By Oluwasola Samuel, Freelance Writer. With medical review and editorial support by the DLHA Team
Elderly African Man at high rik for prostate cancer.
Here is a fact: Prostate cancer is the most common cancer affecting men in Africa. That's right, even though you may not hear about it; prostate cancer poses a serious health risk to men across Africa.
This might sound scary, but knowledge is power. In this article, you will learn about prostate cancer, its cause, risk factors, complications, and other vital information that will help you and your loved ones make wise health decisions going forward.
The prostate or prostate gland is walnut-shaped in people assigned male at birth. It's located right in front of your rectum and below your bladder )see fig 1). The prostate gland plays an important role in the production of seminal fluid (semen) and urine control.
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Fig. 1: Cartoon illustration of the anatomy of the prostate gland. Click image to enlarge
Your prostate gland becomes cancerous when the cells in your prostate begin to grow and multiply uncontrollably. These multiplying cells grow to form a swelling or mass (tumour), which is cancerous (malignant) (see figure 2).
Cartoon illustration showing cancer growth in the prostate gland.
Furthermore, your cancerous prostate cells may grow slowly and stay within your prostate gland or they could grow rapidly, invading nearby tissues and spread beyond the prostate to other parts of your body (metastasis).
Prostate cancer arises due to the abnormal growth and multiplication of prostate cells. As with most cancers, experts aren't sure what causes prostate cells to become cancerous over time.
As cancerous cells continue to grow and multiply in the prostate, normal cells begin to die. Cancerous cells take over and grow into a lump, also known as a tumour. It's unclear how prostate cells become cancerous. What is known is that every cell has a DNA of its own.
It's the DNA that controls how it grows and multiplies. DNA can be altered or damaged. Ageing and exposure to harmful chemicals or radiation can alter DNA, causing cells to die, grow out of control, or become cancerous. The process where a cell’s DNA is altered or damaged is called “gene mutation.”
Every man’s risk of prostate cancer varies based on his age, race, and other factors. Medical experts have identified some risk factors that open you to having prostate cancer.
Knowing what puts you at risk of this condition will better equip you with the necessary information and make you more proactive in making wise health decisions.
Some of the risk factors include:
As you grow older, you are at risk of prostate cancer. People who are 65 and older are at higher risk of developing this condition. [1] Also, 6 in 10 men between the ages of 65 and above are diagnosed with prostate cancer worldwide.
This shows you the link between age and cancer growth. As you age, your cells gradually become weaker and lose their ability to function normally. It begins to function abnormally, giving room for cancerous cells to thrive.
Men of all races are at risk of this condition. If you are an African, African American, or Caribbean man of African descent, you are at higher risk compared to white men. [2] You are also likely to die because the condition is more deadly for black men. This doesn't mean you should panic, because an early diagnosis will give you a better chance of survival.
1 in 6 black men are diagnosed with prostate cancer, compared to 1 in 8 white men. It's still unclear why black men or people of black descent are at higher risk of this condition. More research is being carried out to ascertain the actual reason for this.
Every family has its genetic history. If you have a family history of other types of cancer, you are at risk of developing this condition. Prostate cancer seems to run in some families, which could be due to inherited genes or genetic factors.
If you have a brother, son, father, or uncle with prostate cancer, you are twice as likely to develop this condition later in life. You may need to visit your healthcare professional to know your risk level and/or if you already have the condition.
If you have a mutated gene variant like BRCA1 or BRCA2, you are at risk of prostate cancer. [3]
After lung cancer, prostate cancer is the most common cancer type affecting men worldwide.
In 2020, 1,414,259 estimated prostate cancer cases were reported globally, with 375,304 deaths. [4]
Prostate cancer cases have been on the increase in the last decade worldwide. While the reported trend has dropped in high-income countries due to improved screening methods that can screen asymptomatic men, the same cannot be said of low-income countries like in sub-Saharan Africa.
According to data obtained from the International Agency for Research on Cancers' for the year 2020, prostate cancer is the most common type of cancer among men in 40 sub-Saharan African regions. [5] Also, 77,300 cases were recorded in the year 2020.
