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Carcinoma of the prostate

Posted by on November 13, 2021 0


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This gland, the prostate, is a small gland that sits at the base of the urinary bladder and forms a girdle around the part of the urethra that passes through the centre of the organ. It is found exclusively in men and it has no counterpart in women. It functions as a reproductive organ and plays a distinct role as such in normal male sexual life. It is a well appreciated component of the lower part of the male urogenital system made up of the kidneys, ureters (which are the pipes that collect urine from there and deposit in the bladder), the bladder (which is the storage tank), and the urethra which is another pipe that finally leads the urine out of the body whenever we want to urinate. Of all these parts, only the prostate is absent in both sexes. It is a small organ, compared to the other parts of the system, but it can have a major contribution to the health and disease burden of a man if it chooses to become sick. Four years ago, on this page, we explored the problem of benign prostatic hyperplasia (BPH) but merely referred to the entity of prostate cancer in passing. This is the most common type of cancer in men and it is therefore, a major series of problems arising from such a small structure.

The people who are most at risk from this condition are not known to have anything in common other than advancing age. It affects poor men as much as it affects the rich. World leaders, military commanders and Nobel Prize laureates have all suffered from it and the most prominent of this lot is the former President of France, Francois Mitterand. Some farmers in the Southern parts of the country have also been diagnosed with the condition and succumbed to it. There is, therefore, an increased need for awareness about this disease because a gland that is responsible for causing cancer most often in men in Nigeria must be somewhat special. It is more common in blacks than in other races and begins to show its presence from as early as 41 years. The peak incidence is between 61 and 70 years and then it begins to fall again. So, the common causes are linked to age, race, hereditary factors and the things we consume. When you eat a meal that is rich in processed fat and proteins such as we increasingly find in cheese and butter, we are courting trouble. The same goes for the consumption of processed meat as found in sausage, hotdog, bacon, corned beef and luncheon meat as we often find them in shawarma and burgers.

Therefore, the increased incidence of chronic infections of the prostate, be it from bacteria or viruses and more specifically as a consequence of sexually transmitted infections also plays a huge role in causing this major disease. Obese men and those who smoke tobacco are also at an increased risk from suffering this particular type of cancer. On the whole, the prostate increases in size throughout adult life. The rate of increase in growth is, of course, very different in different men. It is more rapid in some than in others so that while some men will experience the effects of such an increase in size earlier than others, some will not experience any such changes. In the latter group, therefore, the features of an increase in the size of the prostate may not be very evident. That, however, does not mean that cancer developing in the prostate always comes with an increase in size; it is far more dependent on which lobe of the prostate is primarily involved in starting the problem. The prostate has got three lobes; it has one on either side of the oval organ, and one in the middle. It is the middle lobe that winds around the urethra that is often most commonly responsible for some of the symptoms which develop when the organ has developed cancer. On the whole, this organ is usually about the size of a walnut.

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The common features seen in the men who have this condition include a certain urgency with urinating; there is a feeling that one cannot hold on for a little more time before the urine comes out so that such men are often caught in a rush to the bathroom. And when there is an urge to pass urine, some urine leaks out even before the penis is out of the pants. These people often emerge from the bathroom with stains of urine around the flat at the front of the trousers. Over the course of time, the urine will take some time to start flowing out even after getting to the bathroom. The stream may be poor and will not often reach the desired location. The frequency of passing urine is then increased, and will be worse at night so that the patient wakes up a lot more often to pass urine. At the same time, the flow of urine may no longer occur in one smooth flow and will run for some time, be cut off and then run again until the urge passes. At about the same time, there is a feeling even after leaving the bathroom that the urine has not quite finished in the bladder but by then there is no urge to pass any more urine. This means that the bladder takes a shorter time to get full thus exacerbating the cycle. Sometimes, an extra pressure mounted by the muscles of the abdomen can squeeze out just a little more urine and within several months could become the main means by which the bladder is emptied.

As time passes and no attempt is made to seek medical attention, there develops some weight loss; blood may then begin to appear in the urine and the man may suddenly wake up one night and find that he is no longer able to even urinate. At this point, the disease is about to progress into an expensive phase where there will be frequent hospital visits, investigations and treatment including even the probability of hospitalisation. Long before this sudden turn for the worse, however, the man may have had some occasion in which the amount of urine left in the bladder after he has visited the bathroom progressively increases. He will then have a local area of increased weight below the navel which could become painful over time. The urine having lost its ability to flow freely and when necessary has become relatively static and can be invaded by bacteria to cause a urinary tract infection some of which can spread into the bloodstream and lead to major sickness. The blood pressure can experience a progressive rise and the kidneys can fail progressively as well. The person also will develop erectile dysfunction leading to impotence as interest in sexual activities progressively diminishes.

