By Dr. Douglas Bwakucha | General Practitioner at UMC Victoria Hospital
Prostate cancer is the most common cancer among men in Africa and 3rd commonest cancer over all. In sub Saharan African, the relative burden is higher, with prostate cancer representing 20.3% of all cases of cancer in men, Zimbabwe and Uganda having the highest incidences.
Incidence of PCA in Uganda is estimated to be increasing by 5.2% annually and projected to increase by 33.4% by 2030. PCA is a more aggressive cancer and at time of diagnosis, patients present with a higher stage of cancer owing to its persistent high mortality rates.
WHAT IS PROSTATE CANCER?
It is Cancer of a prostate gland and is attributed mainly to high levels of testosterone. The prostate gland is a walnut shaped gland in men that surrounds the urethra at base of bladder. The prostate gland is responsible for producing seminal fluid that helps to protect, support and transport sperms. Prostate cancer can take a form of primary cancer or metastatic form.
WHO IS MOSTLY AT RISK?
Men 65yrs above account for 70% of cases, the black race and ethnicity is associated more aggressive and advanced disease, and family history of PCA and genes of breast cancer. These constitute the major risks others including obesity, diet deficient of vitamin D or excess red meat and dairy products with high fat along with high levels of testosterone.
RED FLAGS OF PCA
Difficulty and frequency in urination, urine retention, decreased force and size of urine stream, blood in semen, painful ejaculation, hematuria, dribbling of urine and urgency. Later signs, anorexia, weight loss, weakness, nausea and renal failure.
IS EVERY PROSTATE SWELLING CANCER?
Certainly not. Other prostate lesions may include benign prostate enlargement, cysts and calculi among other infections like TB and prostatitis.
HOW DO I TELL THE DIFFERENCE BETWEEN PCA AND OTHER PROSTATE LESIONS?
Through screening, prostate lessons can be determined whether they are cancerous or not. The following will be done by the medical profession; digital rectal exam, prostate surface antigen levels both velocity and density. Diagnosis will be confirmed with taking a biopsy, Trans rectal ultrasound scan (trus). Other imaging tools can be used to determine if cancer has spread which may include lumbosacral x-ray, trus, pelvic CT and MRI, and bone scan.
CAN PCA BE TREATED?
Yes however treatment depends on the stage of disease on diagnosis. The following treatment modalities may apply, lifestyle modification, radiation therapy, androgen deprivation, focal therapy others including thermal, cryotherapy, high intensity focused ultrasound scan and laser ablation. As the notion goes, prevention is better than cure.
CAN PCA BE PREVENTED?
Improving our diet with more vegetables, vitamins and less fat, protein, routine exercises, cessation of smoking and weight loss.
IN CONCLUSION
The earlier PCA is detected and appropriate treatment initiated the better the outcomes with advanced disease decreasing one’s life expectancy to less than 10yrs. Therefore routine screening is advised for all men from 55yrs of age, however it may be as low as 40yrs for those with family history of cancer or brac1 and genes in first degree relatives like father or mother.
