Oluwatobiloba Jaiyeola
A Consultant Urologist at the Lagos State University Teaching Hospital, Ikeja, Dr. Oluwaseun Akinola has urged Nigerian men to go for regular prostate screening for early diagnosis of prostate cancer.
The urologist said when screening is done and the cancer is detected early; there is a higher chance to cure the patient completely.
Akinola stated this on Friday, at the Marcelle Ruth Friends Cancer Support Group Educational and free Prostate Cancer Awareness and Screening programme, organised by the Marcelle Ruth Cancer Centre & Specialist Hospital, Lagos.
The expert explained that the prostate is an almond fruit-sized organ located below the bladder where urine is stored.
He warned that with prostate cancer, usually there are no symptoms experienced until the condition is advanced, hence the need to go for regular screening.
Akinola also noted that prostate cancer is most common in African men, adding that it is often detected too late to be cured. He added it is usually much more aggressive in Nigeria than what is seen abroad.
Akinola explained, “When we talk about cancer, we are referring to abnormal cells. Cells that used to be normal, something happened to them and over time they lost control.
“Normally cells are supposed to live and die but what happens with prostate cancer is we have cells that grow and they don’t stop growing and then they start to impinge on places they shouldn’t be, at some point they can leave where they are supposed to be and go somewhere else and cause damage there. In essence, when we say prostate cancer, we are talking about cells of the prostate undergoing this process.
“With prostate cancer, it is important to know that if it is caught early, you can cure the patient but once it is spread, it becomes more of a long journey and sometimes you can’t treat and it is no longer curable at that point.
“In Nigeria, the majority of men that have been diagnosed unfortunately are at the stage where they are having symptoms and that is the only reason they came.
“The idea of screening is to identify disease at a point where you can still do something about it, and for prostate cancer, there are two things; a physical examination by the doctor, and then a blood test, the Prostate-Specific Antigen (PSA).
“You don’t wait for symptoms to screen for prostate cancer because there are no symptoms until it is advanced. If you are having symptoms as a result of prostate cancer it most likely means by that point it is too late and this is why screening is very important,” Akinola stressed.
He added, “Men of African heritage have a higher risk of prostate cancer, it tends to happen much earlier than in Caucasian counterparts and it tends to be more aggressive. Studies in the United States have shown that there is twice the risk of dying from prostate cancer in men with African heritage versus Caucasians.”
In the western world, about 96 per cent of patients diagnosed with cancer are diagnosed on screening without necessarily experiencing any symptoms.
The urologist also noted that over the years there has been a lot of research going on to find out what the actual cause of prostate cancer is, but an exact cause is still not known ultimately, it is known that it ends up with DNA damage that leads to the process.
Akinola further suggested that African men who have additional risk factors like family members who have had prostate cancer should consider doing a PSA test early.
He said, “For men at average risk, age 40-55, no routine screening in that population is recommended. The consensus is that it is wise to have that decision earlier for men of African descent. Men at age 45 for example should have a discussion with their doctor about what role screening plays.
“The disease we see in Nigeria is much more aggressive than what we see abroad.
“If you have additional risk factors, for example, you are an African man and you have a father or a brother that has prostate cancer, you could consider going lower than this age. There are protocols e.g. when you screen at age 40 and you check your PSA if it is normal you don’t have to check for another five years.
“For men aged 55 to 69, the American Urological Association recommended shared decision making which is you sit with your doctor to talk about the pros and cons, the risks, what comes next after the screening, to decide on whether or not you want to be screened.
“Then after age 70, people with less than 10 years life expectancy we don’t recommend screening because usually, the prostate cancer is not the cause of eventual demise in that population.”
“It is important to keep in mind that the data all of this is based on is a majority of the Caucasian population so it may not apply directly to us.
“Prostate cancer is common in African men and it’s often caught too late to be cured and that is what we are hoping to change,” Akinola noted.
Also speaking in the same vein at the programme, the CEO and co-founder of the Marcelle Ruth Cancer Centre & Specialist Hospital, Dr. Modupe Elebute-Odunsi, urged men to always embark on routine medical screening for early detection and treatment of prostate cancer.
She also urged the government to organise free screening programmes for citizens.
Elebute-Odunsi said, “Cancer is curable and early detection is key.
“The government also needs to understand that there should be national screening fully paid for by the government that can be easily done in small hospitals, big hospitals, and so on, to make sure that we get patients at early stages so that we can use all the treatments we have and the survivorship rate can increase. We want to make sure we are curing cancer.”
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