A discourse on prostate cancer

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If you are a social media savvy or TV show enthusiast Nigerian, or you are a non-Nigerian that is conversant with the Nigerian social media space, you will know that one TV that is trending right now is the Big Brother Nigeria - a social experiment reality TV show. Well, I happen to be one of the enthusiasts of the show and one of the take-homes from the show forms the basis of my today's post.

The housemates were having a discussion about the effects of technology on the life-span of humans generally. The following conversation ensued:

Housemate 1
Technology has been detrimental to humans. The average life-span of we humans has been decreasing with the advancement in technology.

Housemate 2
Well, it depends on how you look at it. Take for example the case of prostate cancer in men. A large percentage of black men between ages 45 and 60 are susceptible to prostate cancer - about 60%--

Housemate 3 [interrupts housemate 2]
40% actually.

Housemate 2
Okay. About 40%. In my family, most of the men from my father's side die between the age of 49 and 52 due to prostate cancer issues that are usually discovered late. So my Dad made it a matter of duty to check something called the 'PSI level'. The PSA level is like an indicator of prostate cancer. It uses a test strip. If the PSA level stays below 0.1, the person is safe. But if it gets to 0.1, the person is in danger of having prostate cancer.

At the age of 49, my Dad's PSA got to 0.1 and he went through surgery to remove the prostate. He's been fine since then and has now lived longer than most of the men in his family. Without technology, of course, my Dad would have died at a younger age. Hence, technology is a double-edged sword that has the potential to cut short one's life-span on one hand and elongate it on the other hand.

Housemate 1 and 3
Yea, you are right.

Extracts from the discussion

The discussion really piqued my interest and opened my eyes to what I did not know about prostate cancer before now. There are a couple of inferences I was able to deduce from their short discussion about the topic:

  1. Black men are more susceptible to prostate cancer.
  2. Prostate cancer could be genetic.
  3. There are screening procedures to monitor and detect prostate cancer early.

How true are these inferences?

Even though the housemate that talked about his experience and some statistics relating to prostate cancer sounded really confident, I needed to check the veracity of claims made in his mini-presentation.

On the issue of Blacks being the most susceptible race to prostate cancer, the research of Hoffman et al. (2001) corroborates this assertion. They carried out an investigation into racial and ethnic differences in advanced-stage prostate cancer and what could be the reason for the differences if any. They found out that African-Americans had the most cases out of the study subjects and this is largely due to socioeconomic, clinical, and pathological factors. In actual fact, Hankey and his coworkers in 1999 had earlier established that African-Americans have the highest incidence of prostate cancer in the world and about two times more likely to die from the abnormality than any other race in the United State. However, the statement that about 40% of black men between the age of 45 and 60 are susceptible to prostate cancer is quite disputable with no data to back it up. In an extensive review of available data by Adeloye et al. in 2016, the incidence rate stands at 22 out of 100,000. Although they emphasized that the figure might not be totally accurate due to the poor cancer registration system in Africa, the figure is still some way off from being 40% as reported by the housemates.


By National Human Genome Research Institute (NHGRI) from Bethesda, MD, USA - Prostate Cancer, CC BY 2.0, https://commons.wikimedia.org/w/index.php?curid=52360075

Is prostate cancer genetic? According to the American Cancer Society, genetic inheritance represents one of the risk factors of prostate cancer although most people with prostate cancer cases have no history of the abnormality in their family. According to the Society:

Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease. (The risk is higher for men who have a brother with the disease than for those who have a father with it.) The risk is much higher for men with several affected relatives, particularly if their relatives were young when the cancer was found.

source

Hence, in the aspect of prostate cancer being genetic, the housemates were right.

Of course, there are available procedures to screen for possible signs of prostate cancer. Screening can only give an indication, it is not a confirmation of prostate cancer. Tissue biopsy remains the only recommended procedure for the confirmation of cancerous growths. Some of the screening tests for possible signs of prostate cancer include:

  1. protein-specific Antigen (PSA) blood test: PSA is synthesized by the prostate itself but a higher than normal PSA level has been reported to be an indicator of prostate cancer. The chances of having prostate cancer increase as the PSA level increases although a confirmatory test would still be needed in order to establish that indeed, there is prostate cancer. There are varied procedures for determining the PSA level of individuals. More about the test can be accessed here.
  2. Digital Rectal Examination (DRE): This procedure requires that a professional inserts their gloved and lubricated fingers into the rectum of patients in order to feel the prostate gland. The observation of bumps or hard areas around the rectum gives a presumptive indication of prostate cancer. A confirmatory test will, however, be needed.

There are a variety of methods available for the management and treatment of prostate cancer. These include surgical removal procedure known as radical prostatectomy, radiation therapy, cryotherapy, hormone therapy, chemotherapy, immunotherapy, and other targeted therapy for prostate cancer.

References

  • Richard M. Hoffman, Frank D. Gilliland, J. William Eley, Linda C. Harlan, Robert A. Stephenson, Janet L. Stanford, Peter C. Albertson, Ann S. Hamilton, W. Curtis Hunt, Arnold L. Potosky, Racial and Ethnic Differences in Advanced-Stage Prostate Cancer: the Prostate Cancer Outcomes Study, JNCI: Journal of the National Cancer Institute, Volume 93, Issue 5, 7 March 2001, Pages 388–395.
  • Hankey BF, Feuer EJ, Clegg LX, Hayes RB, Legler JM, Prorok PC, et al. Cancer surveillance series: interpreting trends in prostate cancer—part I: evidence of the effects of screening in recent prostate cancer incidence, mortality, and survival rates. J Natl Cancer Inst 1999;91:1017–24.
  • Adeloye, D., David, R. A., Aderemi, A. V., Iseolorunkanmi, A., Oyedokun, A., Iweala, E. E., Omoregbe, N., & Ayo, C. K. (2016). An Estimate of the Incidence of Prostate Cancer in Africa: A Systematic Review and Meta-Analysis. PloS one, 11(4), e0153496. https://doi.org/10.1371/journal.pone.0153496
  • Treating Prostate Cancer


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5 comments
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This is quite educative. I'm wondering if there are lifestyles one could observe to reduce the chances of having prostate cancer. Also, are there lifestyles that can increase one's chances?

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Of course, there are some lifestyles that can predispose a man to prostate cancer. They include smoking, sitting down for too long, riding bicycle etc. Avoiding these lifestyles as well as observing some diets can reduce the chances of having prostate cancer.

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