It's difficult to get accurate figures of the incidence and death caused by prostate cancer in sub-Saharan Africa because most African countries don't have a cancer registration system. For a few that have, the data is unreliable because not all prostate cancer cases are reported.
The International Agency for Research on Cancer (IARC) predicted that prostate cancer-related deaths will more than double from 47,000 recorded in 2020 to 100,000 by 2040. [6] This will be due to poor screening methods and an ageing population. Hence, there is a need for quality diagnostic methods, public education, and early checks to detect cancer early.
There are different types of prostate cancer; from different cells. To know which kind of prostate cancer you have, your healthcare professional takes a tiny bit of prostate tissue from you (biopsy) and sends it for study under a microscope by another specialist doctor (a histopathologist).
The examination also reveals the stage of prostate cancer to help find the best treatment plan.
The various types of prostate cancer include the following:
This type of cancer is the most common type of prostate cancer. Majority of men with prostate cancer have adenocarcinoma. It begins to develop in your gland cells and the tube that lines your prostate gland. As they grow in your prostate gland, they begin to produce and secrete mucus, digestive juice, or other fluid.
Adenocarcinoma has other forms, such as:
Most people have this type of adenocarcinoma. It accounts for almost all types of prostatic adenocarcinoma. Acinar adenocarcinoma develops at the back of your prostate. As a result, it increases prostate specific antigens (PSA) in your blood during tests.
This type of cancer is rare. It grows and spreads quickly compared to acinar adenocarcinoma. This type of cancer develops in the cells lining the tube (duct) of your prostate gland. This prostate cancer doesn't increase prostate-specific antigen (PSA) in your blood, making it difficult to detect.
This is also known as urothelial cancer. It may occur in the cells that line your urethra. But more often, it arises from the bladder and spreads to the neck of your bladder and nearby tissues.
This type of prostate cancer is considered to be the most aggressive of all. It affects 1% of the cases recorded worldwide. [7] It has an overall poor survival rate, which means it is deadly. It can be classified as a type of neuroendocrine prostate cancer. Men diagnosed with this condition usually have advanced prostate cancer at the time they are diagnosed. This gives them a slim chance of survival.
This form of cancer is also known as carcinoids. It is a rare form of prostate cancer and it doesn't produce PSA. These types of prostate cancer can be very aggressive and can be detected at a later stage. The neuroendocrine tumour often spreads beyond the prostate and metastasizes to the liver and lungs.
This type of prostate cancer is rare, and it develops from connective tissue cells, the muscle, and the nerves of the prostate. Furthermore, it's easier to treat it if it hasn't spread beyond the prostate region. This gives you a better chance of survival.
Aside from these types, prostate cancer can also be categorized into:
Non-aggressive prostate cancer grows slowly, while aggressive or fast-growing prostate cancer grows rapidly and spreads to other parts of the body (metastasise).
The staging of cancer is important because it helps your healthcare professional know if the cancer has spread beyond its origin, where it started. It also helps healthcare professionals understand the condition and influences decisions like how to approach treatment.
Usually, the lower the stage, the less the cancer has spread beyond your prostate region.
Prostate cancer stages include:
At this stage, prostate cancer is in its least severe form. It is usually found in the prostate, and it has not spread outside your prostate.
At this stage, cancer is still within the prostate gland and hasn't spread to other parts, but you may exhibit high levels of PSA, which is detected when a blood test is conducted.
At this stage, the tumour has grown and can be found outside of your prostate, spreading to nearby tissues like the seminal vesicles.
At stage 4, prostate cancer is in its most advanced and dangerous form. Furthermore, the cancer has spread throughout the body. When it spreads, it can be found growing in your rectum, bladder, bones, or urethra.
The symptoms of prostate cancer depend on two things. The first is if it's still within your prostate, while the second is if it has spread beyond your prostate to other parts of your body.
Early-stage prostate cancer rarely exhibits any symptoms. You may begin to experience the following symptoms as cancer continues to progress in your prostate:
If you or anyone else is experiencing any of the above-listed symptoms, do not ignore them to avoid complications that could become life-threatening. It's advisable to visit your healthcare professional for a check-up and advice.
