Understanding Prostate Cancer, Risk Factors, and the Importance of Early Screening

In 2020, the World Health Organization (WHO) reported approximately 1.4 million diagnoses of prostate cancer, marking it as the leading cause of death among men, particularly in Sub-Saharan Africa and the Caribbean.

The prostate, a small walnut-shaped gland located just below the bladder in men, encircles the urethra, the passage for urine and semen. In Kenya, prostate cancer holds the unfortunate rank of being the most common cancer in males, affecting 17.3 per cent. Alarmingly, most men seek treatment at advanced stages, a trend highlighted by Kenya’s Ministry of Health Cancer Screening Guidelines 2018. Barriers to early diagnosis and treatment contribute to this, compounded by the asymptomatic nature of prostate cancer.

The key to reducing mortality lies in early detection and treatment before metastasis occurs.

Survival rates significantly improve with early detection, positively impacting the patient’s quality of life by potentially avoiding extensive treatment and surgery. Despite the gravity of prostate cancer, Kenya lacks a national-level screening program, unlike the well-established breast cancer screening initiative exhibited by healthcare facilities. Prioritizing prostate cancer screening through early diagnostic programs could prevent thousands of deaths.

In recognition of Prostate Cancer Awareness Month this November,  The Nairobi West Hospital has launched an extensive screening campaign. This initiative aims to detect cases in their early stages, employing innovative solutions such as magnetic resonance imaging (MRI) to complement traditional methods. Encouraging thousands of high-risk men to participate, the hospital recognizes the potential of MRI screening to identify cases missed by blood tests, especially in the absence of symptoms.

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Guidelines recommend men aged 55-69 undergo prostate cancer screening, involving a prostate-specific antigen (PSA) blood test, which is a very simple test. While PSA screening facilitates early detection, it also carries the risk of identifying non-life-threatening tumors. Consequently, PSA screening guidelines vary between countries and have evolved over time to strike a balance between timely detection and minimizing unnecessary interventions.

While emphasizing the importance of early detection, it is essential to understand key aspects of the prostate and associated risk factors. The prostate’s primary function is to produce fluid that nourishes and protects sperm, playing a vital role in reproduction. Aging men commonly experience prostate-related issues, such as benign prostatic hyperplasia (BPH) and prostatitis, leading to urinary problems and discomfort.

Prostate cancer, a prevalent form of cancer in men, manifests through symptoms like frequent urination, weak urine flow, and pelvic discomfort. Risk factors include age, family history, and ethnicity, with African American men and those with a family history facing elevated risks.

Preventive measures, including maintaining a healthy lifestyle with regular exercise and a balanced diet, contribute to overall prostate health. However, regular check-ups with healthcare providers with established oncology departments like The Nairobi West Hospital are crucial for monitoring and addressing emerging issues.

The low uptake of prostate cancer screening in Kenya necessitates effective and innovative screening programs targeting high-risk groups. Raising awareness among men and implementing comprehensive screening initiatives could potentially save thousands of lives annually.

In conclusion, addressing the low uptake of prostate cancer screening in Kenya requires a multifaceted approach. Targeting men without health insurance coverage, increasing literacy rates, utilizing mainstream media for sensitization, and expanding insurance coverage are essential steps. By implementing these recommendations, Kenya can make significant strides in improving prostate cancer screening rates and ultimately saving lives.

Article By Dr. Lalit Varadpande, Medical Oncologist, The Nairobi West Hospital.