Prostate Cancer: Unzipping the courage to get screened

From the dusty village squares to the bustling city streets, the expression “having balls” pays homage to the testicles as symbols of maleness, equating their presence with courage and fortitude.

Even in the world of sports, the ball’s comparison to valour comes into play. A man’s love for football is seen as characteristic of manliness, and people who do not like football are seen as feminine.

The proverb “A child can play with its mother’s breasts, but not its father’s testicles” serves as a reminder that matters concerning the male reproductive organs are shrouded in taboo, relegated to the realm of the unspoken. 

Yet, while “balls” are celebrated as the ultimate signifiers of bravery, many men hesitate when faced with the need to confront a health crisis that strikes at the heart of their masculinity – prostate cancer.

This treacherous disease, which afflicts the prostate gland nestled between the testicles, often goes undetected and untreated due to a toxic confluence of misconceptions, fear, and a deep-seated sense of invincibility. 

Prostate Cancer

Prostate cancer is a type of cancer that starts in the prostate gland, a small walnut-sized gland in men that produces seminal fluid. It is one of the most common cancers affecting men worldwide and a leading cause of cancer-related deaths. While the exact causes of prostate cancer remain unclear, several risk factors, including age, family history, and race, have been identified.

In Ghana, prostate cancer is the second most common cancer among men and the most frequently diagnosed at the Korle Bu Teaching Hospital.

Grim Statistics 

A recent report published in the Journal of the West African College of Surgeons has shed light on the devastating impact of prostate cancer in Ghana.

The report revealed that a staggering 234 men died from prostate cancer in the country between 2013 and 2022. These deaths were primarily attributed to the aggressive nature of the disease and its late diagnosis.

According to the report, the clinical records of the men who succumbed to prostate cancer at a tertiary hospital in Ghana showed that their ages ranged from 40 to 90 years, with the highest number of deaths occurring among those between 60 and 79 years old.

Alarmingly, 51.3 per cent of the 234 fatalities occurred within two years of diagnosis, while 23 per cent died between two and five years after diagnosis. Only a quarter of the patients lived for more than five years after their diagnosis.

In December 2022, Ghanaian satirist Kwaku Sintim-Misa (KSM) opened up about his personal battle with prostate cancer in an interview on JoyNews.

The 68-year-old revealed that he was diagnosed with prostate cancer prior and had undergone a prostatectomy, a radical surgery to remove the entire prostate, in the US.

He shared that his journey began when a friend, who had started working at a health institution, persuaded him to get his testosterone levels checked.

Despite initial hesitation, KSM eventually went for the check-up, which revealed high PSA (Prostate Specific Antigen) levels.

“It started when a friend of mine told me he was now working with the American Rejuvenation Centre, so he wants me to come and do a check-up; to come and check my PSA. 

“I kept stalling. So at one point, I said I’ll go, like I’m doing him a favour. And when I did the check-up, the guy said, ‘Actually, your PSA levels are very high. And I’m not comfortable with your PSA level,'” KSM recalled.

Despite feeling strong and fit, with no symptoms like tiredness, loss of appetite, blood in urine, or painful ejaculation, further check-ups revealed that his prostate was cancerous. 

KSM emphasised the importance of proactive health check-ups, even when one feels fit and healthy.

“I didn’t have any symptoms. I go for my walk, no tiredness, no loss of appetite, no blood in urine, no painful ejaculation… Do your PSA check-ups. There’s a difference between being fit and being healthy,” he urged, particularly encouraging black men from age 30 to prioritise their health.

The Late Diagnosis Crisis

The Journal of the West African College of Surgeons report referred to earlier also highlighted the slow uptake of newer treatment strategies for metastatic prostate cancer, confirming existing literature that suggests black men have poorer outcomes due to the aggressive nature of the disease. 

Professor James Edward Mensah, Head of the Department of Surgery at Korle-Bu Teaching Hospital and President of the Ghana Association of Urological Surgeons, told the Ghana News Agency last year that early reporting and diagnosis are crucial in lowering disease mortality.

However, many patients seek medical attention only when they experience urinary problems or back pain, which are often signs of the cancer’s spread to the bone and spinal cord.

Professor Mensah emphasised the need for early detection and appropriate intervention to improve disease outcomes. He urged individuals to seek medical attention as soon as possible and to be aware of the risks and symptoms of prostate cancer.

The High-Risk Groups

The urologist advised men at higher risk of developing prostate cancer, including black males and those with a family history of the disease, to undergo regular PSA blood tests and biopsies starting at age 40. Early engagement with healthcare providers is crucial for proper management and treatment.

Treatment Options/Challenges

While various treatment modalities for localised prostate cancer are available in Ghana, including watchful waiting, active surveillance, open radical prostatectomy, brachytherapy, and external beam radiotherapy, Professor Mensah stressed the need for more specialised medical personnel and ensuring that the necessary equipment for prostate procedures is available in all regions of the country.

Prostate cancer remains a significant health threat for Ghanaian men, with late diagnosis and aggressive forms of the disease contributing to the high mortality rate. Raising awareness, encouraging early screening, and improving access to specialised care are essential steps in combating this deadly condition. 

In a Nutshell

As the shadow of prostate cancer looms ever larger across Africa, it becomes a matter of urgent necessity for men to shed these self-imposed shackles and confront this formidable foe head-on.

It is time to rewrite the narrative, to imbue the metaphorical “balls” with a newfound resilience – a defiant spirit that refuses to succumb to fear, taboo, or complacency when the very essence of his manhood is threatened.

Only then can men truly embody the bravery their ancestors extolled, emerging victorious in the face of this formidable challenge that strikes at the core of what it means to be a man.

BY JONATHAN DONKOR

The post Prostate Cancer: Unzipping the courage to get screened appeared first on Ghanaian Times.

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