By Henry Umahi
Mr Charles Chukwuemeka Oputa, popularly known as Charly Boy or Area Fada, has fought many battles. In fact, he is known for his non-conformist or alternative lifestyle and political views.
Not too long ago, Charly Boy fought a battle that that he will forever remember. He had prostate problems and survived.
At the time, he said: “I’ve fought so many battles and I’ve won so many battles but for the past 10 days, I’ve been battling with something very huge but as God will have it, He saved my life and I beat that sucker in fighting my prostrate issue.”
Characteristically, told everyone who cared to listen about the battle he faced. The essence was to give hope to fellow men battling the same conditions but would prefer to die in silence. As a matter of fact, he established a foundation to help men.
He told a newspaper: “I thank God that through his grace, I’ve been able to have very active, fulfilling youthful years, so I don’t think I’m missing out on anything, but the reason I went to town with my challenges was simply because I had to get that message out, I had to tell my fellow men that it’s alright not to be alright. I had to tell my fellow men to desist from not being able to be as open as I was going about my challenges, that there’s something sinister, something technically wrong with not being open, and I know most of this comes from how we men have been brainwashed over the years. They say, ‘a man is not supposed to cry’, ‘whatever you have that is paining you, just chest it, don’t even tell anybody’. And the worst of all, ‘if you’re married, don’t let your wife know, because she might use the information against you’ and all that.”
Ace writer, Mike Awoyinfa, also had prostate challenge. He said: “Old age has its own challenges. Shortly before I became 70, I was diagnosed with prostate cancer. These are things you don’t think will ever come to you. You think it is somebody else’s sickness. You don’t think you will ever be a victim. But that is reality for you. I am very, very health-conscious. I go for regular checkups. It is by the grace of God that the doctor discovered this thing very early before it begins to metastasise. I have survived it. Doctors said I am a cancer-survivor. I did radiology for 45 days. Radiology or chemotherapy has its own challenges too. It takes both the good and the bad. Here am I. Me that used to be an exercise freak, me that wakes up every morning jogging. Now I cannot even jog again. That’s one of my regrets.”
Professor of political economy and founder of Centre for Values and Leadership, Patrick Utomi, was also diagnosed with cancer in 2022. He explained that he tested positive after a biopsy.
He tweeted: “I am moved this dawn of light to confront an epidemic under the carpet with great harm to men. Prostate cancer is bringing death and misery to many men. Had they been forewarned the misery, containment and even chances of cure could be much enhanced, like women have with breast CA.
“I agreed with the Gambian Real Estate Entrepreneur Taf Njie while I battled the disease that we should do more to create awareness. Nearly 30 years ago, I went to Ibadan to speak and lend a hand to (the then) Ondo State First Lady Betty Akeredolu as she raised the breast cancer banner.
“Did not see why it was taboo to say you were in a battle with cancer. The more I talked about it, the more I found many of my age in similar circumstances. It almost seems like an epidemic for Nigerian men over 60. Not talking makes them lose the benefit of early detection.”
It is wonderful that these celebrated Nigerians survived the battle, many didn’t. Indeed, prostate cancer is one of the most common types of cancer in males. It starts in the prostate, a small gland about the size of a walnut that is part of the reproductive system. It sits just below the bladder and helps make semen, the fluid that carries sperm.
What are the causes and remedies?
Dr Christian Agbo, a consultant neurologist and the Benue State University Teaching Hospital, (BSUTH), Makurdi and a senior lecturer at Rev Fr Moses Orshio Adasu University, Makurdi, explained: “When you talk about causes of prostrate cancer, we don’t have a specific cause but we talk about risk factors, starting from family history. A person that has positive family history, maybe the father or second degree relatives, may have high risk of prostrate cancer.
Another risk is the gender. Being a male is a risk because of the peculiarity of the hormones which is the testosterone and majority comes from the testis and that is why it’s exclusively a male disease and it is the commonest cancer among men, especially in Nigeria.
“The other risk factor is genetics. Genetics play a great role and that’s why it is more common in African Americans and that’s why they have more aggressive type of prostrate cancers compared to the western population.
“The other risk factors is that most of them are still under investigational studies like the diets, the role of vitamins, then sexual activity.
“You must have read the common findings from studies that shows that a man that ejaculates about 21 times a month has about 33 reduction of prostrate cancer in them. There is a study on that but it’s not conclusive as there are confounding factors.
“There are other studies that have talked about multiple sexual partners increasing the rate of prostrate cancer because a man that has multiple sexual partners is at the risk of sexually transmitted disease and when there is sexually transmitted disease, there is risk of infecting the prostrate which we call prostatitis and once there is prostatitis in chronic form, there is transformation into malignant type.
“So, high sexual activity can either increase or decrease depending on how you look at it and that is why those studies are not yet conclusive. So, what I tell my patients is that moderation is the key to everything.
“Basically these are some of the risk factors. Generally, we don’t have a specific cause.”
Agbo also talked about remedy. He said: “For the remedy, we start by the patient having a knowledge of when the symptoms is there because the remedy will depend on the stage of the disease.
“These urinary symptoms include frequency. Patients will notice they will be passing urine frequently as compared to their previous number of times. Waking up at night frequently; we call it nocturia. Some may even have difficulty in passing urine at all, the urine may not be coming out.
