The Prostate …a ‘powerhouse’ that needs to be protected

Mr Brobbey

The prostate is a vital but often overlooked organ in the male reproductive system. This small gland plays a crucial role in men’s health, yet issues such as prostate cancer, benign prostatic hyperplasia (BPH), and prostatitis can affect its function and overall well-being.

The prostate is a walnut-sized gland located below the bladder next to the rectum. Its primary function is to produce fluid that nourishes and protects sperm, aiding in sperm motility and fertility.

The prostate also plays a role in controlling urine flow and ejaculation. Maintaining a healthy prostate is essential for overall male reproductive health and quality of life.

Prostate health can be affected by various conditions, with the most common being prostate cancer.

Prostate cancer is the second most common cancer among men worldwide. Early detection through regular screenings, such as the prostate-specific antigen (PSA) test and digital rectal examination, is crucial for timely diagnosis and treatment.

Prevalence 

According to the National Library of Medicine (NLM) in the United States of America (USA), Prostate cancer is the second most commonly diagnosed cancer and the fifth leading cause of cancer death among men worldwide, with an estimated 1,414,000 new cancer cases and 375,304 deaths in 2020.

It also said, in Africa, Southern Africa has the highest incidence rates of 64.1 per 100,000, followed by Northern Africa with 35.9 per 100,000 while Western Africa recorded 31.9 per 100,000, whereas Eastern and Western 23.9 per 100,000 and 13.2 per 100,000, respectively.

According to NLM prostate cancer is the second leading cause of cancer deaths in men of African descent.

In Ghana, evidence from population-based screening showed a prevalence of seven per cent in men between 50 and 74 years with the chance of having prostate cancer going up with age.

According to recent GLOBOCON data, it is the leading cause of cancer deaths among Ghanaian men and accounted for over 2000 new cases in 2020 alone.

Also the chairman of the Taussig Cancer Institute, Professor Alex Adjei, at an annual public lecture on cancer last year said 82 per cent of men with prostate cancer in Ghana die annually.

This, he said indicated that the mortality rate of prostate cancer in the country was higher than deaths related to breast and cervical cancers.

“This is a worrying situation because comparing Ghana to other countries such as US and the UK, they recorded more cases of prostate cancer annually, but have   lower mortality rates while the majority survived.

According to Prof. Adjei, Ghana which had three times lower incidence of prostate cancer cases, however, had higher mortality compared to those countries due to late reporting.

Symptoms                                                                                                 

 An oncology nurse at Korle-Bu Teaching Hospital, Mr Eric Brobbey, said early prostate cancer usually causes no symptoms, while more advanced prostate cancer can cause symptoms such as trouble urinating, blood in urine or semen.

Also, he said persons suffering from the disease will have the urge to urinate more often especially at night, have erectile dysfunction, decreased force in the stream of urine, discomfort in the pelvic, pain in the hips, back (spine), chest (ribs), or other areas from cancer that has spread to bones.

He mentioned that they also have weakness or numbness in legs or feet, due to spread of cancer to the spine and loss of bladder or bowel control from cancer pressing on the spinal cord.

Risk Factors

Mr Brobbey said the chance of having prostate cancer goes up quickly after the age of 50 while men with a first degree male relative (father, brother) who had prostate cancer before age 65 have twofold risk of developing the disease compared with men who do not have a first degree relative with the disease.

“Also, the disease is more common in men of African descent compared with men of other races,” he said.

Screening and early detection

Mr Brobbey said cancer screening was aimed at detecting cancer before any symptoms appear adding that the method used depended on the cancer being screened for.

The benefits of screening, he said included early detection of disease and early treatment possibly for cure.

He mentioned that prostate cancer screening can be done with Prostate Specific Antigen (PSA) test, this is a simple blood test.

Mr Brobbey explained that the antigen was specific to the prostate but not specific for prostate cancer and urged that men should make an informed decision on whether they would like to be screened every year with the PSA test.

  Treatment

 The oncology nurse said the treatment of the disease depended on the stage of the disease and there were different options for its treatment, stating that sometimes two or more treatment options were needed to be combined and not all treatments were for cure.

“Prostate cancers are treated based on stage, grade and age of the patient,” he added.

Mr Brobbey said that the stage describes the extent of spread of the disease, explaining that stage one is early prostate cancer while stage IV is advance prostate cancer where the tumour has spread to other parts of the body.

“The grade of the disease refers to the appearance of the cancer cells when examined by a pathologist and this is an indication of how quickly and aggressively a cancer is growing,” he stated.

Mr Brobbey urged men to get screened and have their PSA test done to help detect the disease early before symptoms begin to show.

Recommendation

In an attempt to fight the disease at an early stage, a national intervention is needed to create maximum awareness of the disease and also encourage men to go through screening just as breast cancer.

Also lack of coverage for prostate cancer treatment under the National Health Insurance Scheme (NHIS) in Ghana makes it difficult for the less privileged to access and sustain cancer care at any stage of the disease. 

Just as some aspects of treatment such as surgery, chemotherapy and some targeted therapies for breast cancers  are catered for under NHIS, it is time some aspects of prostate cancer treatment was included in the scheme to give relief to patients.

With the current rate of the disease among men in the country, it is time Ghana embarks on a concerted effort to develop a better strategy for cancer control and invest in the setting up of well-equipped cancer treatment centres for early detection, diagnosis, treatment and research.

Conclusion

The prostate plays a vital role in men’s health and well-being, and protecting this powerhouse is essential for a fulfilling and healthy life.

By adopting a proactive approach to prostate health, making informed lifestyle choices, and seeking timely medical care, men can reduce their risk of prostate-related conditions and maintain optimal prostate function.

 It is therefore important to prioritise its protection and care as a healthy prostate is a cornerstone of a man’s overall well-being.

By Jemima Esinam Kuatsinu