“Ignoring prostate cancer won’t beat it,” says Dr Raphael Nyarkotey Obu, a research Professor of Prostate Cancer and Holistic Medicine.
Dr Abu who doubles as the founder of Men’s Health Foundation, a charity and a prostate cancer advocate, believes the current efforts by government in addressing the cancer issue is not enough to address the silent cancer eating up the male population of the country.
He says judging from the overwhelming notion Ghanaians have over the certainty of cancer, little efforts seems to go into the ultimate cancer cure.
“The ultimate cancer cure is its prevention. Ghana needs to channel its resources into preventive medicine and not curative medicine,” Dr Obu states.
Prostate Cancer in Ghana
Causing more than 8.2 million deaths annually, cancer is one of the top killer diseases in the world.
The estimated number of 14 million plus new cases occurring every year is expected to increase by 70 percent in the next two decades.
In Ghana, according to Dr Abu, although there is scanty data on prostate cancer epidemiological studies have revealed that more than 200 out of every 100,000, male have the disease.
He further mentioned that more than 70 percent of Ghanaians presenting with prostate cancer do so very late with locally invasive and metastatic disease and over 80 percent death.
“No significant improvement in prostate cancer mortality has been seen and mortality rates appear high in Ghana,” the Men’s Health Foundation founder says.
He indicated that prostate cancer is more aggressive in men of African descent than men of other races and further added that if men know what they stand to get if the prostate is in good health they wouldn’t ignore it.
“There are a lot of disparities in prostate cancer yet most men in the black communities are not aware of the disease, let alone go in for screening programmes,” he says.
He said cancer is often misunderstood by even the most respected medical professionals in the world. Parts of the problem lies in the belief that a person ‘gets’ cancer like the way they would get cold or bacterial infection.
But in reality, every cell has the ability to cancer, and a variety of factors can prompt a cell to do so. And while most oncologists (and even leading cancer associations) consider cancer a genetic disease, I realised that this is not entirely true,” he says.
“From my research cancer isn’t a disease of the genes, rather it’s a disease where cells evolve to look and behave a certain way, using gene alterations to get there simple. You see when we find a way to repair one gene alteration; cancer finds an alternative route quite quickly.
Cancer, therefore, occurs when genes within a cell lose their ability to regulate that cell’s growth. These disobedient cells don’t know how to stop multiplying or die. But all cells have the potential to lose this ability, meaning any cell can cancer at any time depending on the environment it find itself!” he adds.
He indicated that prostate cancer treatment is very expensive with most men diagnosed with prostate cancer being in their old age and cannot even afford the treatment, thus, supporting the call for the inclusion of prostate cancer treatment on the NHIS.
Men’s Health Policy
Currently, there is no national prostate cancer screening programme, and annual PSA checks are not practised routinely in Ghana.
However, screening programmes exist for breast and cervical cancer in Ghana. The month of September is celebrated globally as prostate cancer awareness month. It is a month charities, government and policymakers raise awareness and educate the public on prostate cancer, thus, the Men’s Health Foundation had proposed that the day be celebrated concurrently with fathers to increase the awareness of the disease.
The foundation, therefore, submitted a proposal to the president and the Ministry of Health (MoH) to declare Father’s Day as a national awareness day to strengthen the fight against prostate cancer.
The foundation believes it is now imperative that every man over 40 (and younger men at higher risk of the disease) has access to balanced information about the pros and cons of the PSA test so that they can make an informed and individual choice about whether to have it .
It also advocate early detection programme for prostate cancer for Ghanaian men.
“Thought the PSA test is not a test for prostate cancer, it is a risk assessment test for men to know what is happening to their prostate, notwithstanding it has a role to play in terms of the disease monitoring or progression,” Dr Abu says.
The foundation wants a National Cancer Plan in Ghana in their submission to involve free PSA testing for men concerned about prostate cancer under the NHIS.
It, however, mentioned that before testing, men should be given a balanced information about the pros and cons of the PSA testing for prostate cancer, side effect of treatments, statistics of prostate cancer and side effect of biopsy and men must make their informed decision on testing and treatments based on information given for men 40 years and above but men in a high risk group like family history of the disease can start screening at 35 years.
Facing the challenges
Dr Nyarkotey believes that collaboration between complementary and alternative practice must also be considered as complementary and alternative as therapies have been proven to support patient’s quality of life and rate of survival.
“For instance, with our men’s charity work in the various churches where we interviewed 50 women, I found that women “play a significant role in the health behaviours of some Ghanaian men” but many have misconceptions about the disease, or have concerns that could potentially restrict the provision and effectiveness of care,” he states.
He said some section of the population believe that promiscuous men get this disease and so most men refuse to check their prostate partly because they are afraid that eventually they will be diagnosed with the disease and their wives will leave them.
On the contrary, Dr Abu says some women are understanding and, therefore, support their men to go for regular screening programs.
“Another challenge has to be the use of digital rectal exam for prostate cancer diagnosis, as most Ghanaian men are not happy with the practice, especially a female performing the procedure. For example, some men expressed anxiety about a female doctor performing tests.
So increasing the number of trained male healthcare providers in Ghana who offer screening could help improve the situation in Ghana,” he adds.
Dr Abu pointed out that despite the challenges, there has to be an extensive educational interventions aimed at Ghanaian men to help improve support for prostate cancer screening, as part of wider efforts to improve the availability of and access to preventive care.
He, however, indicated that another education must also target women to educate them on the importance of the prostate gland and its impact on men sex life and that if a man has a problem with his prostate, he can also affect the woman in several ways such as his sex life, financial challenges in their various homes and the psychosocial aspect of the disease can also affect the women.
He urged urologists in Ghana to step up their fight against the disease and collaborate with others knowledgeable in the disease to help formulate policies to strengthen the disease.
“There should be special programmes to help men deal with the side effect of conventional prostate cancer treatment and this can be supported with government’s commitment to recognise the Father’s Day in Ghana as a National Prostate Awareness Day,” he says.