Prostate cancer is a formidable adversary for men across the globe, with over 1.2 million cases reported in 2018 and its impact reverberates deeply in African communities.
Africa has a prostate cancer incidence rate of 26.6 per 100,000 and in sub-Saharan Africa, about 70,000 cases of prostate cancer are reported annually, Uganda has registered the highest incidence and mortality rate from prostate cancer, with incidence rate standing at 37.0 per 100,000, an annual increment rate of 5.2% and mortality: incidence ratio of 71%.
In Uganda, the prevalence of prostate cancer is striking, making it imperative for every man to understand the basics of this disease and take proactive steps towards its prevention and early detection.
About 90% of men with prostate cancer are diagnosed at an advanced stage.
Understanding the Anatomy: The prostate gland, a vital component of the male reproductive system, plays a crucial role In the production of seminal fluid. Situated beneath the bladder, it encircles the urethra and seminal tube, facilitating the passage of urine and semen. As with other cancers, it begins when cells mutate, grow out of control and eventually damage and steal nutrients from the surrounding healthy cells leading to prostate cancer
No man wants to hear that they have prostate cancer, but after diagnosis, learning about the disease and how it is treated is essential to managing the disease.
Recognizing the Risk Factors: While the exact causes of prostate cancer remain elusive, certain risk factors predispose individuals to this disease. In Uganda, as in many parts of the world, black men face a disproportionately higher risk of developing prostate cancer. Alarmingly, they are 50 percent more likely to develop the disease and twice as likely to succumb to its consequences.
While specific prostate cancer causes have not been identified, some studies identified a few risk factors such as:
- Age: The most common risk factor. The older you are, the more likely you are to develop prostate cancer
- Race: Black men are more likely to get prostate cancer, get it at a younger age, have advanced disease before it is diagnosed, and are twice as likely to die from prostate cancer
- Weight: Being overweight can increase your risk
- Genetics: Having a close family member who’s been diagnosed with prostate cancer raises your risk
Hence, it is paramount for black men to consider prostate cancer screenings starting at the age of 40.
Challenges in Uganda: Prostate cancer stands as the most prevalent cancer among men in Uganda, with an age-standardized incidence rate of 41.6 per 100,000. Regrettably, the country grapples with a grim reality: the late presentation of prostate cancer cases. The majority of patients referred to the Uganda Cancer Institute (UCI) for treatment are already at stage IV, underscoring the dire need for improved access to early diagnosis and treatment.
Screening tests can help find cancer at an early stage, before symptoms appear. When abnormal tissue or cancer is found early, it may be easier to treat or cure. By the time symptoms appear, the cancer may have grown and spread. This can make the cancer harder to treat or cure. It is important to remember that when your doctor suggests a screening test, it does not always mean he or she thinks you have cancer. Screening tests are done when you have no cancer symptoms.
Prostate cancer may cause no signs or symptoms in its early stages, but If you have any of the following symptoms, be sure to see your doctor right away
- Trouble urinating
- Decreased force in the stream of urine
- Blood in the urine
- Blood in the semen
- Bone pain
- Losing weight without trying
- Erectile dysfunction
Screening tests include the following:
Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body.
Imaging procedures: Procedures that make pictures of areas inside the body.
Genetic tests: Tests that look for certain gene mutations (changes) that are linked to some types of cancer.
Certain screening tests may be suggested only for people who have a high risk for certain cancers.
Anything that increases the chance of cancer is called a cancer risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Some screening tests are used only for people who have known risk factors for certain types of cancer. People known to have a higher risk of cancer than others include those who:
- Have had cancer in the past; or
- Have two or more first-degree relatives (a parent, brother, or sister) who have had cancer; or
- Have certain gene mutations (changes) that have been linked to cancer.
People who have a high risk of cancer may need to be screened more often or at an earlier age than other people.
Barriers to Screening:
- Despite the pressing need for early detection, prostate cancer screening remains underutilized in Uganda. Studies reveal alarming statistics, with only a fraction of Ugandan men considering or undergoing prostate-specific antigen (PSA) tests for screening purposes. Factors influencing this low uptake include limited awareness, socioeconomic constraints, and the scarcity of screening facilities, particularly in rural areas like Lira City.
- Qualitatively, the belief that all cancers have no cure was a barrier against most participants considering screening to be of any value, coupled with the fear of screening positive for Prostate Cancer (PCa) and the associated stress. In addition, poor Prostate Cancer knowledge and lack of screening services in prisons were perceived as barriers to screening in prison settings.
To combat the scourge of prostate cancer in Uganda, concerted efforts are imperative.
- Firstly, there is a pressing need for enhanced public awareness campaigns, emphasizing the importance of early screening and detection.
- Additionally, healthcare infrastructure must be strengthened to ensure widespread access to screening services, especially in underserved regions like Lira City.
Prostate cancer poses a significant threat to men’s health in Uganda and across Africa. By understanding the basics of this disease and addressing the barriers to screening and treatment, we can strive towards reducing its burden and improving outcomes for affected individuals. Through collaborative efforts between policymakers, healthcare professionals, and communities, we can pave the way toward a future where prostate cancer no longer looms as a formidable foe, but rather as a manageable condition with timely interventions and widespread awareness.https://theprism.co.ug/mulago-hospitals-kidney-transplant-program/
Comments 1