In its feature article of June 2 2022, The Guardian stated that more than 40% of Nigerian men in the age group of 40 and beyond have been affected by prostrate cancer. According to The Guardian, most of the deaths which which were caused by prostate cancer were due to lack of awareness, lack of timely treatment and lack of medical infrastructure.
What is prostrate and where is it located in a man’s body?
Prostate is a walnut-sized gland located between the bladder and the penis, the Prostate is located in front of the rectum, the upper part of the anus. The urethra (or urine pipe) runs through the center of the prostate, from the bladder to the penis, letting urine flow out of the body.
The prostate secretes seminal fluid which nourishes and protects sperm. During ejaculation, the prostate squeezes this fluid into the urethra, and it comes as semen, with the sperm.
The prostate has 3 main functions: (a.) it produces seminal fluid, which is a component of semen (b.) it plays a role in hormone production and (c.) it helps regulate urine flow.
Why Prostate challenges should be of concern to women, too
Do women need to know about the challenges Prostate might pose in men? Yes, they do, because women are very relevant to family structure and stability, either as wife, mother, or sister.
Urinary obstruction exerts a lot of cost on family finances, especially if it occurs during retirement age, when the man is no longer working. This could be worsened by the high cost of OOPHE (Out of Pocket Health Expenses) in Africa, where health insurance penetration is very low. Also, prostatic surgery and drugs can worsen erectile dysfunction in men, thereby causing emotional stress in the family.
Does every enlargement of the Prostate lead to cancer?
The size of the Prostate increases as a man gets older, but not every prostate enlargement is cancer. Common causes of such enlargement include chronic infection of the prostate (known as Prostatitis), Benign Prostatic Hyperplasia (BPH) and Prostate Cancer.
No doubt, the major change for which to watch out is the cancerous change in the prostate. However, significant health problems also arise, when the size of the prostate increases to obstruct flow of urine as in BPH.
Men above 40 and Prostate Challenges
During the first half of a man’s life, he may hardly be aware of the presence of his prostate. A healthy prostate goes about its business, without drawing a lot of attention to itself.
On the other hand, as a man gets older, this state of affairs often changes. Starting around the age of 25, the adult prostate begins to enlarge slowly, but this has nothing to do with cancer.
Around the age of 50, many men begin to have uncomfortable symptoms, as a result of this enlargement. They may have to go to the bathroom more urgently and more often, especially at night and when they do, it is often difficult to get a strong stream started or to empty the bladder completely. Sometimes, this can lead to a complete blockage of urinary flow and medical emergency.
Urinary problems caused by BPH are known as Lower Urinary Tract Symptoms, or LUTS. Men with LUTS often have problems in the bedroom, as mentioned earlier.
The link between LUTS and sexual problems is not fully understood, but many men who have such symptoms are known to also have a lowered sex drive, trouble maintaining an erection and they are less satisfied with sex. Depression, loss of sleep due to frequent nighttime trips to the toilet, or some related physical cause may play a role.
Whatever the reason, the worse LUTS get, the more trouble a man may have in the bedroom. The good news, though, is that this can be treated.
Black men and Prostate Issues
This disease is not just more prevalent among black men, in comparison to their white counterparts, but black men also tend to have it at an earlier age and their cancer tends to spread more quickly.
Here are some factors that might be responsible:
- Genetics -genetic components are likely
- Poor attitude to healthcare -delayed health screening, lack of access to quality and comprehensive healthcare and refusal to embrace novel treatment and clinical trial.
- Environmental factors, unhealthy lifestyles, ignorance and denials and the occurrence of additional co-morbidity (i.e other illnesses or factors present in the patient with prostate problem, such as diabetes, kidney problem, hypertension etc and these could coexist with prostate issues, thus complicating treatment and outcome)
6 Causes of Prostate Enlargement and Prostate Cancer
The causes of BPH and prostate cancer are generally unknown, but hormonal changes in man, as he grows, have been implicated.
Here are some risk factors:
- Age -the risk of prostate cancer increases with age, especially after age 50. Approximately 60% of prostate cancers are diagnosed in people who are 65 years or older.
- Race -as mentioned earlier, black men are more likely to develop prostate diseases earlier, experience more aggressive variants and die. Therefore, men of African descent need to pay more attention to prostate health.
- Family History -prostate cancer which runs in a family (called familial prostate cancer) makes up about 20% of all prostate cancers. This type of prostate cancer develops, because of a combination of shared genes and shared environmental or lifestyle factors. So if a man has a family history of diagnosed prostate cancer, he needs to pay more attention to his prostate health.
- Lifestyles and some chemicals -a sedentary lifestyle, alcohol consumption, obesity and exposure to some chemicals can be risk factors.
Signs and symptoms
Prostate enlargement and prostate cancer may be asymptomatic and can manifest as an advanced disease.
Early warning symptoms of enlarged prostate gland include
-Dribbling urine, which refers to continuing dropping of urine with prolonged voiding (urination) time
– Pain or burning during urination
– Frequent urination and feeling of non-emptying of the bladder
– Blood in the semen or urine
– Frequent pain or stiffness in the lower back, hips, pelvic or rectal area, or the upper thighs
– Urinary incontinence (the inability to urinate)
– Painful ejaculation
– Loss of interest in sexual pleasures
If you have symptoms, please do not panic. Just get an expert opinion
Effects of Prostate Enlargement or Cancer
Prostatism historically applied to almost all symptoms of micturition disorder in older men (micturition is the process of passing urine)
Lower Urinary Tract symptoms (LUTS) applies to any patient with urinary symptoms which include:
(a.) Frequency, Urgency and Nocturia (a condition which causes one to wake up at night to urinate)
(b.) Hesitancy, straining, slow stream, intermittent or interrupted flow, terminal dripping and the sensation of incomplete emptying
All these lead to recurring infection, loss of sleep, back pressure on the bladder and kidneys, low libido and financial loss from frequent hospital visits. Moreover, the flow of urine can be blocked in some cases.
Prostate cancer can spread to other parts of the body. These include urinary retention (acute and chronic), hematuria (presence of blood in the urine), urinary tract infection, bladder stones, bladder wall damage, renal dysfunction, incontinence and erectile dysfunction. Early recognition of the complications of BPH/BOO (Bladder Outlet Obstruction) enhances more effective management of these complications.
Image: City of Hope/cancercentre.com