Sun exposure and prostate cancer in black men
Cancer is one of the leading causes of death globally with burden of death on the developing countries. Although infectious diseases like malaria, HIV/AIDS, tuberculosis still plague developing countries like Nigeria, cancer now kills more people globally than these three infectious diseases put together. There is an upward of cancer incidence in developing countries including Nigeria; and this, in part, is due to late diagnosis and inadequate health system designed to address this problem.
In Nigeria, prostate cancer represents the leading cause of death among men and this pattern is similar to what obtains among black male populations globally. Some urologists have suggested that up to 40% of men in Nigeria could be living with problems in their prostate. Unfortunately, even in developed nations with good health systems like U.S., the burden of death due to prostate cancer is on the black population. Despite the advances in medical treatments of prostate cancer, death due to prostate cancer among the black community continues to increase. This observation has been validated by several scientific reports that have documented a huge disparity in the burden and outcome of prostate cancer, with the black men being at disadvantage. What continues to puzzle medical experts is the extent to which the biology of prostate cancer is different between blacks and whites.
There are many risk factors of prostate cancer opined by experts but the major ones are race and age. Since both white and black grow old, the obvious factor accounting for the disparity is skin colour. This simply means that the fact that one is a black man increases one’s risk of having prostate cancer. Hence, this makes it essential to seek information that will re-script and re-programe our understanding and perception of this disease. This will be very important in knowing how we can maximise our environment to suit our biology. Nigeria is the most populous black nation on earth and every disease that has the blacks as the risk group could have up to 25 per cent burden on Nigeria. Behind the numbers and statistics of prostate cancer deaths are tears, pains and sorrows of families and loved ones, who wondered on whether something could be done to prevent it.
So, the question to ask at this juncture is: what is different between the black and white man? The colour of the skin makes a glaring difference between both. The dark skin of the African man confers a uniqueness that needs to be understood properly.
A major function of the skin is the harnessing of the sun radiation to produce Vitamin D. The darkness of the black skin reduces the efficiency of the solar ultraviolet β (UV β) radiation to stimulate the production of biologically functional Vitamin D. The implication of this is that the black man requires more solar exposure than the white to generate the same amount of Vitamin D. Hence, our adaptation of foreign lifestyle and fashion that limits our exposure to sun will limit the amount of Vitamin D in the black man. One wonders at this point on the reason the aged, in most ancient cultures, are often exposed to the sun to keep them healthy. Sure, this cannot be for warmth because warmth can be obtained through other means. They must have observed that those exposed to sun live healthier than those who were not.
At present, scientific evidences are emerging indicating that despite the year-round sunny days, Vitamin D deficiency and insufficiency is widespread in Africa. Unfortunately, warnings on the consequence of Vitamin D deficiency is often restricted to children because it helps them build bone and its deficiency results in physically observable bone problem. Beyond bone health, Vitamin D is also necessary for normal prostate biology. In fact, it is a major Vitamin that the prostate depends on to maintain physiological balance. Scientists have demonstrated that it reduces inflammation and progression of low-grade prostate cancer. One of such scientific clinical trials published in the British Journal of Cancer showed that adequate Vitamin D could reduce the risk of death by 700% even in patients with prostate cancer and also reduces the prostate specific antigen (PSA) by 50%.
The unfortunate thing is that many people focus their attention on the negative aspect of sun exposure based on information that sun exposure could cause cancer. This represents, as put by Chimamanda Adichie, the danger of a single story. This type of campaign relies on information obtained primarily among the white population and appropriates it to the black without putting our uniqueness into consideration. Any form of information that discourages the black man from taking a daily healthy dose of the sun will continue to impact negatively on his prostate health and results in poor disease outcome. The situation we have at hand now is that both fatal prostate cancer and Vitamin D deficiency are co-occurring in the black population. This requires urgent attention by directing serious enlightenment and advocacy in educating the Nigerian populace.
There are many sources of Vitamin D, ranging from dietary to pharmaceutical, but the sun is freely available for every man to utilise and maximise its benefit for a healthy prostate. There are, however, some important things to note about sun and Vitamin D generation. The amount of UV β radiation varies by location, not all the day long sun exposure is good for Vitamin D generation and the ability of skin to generate Vitamin D reduces with age. One way that an average man can take adequate advantage of the sun to get Vitamin D is by using mobile technology. There are mobile apps, like dminder, that use information like your age, location, clothing and skin tone to advice you daily on the best time and duration to get adequate Vitamin D from the sun without getting hurt. This type of apps also use your diet to predict whether you still require it.
Cancer is conquerable but it requires requisite knowledge and adequate personal actions like screening to detect and catch it early. Every man of 40 years old should get their baseline PSA as part of medical checkup and discuss with their doctors about prostate cancer. It important to know that it is your body and you have the responsibility to take care of it. We are made to live here and our ability to maintain a healthy lifestyle and balance with nature together with its resources will determine our survival.
Rotimi (PhD), is a biochemistry lecturer at Covenant University