Taming prostate cancer with early, subsidised treatment

The rising incidence of prostate cancer in Nigeria, as highlighted in a recent report, underscores a critical public health challenge. With prostate cancer now the leading cancer among Nigerian men, accounting for 29.1 per cent of all male cancers, the need for effective strategies to combat this disease is urgent. What is even more alarming is the very high cost of treatment of the diseases, which is beyond the reach of the average Nigerian, thereby making them vulnerable consequences of the ailment.

Prostate cancer is a significant health concern, particularly for men over the age of 50. It originates in the prostate gland, which is responsible for producing seminal fluid. The disease often develops slowly and may not present symptoms until it reaches an advanced stage, making early detection crucial for effective management.

As such, understanding the risk factors associated with prostate cancer can help in prevention and early detection. Generally, the risk increases significantly after age 50, with most cases diagnosed in men over 65.

Also, family history of prostate cancer can elevate risk, indicating a genetic predisposition; while ethnicity is also a contributory factor as African American men are at a higher risk compared to men of other races, and they often experience more aggressive forms of the disease.

Furthermore, high-fat diets and obesity have been linked to an increased risk of prostate cancer; and hormonal factors, in particular, elevated levels of testosterone may contribute to the development of prostate cancer.

While there is no guaranteed way to prevent prostate cancer, certain lifestyle changes can reduce risk. Consuming a healthy diet rich in fruits, vegetables and whole grains, while limiting red meat and high-fat dairy products may lower risk. Also, maintaining a healthy weight through regular physical activity can help reduce the risk of developing prostate cancer. Men, particularly those with risk factors should discuss regular screening options with their healthcare providers.

For those already diagnosed with prostate cancer, the management depends on various factors including the stage of cancer, patient health and personal preferences. For low-risk cases, active surveillance may be deployed; and doctors may recommend monitoring the cancer closely rather than immediate treatment. Again, surgery may be recommended for localised cancer that is radical prostatectomy, which involves removing the prostate gland and some surrounding tissue.

Others include radiation therapy which includes external beam radiation or brachytherapy (internal radiation), effective for localised or advanced cases; hormonal therapy, used to lower testosterone levels that fuel cancer growth and this may involve medications or surgical procedures. Chemotherapy is typically reserved for advanced stages when cancer has spread beyond the prostate.

Prostate cancer remains a critical health issue that requires awareness and proactive management both individually and collectively. So, at the individual level, men should make proactive health choices today for a healthier tomorrow.

Given that the high costs associated with treatment and late detection further exacerbate this crisis, men can take significant steps toward reducing their risk through regular screening and discussion with healthcare providers for early detection and effective management of this disease.

On cost and treatment, the first option is operation, to remove not only the prostate but also seminal vesicles, which are attached to the prostate. That is radical prostatectomy or radical surgery generally, and it may gulp about N3 million or more.  Other options include radiotherapy, which is an artificially generated radiation directed to the site of the cancer to kill the cancer cells. Radiotherapy is also expensive, given once, for between N800,000 to N900,000 at the National Hospital. In private facilities, it costs about N3m to N4m, while the average cost for laparoscopic radical prostatectomy is about N15 million to N18 million.

Injection and new drugs are available in the market but hardly affordable. An injection to be administered once every three months costs N300,000, while the daily tablet amounts to N90,000 monthly. This means that a patient would require about N570,000 every quarter for treatment. Newer drugs can cost about N500,000 to be used  for one year or 18 months,

For the reason of cost therefore, men should prioritise their health by adopting healthier lifestyles and seeking medical advice promptly when experiencing symptoms such as difficulty in urinating or pelvic pain because early intervention could save lives.

Also, the fight against prostate cancer in Nigeria requires collective action, necessitating a multi-faceted approach involving various stakeholders including government authorities, healthcare providers, NGOs and communities.

Some of the key interventions stakeholders should adopt for addressing prostate cancer in Nigeria include the implementation of widespread screening programmes as evidence suggests that regular screening can significantly reduce mortality rates by identifying cancers at treatable stages.

As such, community health initiatives should focus on educating men about the importance of screening, particularly for those over 50 years old. Sensitising them about prostate cancer symptoms and risk factors is crucial. Campaigns should target both urban and rural populations, utilising various media platforms to disseminate information. Again, it is important to engage local leaders and influencers to enhance outreach efforts, ensuring that messages resonate within communities.

In addition, given the hefty costs associated with prostate cancer treatment, establishing financial assistance programmes is essential. So, there is also the need to have a financial support mechanism for improved uptake of screening; and this may necessitate partnerships with non-governmental organisations (NGOs) and international development agencies to provide subsidised treatments or free screenings for low-income populations.

Furthermore, the management of men diagnosed with prostate cancer requires qualified healthcare professionals. The government should invest in training programmes for them to ensure that they are equipped to diagnose and manage prostate cancer effectively. Therefore, continuous professional development should be prioritised to keep practitioners informed about the latest treatment protocols and technologies.

Again, the government should encourage research on prostate cancer epidemiology in Nigeria to provide valuable insights into its prevalence and risk factors; and it is also crucial to establish a national cancer registry to help track incidence rates, treatment outcomes, and survival statistics. So, it is important to advocate for policies that prioritise prostate cancer research funding as research findings would guide policy decisions and resource allocation.

Still on advocacy, stakeholders should advocate for healthcare accessibility; and collaborate with government bodies to create a legislative framework that supports cancer care initiatives and integrate them into the national health agenda. Health insurance is vital.

Health authorities at all levels of government must act now to significantly improve early detection rates, reduce treatment costs and ultimately save lives! Nigeria should unite to tackle this pressing health issue and ensure that no man has to face prostate cancer alone. Together, people can turn the tide against this disease and foster a healthier future for all Nigerian men.