Note however that having any of the above symptoms might not mean you have prostate cancer; it could be something else, like Benign prostatic hyperplasia, also known as BPH.
If you have a cancerous tumour in your prostate, it can lead to several complications, which can lead to discomfort and affect your daily activities.
Prostate cancer complications start to manifest only when it’s in its advanced stage or when it has spread beyond your prostate while affecting other body parts.
It takes many years before prostate cancer spreads to other parts of your body, for example, your liver or lungs. This is because the most common prostate cancer grows slowly, except for the rare and aggressive ones.
Some of the complications you might begin to experience with prostate cancer include:
Prostate cancer can cause several discomforting and disabling symptoms that reduce your quality of life. When your symptoms become severe, you become uncomfortable due to the pain or discomfort of the symptoms.
However, not all prostate cancers usually exhibit symptoms. At an early stage, it rarely exhibits any symptoms. This is because prostate cancer grows slowly. You can live with it for many years without knowing it or needing treatment.
Furthermore, prostate cancer can affect the ability of a man to achieve or sustain an erection (erectile dysfunction). This affects a man's ability to have a satisfying sexual experience, both for himself and his partner. If this continues for long periods, it can cause the man low self-esteem. It can also affect the man mentally, causing depression and anxiety.
Prostate cancer can take a long time to develop without showing symptoms. As with cancer, they grow slowly while killing off normal cells. However, some aggressive prostate cancers grow faster and evade nearby tissues.
No, prostate cancer is not infectious. You cannot catch it from another person through close contact, sexual activity, or sharing personal items. Prostate cancer is classified as a non-communicable disease (NCD) because it isn't transmittable, unlike many infectious diseases.
Most times, yes. This is because your testicle and not the prostate is the key organ responsible for sperm production and development in men. Also, when the cancer is in its early stages, it may not significantly disrupt the prostate.
However, when cancer has spread beyond the prostate or is in its advanced stage, it can damage more healthy tissue in your prostate. This can prevent the prostate from producing prostatic fluid to enrich the sperm.
Yes, it can cause death. It's more deadly for Africans, African Americans, and people of black descent.
Prostate cancer can have a hereditary component. Having family members who have this condition does not mean that's the final nail in your coffin. However, you may not have the condition, but it puts you at higher risk than someone with no family history of the condition.
Prostate cancer cells spread by invading surrounding lower abdominal/pelvic organs like the bladder, rectum and seminal vescicles. The cancer cells can also break free from the prostate gland and enter into the bloodstream. This enables the cancer cells to travel throughout the body.
Furthermore, as it travels through the bloodstream, it can get lodged in other organs like bones (a favorite hiding spot for prostate cancer), lungs, or liver. At this point, prostate cancer is said to have spread and becomes more serious.
You may not experience symptoms now, but as an African man, understanding prostate cancer is vital. Early detection saves lives. While some men experience no issues, frequent nighttime urination or changes in sexual health can be early warnings.
Don't wait for symptoms to dictate your health. Take charge! Talk to your doctor about prostate health and risk factors specific to African men. Take charge of your health today for a healthier you and peace of mind for you and your loved ones.
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2. Anderson B, Marshall-Lucette S, Webb P. African and Afro-Caribbean men’s experiences of prostate cancer. Br J Nurs [Internet]. 2013 Dec 12 [cited 2024 Mar 21];22(22):1296–307. Available from: http://www.magonlinelibrary.com/doi/10.12968/bjon.2013.22.22.1296
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6. Makau-Barasa LK, Manirakiza A, Carvalho AL, Rebbeck TR. Prostate cancer screening, diagnostic, treatment procedures and costs in sub-Saharan Africa: a situational analysis. Cancer Control [Internet]. 2022 Mar 30 [cited 2024 Mar 21];29:10732748221084932. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8973068/
7. Bhandari R, Vengaloor Thomas T, Giri S, Kumar PP, Cook-Glenn C. Small cell carcinoma of the prostate: a case report and review of the literature. Cureus [Internet]. [cited 2024 Mar 21];12(2):e7074. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093915/
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