Prostate cancer is a very real medical problem affecting Batswana men. Since I started practicing medicine in Botswana I have come to realize how common and debilitating the disease is. Unfortunately, like other non-infectious diseases in general, it does not get enough attention.

What is Prostate Cancer?
The prostate is a walnut sized gland located at the opening of the bladder, surrounding the urethra (see diagram). The gland is made up of different types of cells.

prostate

Prostate cancer, like other cancers, is an abnormal growth of any of these cells. The type of prostate cancer depends on the type of cell that is abnormal. This cancer is the most common cancer in males and a common cause of deaths associated with cancer.

What causes prostate cancer?

The actual cause of prostate cancer is not known but there are factors associated with increased risk of getting it. These include advanced age, race (with people of African descent having the highest risk), and a family history of prostate cancer. Some lifestyle factors associated with prostate cancer are high fat diet and cigarette smoking. Also, if you have ever had a positive result from previous prostate cancer examinations and/or prostate biopsies you are at a high risk of having prostate cancer.

Symptoms to lookout for

Usually men with prostate cancer do not show any symptoms. Currently, most cases of prostate cancer are identified by screening asymptomatic men by a way of physical examination and blood tests.

Symptoms of prostate cancer include urinary complaints such as difficulty urination, back pain, blood in the urine. However, such symptoms are often from diseases other than prostate cancer (eg, urinary complaints from benign prostatic hyperplasia [BPH], which is a non-cancerous abnormal growth if the prostate gland). Physical examination alone cannot reliably differentiate BPH from prostate cancer.

Prostate cancer can advance either locally or by spreading to other organs such as bones, liver and lungs. Symptoms of advanced disease may include severe loss of weight, bone pain, swelling of the legs, abdominal pain, chest pain, difficulty breathing and coughing.

Is it curable?

Prognosis depends on the stage, that is, how advanced the disease is. The earlier the diagnosis is made the better with very early stages having normal life expectancy. Treatment depends on the stage as well as the individual patient factors.

Doctors might choose to wait and watch. This is usually indicated for very early disease or for older patients who are likely to outlive the cancer. If the disease progresses, only non-curative hormonal treatment can be given. The other option is to actively monitor the disease by repeat blood tests, then give curative treatment if the disease progresses. Locally advanced disease can be treated by removal of the cancer (prostatectomy) or freezing the cancerous tissue (cryotherapy). For advanced disease radiation, chemotherapy and hormonal treatment can be used. If the disease is too advanced and not curable keeping the patient comfortable becomes a priority by means of managing symptoms such as pain.

Is it preventable?

Unfortunately some factors cannot be changed. You cannot change your age or ethnicity and you cannot choose your family. If you have a close relative who had prostate cancer it is advisable to begin check-ups 10 years earlier than the age they were diagnosed. Otherwise, all men should start going for check up from the age of 40-45. The examination is a little uncomfortable but it is very short. And remember the earlier the diagnosis is made the higher the chance of being cured. Lifestyle factors like diet and smoking, however, can be modified. So we should all watch what we eat and quite smoking.

Last but not least, it is important to sensitive the public about this disease and get men to talk about health issues. Men are generally notorious for neglecting their health. November is the perfect month to start spreading the message and get the conversation started. There are many ways to do that. Visit www.movember.com

By: Dr. Alphious Kedikaetswe – BMedSci, MBBS