Prostate cancer has emerged as the most frequently diagnosed malignancy among Nigerian men, presenting a significant and silently advancing public health crisis. A urologist, Sefiu Eniola, warns that the disease is escalating amidst critically low screening rates, delayed patient presentation, and insufficient public awareness. This form of cancer, characterized by the uncontrollable growth of abnormal cells in the male prostate gland, often progresses without noticeable symptoms in its early stages, making timely detection a formidable challenge.
According to the 2022 Global Cancer Observatory (GLOBOCAN) estimates, Nigeria records an alarming figure of over 18,000 new prostate cancer cases annually. This number accounts for the highest cancer burden among men nationwide, underlining the severity of the situation. The report further indicates that approximately 11,443 deaths occur each year, predominantly attributed to diagnoses made at advanced disease stages, when treatment options become limited and less effective.
Globally, prostate cancer ranks as the second most common cancer in men, but its impact is particularly pronounced among individuals of African descent. Dr. Eniola emphasizes that in Nigeria, it has become the leading male cancer. Age stands as the most potent risk factor, with the probability of developing the disease increasing significantly as men grow older; the average age of diagnosis typically falls around 68 years. Post-mortem studies suggest that microscopic prostate cancer can be identified in up to 80% of men aged 80 and above, even when not the primary cause of death.
Beyond chronological age, both family history and racial background play crucial roles in determining an individual’s risk. Men with close relatives who have experienced prostate cancer face a heightened susceptibility. Furthermore, men of African and Black ethnicity are statistically more prone to developing aggressive forms of the disease when compared to their Caucasian counterparts, a disparity that contributes to the higher incidence and mortality rates observed in Nigerian populations.
One of the most formidable obstacles in combating prostate cancer lies in its asymptomatic nature during the initial phases. Dr. Eniola explains that when the cancer remains localised within the prostate, it typically produces no discernible symptoms. Consequently, early detection hinges entirely on routine screening protocols. Symptoms generally surface only after the cancer has advanced or spread beyond the prostate, potentially including difficulty urinating, blood in the urine, persistent bone or lower back pain, erectile dysfunction, leg weakness, and in severe instances, urinary incontinence.
Given the silent progression of early-stage prostate cancer, routine screening emerges as the most effective defensive strategy. Dr. Eniola strongly recommends that men of African descent commence prostate cancer screening between the ages of 40 and 45. This screening typically involves a Prostate-Specific Antigen (PSA) blood test, often complemented by a digital rectal examination (DRE). These diagnostic tools are vital in distinguishing between benign prostate enlargement and malignant disease, guiding appropriate medical intervention.
Treatment pathways for prostate cancer are largely contingent on the stage at which the disease is identified. For early-stage, localised cancer, curative options include radical prostatectomy, which involves the complete surgical removal of the prostate gland, and radiotherapy, utilising targeted radiation to eradicate cancer cells. Another effective method, brachytherapy, entails the direct implantation of radioactive seeds into the prostate. In carefully selected low-risk cases, active surveillance may be recommended, closely monitoring the cancer without immediate treatment to avert unnecessary complications.
When prostate cancer disseminates beyond its original site, treatment shifts towards palliative care, focusing on slowing disease progression and enhancing the patient’s quality of life. Advanced prostate cancer frequently necessitates hormonal therapy, designed to reduce testosterone levels, a hormone crucial for the proliferation of prostate cancer cells. This reduction can be achieved through periodic injections or, in some instances, surgical removal of the testes.
Untreated, prostate cancer inevitably advances, leading to severe deterioration in quality of life even before it becomes fatal. Patients may experience intense bone pain, paralysis, and an inability to walk. The more aggressive nature of prostate cancer observed among African men further contributes to poorer survival outcomes compared to high-income countries, where widespread early detection initiatives often lead to better prognoses and successful management.
The critical insights from medical professionals underscore an urgent need for enhanced public health campaigns and improved access to screening services across Nigeria. Addressing the prevailing low awareness and late presentation through proactive educational initiatives and accessible healthcare infrastructure is paramount. Such concerted efforts are essential to reverse the alarming trend, facilitate earlier diagnoses, and ultimately improve survival rates and the overall well-being of Nigerian men affected by this devastating disease.
