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By Dr. Andrew Odhiambo – Consultant Physician & Medical Oncologist

1. What’s your name and what’s your specialty?
My name is Dr. Andrew Odhiambo. I am a Medical Oncologist. There are different types of Oncologists. A Medical Oncologist specializes in treatment of cancer using chemotherapy, targeted therapy and Immunotherapy. The latter 2 are very new modalities of cancer treatment.

2. What is prostate cancer?
Cancer is defined as abnormal and uncontrolled rapid growth of body cells. When it affects the prostate gland, we call it prostate cancer. Its only found in men as women do not have a prostate gland. Cancer can however affect any organ in the body.

3. What causes prostate cancer?
For many cancers, there is no DIRECT cause like the way we know Malaria is caused by a parasite. We talk of risk factors. The more risk factors you have the more likely you are to get prostate cancer. But sometimes even without any risk factors you can still get prostate cancer and vice versa.

Some of the common risk factors are:

  • Increasing Age – commonly over 65
  • Black African race/ethnicity
  • Geography – less common in Asia, Africa, Central America
  • Family History – some cases are familial

Less common/unclear risk factors include – These are merely observations rather than proven risk factors and may not apply in many cases

  • Excess dietary dairy & calcium may increase one’s risk
  • Obesity
  • Smoking
  • Chemical exposures
  • Inflammation of the prostate – Prostatitis
  • Sexually Transmitted diseases like chlamydia
  • Vasectomy

4. What are symptoms or signs of prostate cancer?
It is important to note that early prostate cancer has no symptoms. By the time you experience any symptoms it is likely stage 3 or 4

Some of the common early signs & symptoms include:

  • Straining when passing urine
  • Incomplete emptying of the bladder/urine retention
  • Increased frequency of urination
  • Blood in urine
  • Blood in sperms/ejaculate

Late signs &symptoms include

  • Severe weight loss
  • Persistent lower back pain
  • Bone pains
  • Bone fractures
  • Nerve damage
  • Swollen lymph nodes
  • Yellow eyes

5. Do you think there is a stigma associated with this type of cancer? If so, why?
Stigma is associated with all cancers generally. This is driven by fear, ignorance and lack of knowledge. “Cancer doesn’t have a face until it’s your or somebody you know” – Anthony DelMonte once said.

For prostate cancer I would say it is less than other cancers like breast or cervix. Most times there are no visible signs. Breast cancer has obvious breast swellings and sometimes smelling wounds. Cervical cancer is associated with malodorous vaginal discharge so they can’t be around people in public.

Most educated men will talk freely about prostate cancer but will still not go for screening due to fear of a cancer diagnosis and risk of death.

6. What age group is most likely to be affected by this type of cancer?
Men over the age of 65 in Kenya. More common over 70 and the older one becomes. It is rare under 50 and very rare under 40 bit we have seen some cases.

7. How can men protect themselves and lower chances of getting Prostate cancer?
The truth is you cannot protect yourself from prostate cancer. You can only lower your risk. Unlike cervical cancer where a vaccine applies. You may have no risk factors and still get prostate cancer. You many have many risk factors and never get prostate cancer. The same applies to many other cancers

8. What is the screening process like for Prostate cancer? Where can individuals go for cancer screening

Prostate cancer screening is not recommended for mass populations. Like in churches, gatherings etc. It is individualized because the screening test has implications. Not all prostate cancers are deadly. If you went to your church and lined up 100 men over 65 and offered screening without any information you may diagnose 10 cancers of which only 3 will die from it. The rest could have lived normally and died from something else. Many men may die of heart disease, stroke, and even other cancers and when their prostates were examined at autopsy, they had prostate cancer than they never knew about.

Truly there is no perfect screening test for prostate cancer. We rely on a blood test called PSA which stands for prostate specific antigen. If you test positive, you will be offered a prostate biopsy which then confirms the cancer. Remember a negative test doesn’t mean that you don’t have cancer and vice versa. The screening process involves an informed consultation with you doctor so that you understand the pros and cons of the test. You must be well informed because prostate biopsy and treatment has associated risks.

PSA may be offered to you of you meet the following criteria:

  • African 40 year and above
  • 55 – 69 – Caucasian or Asian
  • 40 – 55 yr. with Family history
    • Screening is not recommended below 40y and above 70 years

      Once the patient is well informed and understands the risk vs benefits then they can be offered the test. Any hospital clinic or institution with an accredited biochemistry laboratory can offer the test.

      9. What are some ways the community can offer support to Prostate cancer patients?
      These patients’ psychosocial support. Some of their treatments are lifelong for those with advanced disease. They also need financial support and good medical insurance because the treatments are expensive. Those of a drug called abiraterone for example need to spend between 600 to 1000 USD every month in perpetuity to stay alive.

      10. Parting shot
      Exercise to keep a normal body weight beware of any early symptoms Consult your doctor before going for screening. If you know someone affected, please offer a helping hand

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