­ing for prostate can­cer. This is the com­mon­est method of de­tec­tion in the West­ern world, where there are or­gan­ised screen­ing pro­grammes for men.

“If not dis­cov­ered at this stage, it can then progress to man­i­fest as lower uri­nary tract symp­toms. Th­ese are symp­toms of dif­fi­culty in pass­ing urine like uri­nary fre­quency, noc­turia (fre­quent uri­na­tion at night), in­ter­mit­tent stop and start pat­tern of uri­na­tion, ur­gent in­abil­ity to post­pone uri­na­tion, ap­ply­ing force dur­ing uri­na­tion, in­com­plete void­ing, feel­ing of urine re­main­ing in the blad­der after uri­na­tion or poor uri­nary stream. There may also be pas­sage of blood in the urine or blood­stain in the sem­i­nal fluid.

“By the time prostate can­cer is ad­vanced, there may be weight loss, loss of ap­petite or gen­er­alised weak­ness. There may be back pains, if it has spread to the back or weak­ness or paral­y­sis of the legs, if the spinal cord is in­volved. There may be yel­low­ness of eye and ab­dom­i­nal swelling, if the liver has been in­volved. There may be cough, ch­est pains and pas­sage of bloody spu­tum, if the lungs are af­fected. The truth is that it can spread to any or­gan in the body, if not dis­cov­ered and treated early.

“The truth is that prostate can­cer is not to­tally pre­ventable, as one can­not mod­ify es­tab­lished risk fac­tors. The ma­jor risk fac­tors are age, black race, and ge­netic fac­tors, which in­clude fam­ily his­tory. Mod­i­fy­ing or elim­i­nat­ing th­ese fac­tors could have helped to pre­vent prostate can­cer. Un­for­tu­nately, none of th­ese ma­jor fac­tors is mod­i­fi­able. For ex­am­ple, no man can change his age, race or fam­ily ge­netic fac­tor.”

He, how­ever, noted that there are other less im­por­tant risk fac­tors, such as the type of food con­sumed.

“Eat­ing food con­tain­ing less fatty com­po­nents and food rich in veg­eta­bles, toma­toes and fruits have been found to re­duce the risk slightly. Avoid­ance of smok­ing, in­clud­ing healthy life­styles among men is gen­er­ally help­ful.

“Once there is pres­ence of any of the symp­toms above, there is need to con­sult a doc­tor prefer­ably urol­o­gists, who are spe­cial­ists that treat prostate dis­eases. “There is no need to panic or live in fear of be­ing di­ag­nosed with prostate can­cer. This is be­cause there are other non­cancer­ous con­di­tions of the prostate, which in­clude be­nign pro­static hy­per­pla­sia, chronic pro­stati­tis, and of the blad­der that can also man­i­fest as dif­fi­culty in pass­ing urine.

“The doc­tor will take his­tory around the symp­toms listed above and con­duct a thor­ough ex­am­i­na­tion, es­pe­cially on the prostate to de­ter­mine if it is en­larged or not, smooth or rough and if rub­bery or hard in con­sis­tency. Find­ings of ir­reg­u­lar and hard prostate on ex­am­i­na­tion may sug­gest ma­lig­nancy. Con­duct­ing a prostate spe­cific anti­gen (PSA) test is manda­tory. El­e­vated val­ues may also sug­gest can­cer, how­ever, there are other dis­eases that can cause el­e­vated PSA. This is why there is need for spe­cial­ist con­sul­ta­tion to dif­fer­en­ti­ate some of th­ese con­di­tions from can­cer of the prostate.

“A tran­srec­tal ul­tra­sound test is also nec­es­sary to give more de­tails about the prostate or­gan, which is an or­gan hid­den deep in the pelvic re­gion of the body. With ab­nor­mal­ity in any of th­ese ex­am­i­na­tions of the prostate, PSA test or prostate scan is needed to per­form a prostate biopsy to con­firm the di­ag­no­sis. Biopsy is the process by which sam­ples are col­lected from the prostate for his­to­log­i­cal ex­am­i­na­tion to de­ter­mine whether it is can­cer­ous or not,” he said.

He ex­plained that ejac­u­la­tion or sex­ual ac­tiv­i­ties, whether in­fre­quent, fre­quent or ex­ces­sive, has no re­la­tion­ship with the de­vel­op­ment of prostate can­cer.

“Stud­ies have not demon­strated a causal and ef­fect re­la­tion­ship be­tween the two,” he said. “So, it is one of the sev­eral mis­con­cep­tions about the eti­ol­ogy or cause of prostate can­cer. Other mis­con­cep­tions in­clude mul­ti­ple sex­ual part­ners, sex­u­ally trans­mit­ted dis­eases and celibacy. None of th­ese has been proven to pre­dis­pose a man to de­vel­op­ing prostate can­cer.

“Usu­ally, any man be­yond mid­dle age, which is 50 years, is at risk. As high­lighted above, the risk in­creases with in­creas­ing age. How­ever, it can oc­cur at a younger age. And so, it is rec­om­mended that all men should un­dergo screen­ing for prostate can­cer from the age of 50 on a yearly ba­sis. For those with pos­i­tive fam­ily his­tory, screen­ing for prostate can­cer should com­mence at 40 years of age.”

Newspapers in English

Newspapers from Nigeria

© PressReader. All rights reserved.