- Circulation of myths, misconceptions and fears about screening for prostate cancer has many men in our communities hesitant to see a doctor. Education on this issue should be pushed harder.
Prostate cancer is a kind of cancer that occurs in the prostate which is a small gland in males located between the anus and the scrotum, it produces the fluid which nourishes and transports sperm.
Dr Harris Mapande, a renowned medical oncologist at the Ocean road cancer institute, says prostate cancer starts when the gland works abnormally and begins to swelling. This often results in causing force to the urethra.
It is a disease that occurs when cells in the prostate gland develop changes in their DNA.
This results in the rapid production of cells in the gland which are called ‘abnormal cells’.
This rapid production, later on, causes an accumulation of abnormal cells, hence the puffiness of the prostate.
Despite the abnormal cells being one of the lead causes of cancer, there are other factors that influence prostate cancer in a man.
Dr Mapande mentions old age starting from the age of 50 years, family history in that it can be passed down from generation to generation.
Overweight is also another influencing risk factor for prostate cancer.
He says men have to develop a habit of doing routine checkups because this type of cancer can be curbed when it is on its early stages.
Alex Senhuyina, a businessman residing in Kibaha, Dar es Salaam is one of the victims of the prostate cancer, a disease that started showing it’s claws in 2019 when he was 69 years old.
Alex says it all started one night when he kept waking up at midnight to urinate even though he barely had drank water that day.
“I would frequently visit the toilet for more six times in a row and other times would find myself wet even though I did not feel the urge to urinate. This habit later on weighed on me, especially during the nights.”
“This made me alert that I had a prostate problem because prior to that condition the normal toilet visitations did not exceed than two during the night and four during the day” he explains.
“The truth is I was worried and over-thought the rumours about getting tested by using a thumb, but I had to make peace with that so that I could get tested.”
Alex says another forewarning symptom was erectile dysfunction.
He says this condition happened even during the mornings when he had to be erect before urination.
To his surprise, when he was taken in for a test, he mentions Prostate Specific Antigen blood test (PSA) as the first test that was done to him.
A doctor drew his blood as a sample screening examination for prostate cancer.
He had not built a habit of random health checkups, not until when he would feel unusual in some of his body parts.
After the test, Alex was informed that he had prostate cancer but the doctors had to determine the severity of cancer before admitting him into treatments which are stage-based.
“I was then taken to theatre where they took ‘vinyama’ (tissue sample) from the prostate gland; they did not use the thumb during the operation as I thought they would.”
“I was luckily found out that I was in early stages that only required me to sign up for chemotherapy instead of operating me. To date I take one dose on a daily basis as well one syringe of medicine monthly,” he says.
According to him, it is a tiring process because when Alex decided to be treated in October 2019, the doctors repeatedly told him that he can never forget to take his medication for a two-year duration.
“I have kept track of the levels of cancer; I started with 298.3 but after I recently checked the levels, I found out that it has dropped to 14.5 so the treatment is evidently encouraging,” he says.
Dr Mapande reveals that men who are ailing from this type of cancer have common symptoms including the inability to stay erect, frequent and decrease in the stream of urination force.
They often urinate in dribbling instead of normal urination.
He says this is because the swollen prostate gland pushes the walls of the urethra, hence increasing the urge for a person to urinate.
There are other uncommon symptoms including bone pain, blood in the urine and semen, well as losing weight without trying to.
According to him, there are two types of swollen prostate glands where in one, there is a tumor that results in cancer and the other that does not.
He says there is a resemblance in the two during the early stages.
These two types of swollen glands have different treatments;the ones with a normal tumor are usually exposed to pills and syringe medication like that of Alex’s whilst the ones with a cancerous tumor get exposed to hormonal medication that is for suppressing the production of testosterone, which are made in the testicles.
When the hormonal medications do not cooperate in healing a man whose testicles have multiplied the production of cells in them, the person will thereafter be advised to have an epididymectomy done.
This is a surgery to remove the tubes that hold the sperm.
The tubes are found in the back of each testicle.
The removal of these tubes does not mean the person will not be productive, Dr Mapande says there will be only a reduction of the fertility rate.
Prostate cancer screening
Being one of the cancer institutes in Tanzania, Ocean Road pushes for the screening of this type of cancer by educating every male that attends a clinic, even for other diseases because due to a myth that has over the years circulated in the society that prostate cancer is tested by using a thumb, men are terrified and hesitant to be screened.
This myth alone has made men to believe that it is shameful for one to go for a check-up specifically for prostate cancer.
Dr Mapande emphasizes on the importance of screening and that, if it is done routinely, it can help in curbing the disease and even spread awareness about it in the society.
Despite the circulation of these myths, Dr Mapande appraises the increase of awareness in the society and he credits the way this cancer carries a whole new image as one of the most acknowledged diseases in the country.
“It is really different now; in the past when a man finds out they have prostate cancer during the examination of another disease or a checkup, the first reaction is they would leave and never come back to the hospital” explains Dr Mapande.
He says the survival rate of this cancer in a person who is in treatment procedure commence from 10 years to more.
Having an experience from when he had been admitted into timely treatment of prostate cancer, Alex says he was fortunate to have had a medical insurance, otherwise, he could have failed to cover fees for the medication he takes because of their surging expenses.
He uses two kinds of medication, Casodex pills and Zoladex which is admitted by using a syringe.
According to Alex, Casodex is sold at sh16, 500 per pill which is taken on a daily basis, on the other hand, Zoladex is sold at sh340, 100 and is used on a monthly basis.
This means if it were not for the insurance cover, he would be using about sh802, 100 per month just for medication.
“I am kindly asking the government to look into this. Some people are suffering from this condition do not have that much needed for treatment; it is expensive for people in a middle-income country” Alex explains.
Prostate cancer is one of the issues that are under addressed in the country, it is time for the society to see the importance of regular checkups and how they could reinforce to boost the decrease in the prostate cancer cases in Tanzania.