“This is in addition to weight loss, loss of appetite, low back pain, inability or even difficulty in walking because the first place prostrate cancer spreads to is the bone and the back and that’s why they usually have those manifestation, those bone pain. Some may also see blood in their urine.
“But depending on the stage of the disease, it guides us on the remedy. For those that are picked early, we do a surgery for them. It is called prostatectomy, where we have to remove the cancer and the prostrate for the early ones.
“But it is sad to say that majority of our patients present late. So, when they come late, most times what we offer them is palliative care, we can’t cure them at that stage.
“In the palliative care, the remedy we do give them is to control pain. If they need blood, we transfuse them. If they’re not able to pass urine, we give them drugs so that they will be able to pass urine or we do a small surgery for them.
“Then there are injections, chemotherapy, radiotherapy for these group of individuals. There are also surgeries that involve removing the testes.
“If you remember, I said one of the risk factor is the presence of testes. So for late cases like that, we also have the option of removing the two testes. Of course, the individuals would give consent before that is done. We usually counsel them before they give us the consent.
“For those that don’t give us consent, we have injections that will help them – we call them the anti-androgen.
“I think these are the remedies we do give them depending on the stage. For those that come early, we offer them surgery where we remove the prostrate and the cancer together. For the late ones, we give them more of hormonal therapy in addition to radiotherapy and chemotherapy.
When Agbo was asked, at what age should a man start checking his prostrate, he answered: “We have various guidelines actually, we have the European guidelines, the American guidelines and recently Nigerians too we are developing our own guidelines.
But on a general note, once a man reaches the age of 50, he’s is expected to do a yearly check up with regards to his prostrate but those that have a prostrate family history should check as early as 45 years.
“In this check up, they should be checking their blood vessel called PSA and also do a digital rectal examination to examine the prostrate. This would help to detect it early.”
Dr. Miracle Omage, an oncologist at the Asi Ukpo Diagnostics Centre, Calabar, Cross River State, also discussed the growing menace of prostrate cancer among men in recent times. He explored what causes the health challenge, its risks, symptoms and treatment options.
First, he explained some key facts about prostate cancer. He said: “From global statistics, prostrate cancer is one of the commonest cancers in the world amongst males and it’s the fifth commonest cause of cancer related death globally.
“Prostrate cancer affects the prostrate gland and the prostrate gland is a small walnut-sized gland that produces seminal fluid, the fluid that mixes with the sperm to create the semen. It is located just below the bladder and anterior to the rectum.
“The reason for the rise in prostate cancer is due to the fact that it is not diagnosed early and usually affect elderly males. There could be associated lower urinary tract symptoms on presentation, which could include painful or burning sensation during urination, increased frequency of voiding, especially at night, incomplete bladder emptying and many more.
“Primary cause of prevalence of prostate cancer is an ever increasing elderly age group as they are more prone to risk of the disease”
Explained other factors predispose to prostate cancer to include “lifestyle factors like smoking, alcohol, diet, especially excessive consumption of highly fatty substances, chemical exposure to radioactive substances, genetic factors and in some cases, family history of the same illness could increase the risk of the same illness.
“In recent studies, obesity and metabolic syndrome has been shown to increase the risk of prostate cancer amongst men.”
In view of this, what treatment options are available to those affected by the disease? Image answered: “Holistic management starts with examination, investigation and then diagnosis. During routine examination, especially amongst patients of geriatric age group, who presents with lower urinary tract symptoms, digital rectal examination could reveal a hard nodule or induration or irregularities around the anterior wall of the rectum
“Second is prostate analysis, prostrate specific antigen. It’s a blood test used to measure the PSA level; with that test we will be able to know the PSA level. It’s usually between 0 to 4. ng/dl PSA levels of greater than 3ng/dl is highly indicative of presence of disease. We could also do a prostate biopsy to confirm the cancer and it staging.
“Other test to diagnose this disease include Prostate Ultrasound Scan, MRI scan. For treatment options, there are a couple of drugs depending on the stage and the level of disease progression.
“If the cancer is localized and has not spread to other parts of the body, then we try to control it using anti androgen hormonal treatment options like Casodex, Zytiga, Flutamide, and surgical approach like radical prostatectomy. However, there could be metastasis to other areas of the body like the spine, lungs, liver and other areas of the body.
“Palliative treatment approach is used in management of advanced stage of the disease and in some case multidisciplinary approaches are used to manage cases with complications. These include chemotherapy, radiotherapy, and targeted therapy to areas of cancer spread.
“Patient who present late with advanced stage of disease can come up with complications like urinary incontinence, erectile dysfunction, bone pain, lower limb paralysis etc
Are young men also susceptible to the disease? Image said: “Prostrate cancer does not affect young men but the advanced middle age and then the elderly people. It is generally called the disease of the old. However, early diagnosis and treatment can prevent its spread and further complications .The complications are usually from the lack of early diagnosis and treatment.
“Prostate cancer is not a death sentence as prognosis is above 90% when diagnosed early.”
The oncologist threw light on how the younger men in the society can work to avoid prostate cancer. He said: “Ensure you have good lifestyle choices, avoid smoking, chronic alcohol abuse, go for routine medical checkups and do regular exercises like kegel exercises. If there are co-morbid conditions like hypertension, diabetes and all that, patient should see a specialist for comprehensive care.”
•With additional reports from Scholastica Hir, Makurdi and Aniekan Aniekan, Calabar
