Prostate cancer: You can survive

2018-01-28 06:00
Desmond Tutu (Roger Bosch, AFP)

Desmond Tutu (Roger Bosch, AFP)

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WATCH: Mbongeni Ngema's last words to his long-time friend, Hugh Masekela

2018-01-23 16:11

Legendary trumpeter, singer and activist Hugh Ramapolo Masekela passed away after a long battle with prostate cancer. The composer died at the age of 78. Long-time friend, Mbongeni Ngema, paid tribute to Masekela on Tuesday. Watch. WATCH

The nation’s beloved former statesman Nelson Mandela had it, Desmond Tutu has been battling it for more than 20 years and, this week, it claimed the life of jazz legend Hugh Masekela.

Prostate cancer affects one in every 18 men who are older than 40 in South Africa, more than any other type of the disease among men in the world.

It helps if it is discovered early, yet few men are brave enough to go to the proctologist because of the dreaded rectal exam.

Experts and activists alike agree that there is still a lot of misinformation and misunderstanding surrounding the disease.

David Lucas, a 60-year-old prostate cancer survivor, said: “It’s scary that, in this day and age, some men still think it’s a white man’s disease, or you are stigmatised into thinking you did something wrong to get it.”

If detected early, the prostate cancer survival rate is better than 98%. When diagnosed late, however, the chances drop drastically, as five men die every day because of this disease.

The cancer occurs when some of the cells in the prostate gland reproduce far more rapidly than normal, resulting in a tumour.

It often grows slowly to start with and might not cause any problems.

But some men have prostate cancer that is likely to spread.

These cancer cells, if left untreated, might spread from the prostate and invade distant parts of the body, particularly the lymph nodes and bones, producing secondary tumours in a process known as metastasis.

Lucy Balona, of the Cancer Association of SA (Cansa), said that, althought basic access to screenings and treatment had improved across the country, particularly with targeted campaigns such as the Hollard Daredevil Run and Movember raising awareness, it still wasn’t enough, and the government needed to do more to make sure more people received potentially life-saving information and advice.

“We are very conscious of reaching black communities in our campaigns because cancer does not discriminate … it doesn’t care if you’re rich or poor, black or white.

"You can do things to lower your risk, and that’s where education about it comes in,” Balona said.

“You can manage it. Mandela lived a long life with the disease; there is hope.”

Six years ago, Lucas had no idea that a sore finger would lead to a prostate cancer diagnosis.

He convinced himself that it was just arthritis, despite consulting a GP friend, who dismissed Lucas’ self-diagnosis outright.

The results of a blood test revealed that his body could be hosting something more sinister.

His blood test came back confirming two things: no, it wasn’t arthritis, but gout. And his prostate specific antigen (PSA) blood tests came back worryingly high.

“At that stage, I had no indication that anything involving my prostate could be wrong. I had no pain while urinating or any of the other symptoms,” the Johannesburg resident said.

Lucas consulted a urologist, who performed tests and a biopsy and, after two weeks, gave him the grim diagnosis – he had stage 1 prostate cancer.

“There is this irrational fear and sense of shame around rectal exams, but many men don’t understand that it’s done only when necessary.

“For me, it was a quick procedure, and the only discomfort I felt was when they inserted a catheter into me for another test.

“In fact, I was recently joking with my 86-year-old uncle, who was also diagnosed with prostate cancer, saying he too was no longer a virgin since his test recently.”

But it’s not just ordinary men who shy away from rectal exams – even some doctors do.

A study published in the South African Medical Journal last year by Dr Kalli Spencer, a urologist at Wits medical school, found that doctors with fewer than seven years of experience were less likely to test male patients for prostate cancer by conducting a digital rectal exam.

Some of the reasoning given by the 303 doctors who participated in his survey included: “It’s more convenient to do a PSA test”; “Urologists will examine the prostate anyway”; “No privacy in the emergency department/admission ward”; “A prostate exam is not relevant to my practice”; “There is not enough time”; and “The practitioner forgets”.

Lucas, who is still not completely free of cancer, said he would be the first to admit that the prostate examination was “not pleasant”.

But, he reckoned, it was a whole lot more pleasant than dying from cancer.

Garron Gsell, chief executive and founder of the Men’s Foundation, said the death of Masekela brought the disease into sharp focus, as did the death of US actor Robin Williams, who suffered from severe depression for years and eventually hanged himself.

Gsell said: “It starts to hit home when we realise how prevalent it is … more men are, however, being diagnosed, which is good because it means more men are going through the healthcare system as well.

“We need to destigmatise men’s health issues because we still have an opportunity to stop men from dying too young if they are aware of the issues and get themselves screened.”

WHO’S AT RISK? 

Your risk of developing prostate cancer increases with age, but that doesn’t mean it’s a disease that affects only old men.

Prostate cancer is the second most common cancer in men worldwide.

Men who have a family history of the disease are two and a half times more likely to get prostate cancer than those who don’t.

If you have a brother, uncle or father with prostate cancer, do the test at the age of 45.

If you’re 50, you should be talking to your doctor about PSA testing. 

WHAT’S A PSA TEST?

It’s a simple routine blood test that is used to determine the measurement of prostate specific antigen (PSA) concentration in the blood.

It is the primary method of testing for prostate cancer. 

Raised PSA levels might suggest you have a problem with your prostate, but this does not necessarily mean you have cancer.

Your GP can conduct a PSA test, so it’s worthwhile to discuss the subject with him or her.

DETECTING PROSTATE CANCER

Not everyone experiences symptoms of prostate cancer.

Many times, signs of prostate cancer are first detected by a doctor during a routine check-up.

Some men, however, will experience changes in urinary or sexual function that might indicate the presence of prostate cancer.

SIGNS AND SYMPTOMS

. A need to urinate frequently;

. Difficulty urinating or holding urine in;

. Weak or interrupted flow of urine;

. Painful or burning sensation while urinating;

. Difficulty in gaining an erection;

. Painful ejaculation;

. Blood in urine or semen; and

. Frequent pain or stiffness in the lower back, hips or upper thighs.

Sources: Men’s Foundation and Cansa

TALK TO US

Knowing what you know now about prostate cancer, will you encourage your friends and relatives to take the test?

SMS us on 35697 using the keyword CANCER and tell us what you think. Please include your name and province. SMSes cost R1.50

Read more on:    nelson mandela  |  desmond tutu  |  health

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