From this point onwards, the disease tends to accelerate and weight loss picks up pace. There is low red blood cell count and cough with associated difficulties with breathing can follow in quick succession. When there is the unfortunate combination of kidney failure, reduced red blood cell count and weight loss, the heart will also be pushed to fail. In many of such men, it is at this point that they arrive at the hospital. The main aim of treatment then is like an attempt to catch-up. They have arrived too late and too ill and sometimes penniless after having spent all of their resources on herbal formulas and wrong treatments. This has a lot to do with the weak referral system in operation in many states as well as the strong, undiluted faith many people continue to hold about the potency of traditional medical applications. Beyond here, there could be persistent pain in the bones and the tummy will swell as excess water gathers in it in a situation called ascites. Such a man will then look a bit like the children with marasmic-kwashiorkor that we talked about a couple of weeks ago. They will look wasted, have spindly legs and hands and have a potbelly full of water. Most of the body’s fat would have gone and a previously obese man, for example, will soon look like the description above.

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Questions and answers

Dear doctor, what should I use to cure a pile or toilet infection that is itching? It is not coming out and it makes my penis to not be strong.                                   0705xxxxxxx 

Thank you very much. By pile I am assuming you mean you have haemorrhoids. Cure depends on the grade that you have and treatment at any degree will only be determined after it is examined properly. Toilet infection is a huge misdirection as many of these infections are actually not contracted from the toilet. The vast majority come from sexual activities and the rest from poor genital hygiene. That infection is also properly treated when a good examination has been conducted and treatment given. Finally, such an infection is not the reason why your erection is not strong, nor is it due to the pile. But as we have no idea of your age and cannot, therefore, say with any certainty what the probable causes in your case could be. However, if you must deal with the itching, you may use Clotrimazole cream.

 

Dear doctor, how is your day going? I contacted you some months ago about the problem of erectile dysfunction I was having. I asked you then if I could start using sex stimulants, a question which made you ask if I was having any underlying health issues. I told you I didn’t have any and you then recommended the use of Vira capsules at 20mg per dose or Honyhill 50mg whenever I am in the mood. But I saw some alarming news in a newspaper yesterday that the use of stimulants can send men to their early graves. Is that true and if it is, what should I do? I am 65. Thank you very much for the service you are rendering to humanity.                 0803xxxxxxx

 Thank you very much for the comments you have made. First of all, you have no health challenges so that despite your age, these medications are safe for your use. The people who cut their lives short are those who obtain these drugs on their own; have some health problems such as high blood pressure, heart disease or vascular diseases but probably do not even know they have them. Besides, those who take a cocktail of medications to achieve what they believe is the ideal effect. Some of those people combine these medicines with others or take it with alcohol or other unrelated medications such as tramadol. You do not belong to any of these categories as far as you have said, so you have no reason to worry. The key advice given when we discussed erectile dysfunction on this page late last year was that anyone with this challenge should see a doctor for a proper examination before starting the use of any of them. The aim of the doctor’s examination is to unravel these problems and find the appropriate drug to prescribe for the patient.

 

Dear doctor, please I have an infection of athlete’s foot and jock itch. I will, therefore, need a prescription. Regards. 0703xxxxxxx

We can only take your word for it and assume you know what it is you are talking about. Certainly, it is possible for these two conditions to co-exist and some people have given jock itch the derogatory name of “sweetie.” You do not need a formal prescription from this page; you already had it properly described last week and all you have to do is go to a proper pharmacy where there is a resident pharmacist and get Clotrimazole cream which they will direct you on how to use.

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Dear doctor, please help me; I am 67 years of age but do not have libido for sex. Kindly help or make a recommendation for me as appropriate. Thanks and God bless you.  0806xxxxxxx                    

Thank you very much for your prayers, sir. God will bless you too sir. Amen. The key advice given when we discussed erectile dysfunction on this page late last year was that anyone with this challenge should see a doctor for a proper examination before starting the use of any of the named medications. The aim of the doctor’s examination is to discover what health problems you might have before taking a decision on which one of them best suits your needs. As I have not had the chance to examine you and you did not disclose if you have any pre-existing health condition, it is difficult to make out an appropriate prescription. So in summary, you must see a doctor to determine if you have hypertension, or heart disease, or a blood vessel condition before you start such a drug.

Dear doctor, how many days or weeks does one continue to use once the rash is gone?                           [email protected]

All together, it is used for an average of two weeks for most skin infections. So that its use should continue even if the problem clears in one week. For problems like an athlete’s foot, it can be in use for several months. In the end, the duration of usage depends on what the problem is and what the judgement of your doctor is.

 

 Dear doctor, please, sir, I want you to recommend a drug that I can use to prevent and cure prostate cancer because the result of the investigation I did, PSA (prostate specific antigen), and it shows 0.1ng/nl (0-4ng/ml) which was carried out at the Military Hospital, Yaba. Thank you. Regards. [email protected]

Good day to you as well. A PSA result of 0.1ng/ml is negative. You have no reason to even think of such a drug at this time because you are not even within a striking distance of getting prostate cancer.

 

Dear doctor, I am the 78-year-old fellow who wrote to you a few weeks ago asking for advice on his hoarse voice. So thank you very much for the prompt response you gave. Now, is it okay for me to also take iced water or cold water every day or every other day? Have a wonderful weekend, doctor. 0802xxxxxxx

Good morning to you sir. Thank you so very much for your very kind words. It is imperative that you avoid taking cold or iced water while the symptoms you have still persist. Iced water, in particular, constricts the blood vessels within the vocal cords and reduces their drainage. This delays the resolution of the problem. You have a wonderful weekend as well.

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