The prostate gland is found only in men. It is usually the size of a small tangerine and is located between the bladder and the penis and surrounds the urethra. It grows bigger with age.
Prostate cancer develops when the cells in the prostate gland start to develop uncontrollably. It is the most common male cancer in Kenya. Quite often, prostate cancer is slow growing.
The symptoms of benign enlargement of the prostate (age related, non-cancerous) and of prostate cancer are similar and include:
- Passing urine more frequently, particularly in the night time
- Difficulty in starting to pass urine
- Difficulty in stopping to pass urine
- Sensation of not emptying the bladder fully.
- Less commonly, pain when passing urine or ejaculating and blood in urine or semen.
Unfortunately, some men have a more aggressive form of prostate cancer and in such cases; the initial presentation may be of the prostate cancer having spread to the bones with symptoms of persistent and worsening pain in the bones.
The causes of prostate cancer are largely unknown, there are, however, certain risk factors that increase ones likelihood of developing the disease. These include:
- Ethnicity – Being of African descent increases your risk of prostate cancer. Men from the Far East are less likely to develop prostate cancer.
- Age – Prostate cancer typically affects men over the age of 50 and the risk increases with age. Men under 50 can get it but this is not common.
- Family history – You are 2.5 times more likely to get prostate cancer if your father or brother has had the disease compared to a man who has had no relatives with a diagnosis of prostate cancer.
- Genetics – Having a close relative who has developed breast cancer at an age younger than 60, particularly related to BRCA1 or BRCA2 gene also increases your risk.
- Obesity, diet and exercise – There are ongoing studies researching the link between prostate cancer and these risk factors. Studies suggest you may be at a higher risk of a more aggressive form of prostate cancer if you are obese.
There are no known ways of preventing prostate cancer; indeed, from the list above, you can deduce that none of the major risk factors are modifiable – one cannot, for instance, change their ethnicity, age, or family history.
As well as regular exercise being good for your well being, there is some evidence that it can also reduce your risk of advanced and/ or aggressive prostate cancer.
There isn’t enough evidence presently to say whether certain foods increase or decrease your risk of prostate cancer. Of course, a healthy diet improves your general well being and can help prevent other serious illnesses.
The diagnosis of prostate cancer is made with the aid of history taking, physical examination including digital rectal exam, PSA testing, biopsy and further tests which would include MRI pelvis and isotope bone scan.
There are different treatment options for prostate cancer and they depend upon the grade and stage of the disease, fitness and wishes of the patient.
For cancer that has already spread outside the prostate area options include chemotherapy as well as newer targeted agents such as Arbiraterone and Enzalutamide. For bone pain, bisphosphonates, Radium 222, and radiotherapy to painful sites are used.
By Dr Angela Waweru Resident Oncologist NAIROBI HOSPITAL