25 July 2008
Kenyan men should brace for bad news — it has been confirmed that cases of prostate cancer are highest in Africans compared to other races.
The good news is that scientists recently discovered a “wonder drug” that can cure up to 80 per cent of the cases.
But why are Africans and men of African extraction more prone to the disease? Because of their genetic make-up.
The gene responsible is called ODC with a certain variant found in higher frequency in indigenous Africans and men of African ancestry than in other races.
Studies have indicated that Asians are least likely to have this gene, explaining why they have the lowest rates of prostate cancer.
The prostate is the gland below a man’s bladder that produces fluid for semen. Prostate cancer is the third most common form of cancer in men after lung and tumours of the head and neck. It is rare in men younger than 40.
Reliable treatment
Recently, medical experts in Kenya carried out studies on the rates and treatment of the disease and concluded that the disease was on the increase and there was no reliable treatment for advanced cases.
In a special supplement of the East African Medical Journal, Prof George Magoha, a urologist and Vice Chancellor at the University of Nairobi, said Kenya should increase the screening for the disease.
But the new drug has been described as potentially the most significant advance in the field of cancer research in the last 70 years.
Reported in the current issue of the Journal of Clinical Oncology this week, the new drug, Abiraterone could be available as a simple pill in two years.
According to the study, carried out by the University of Edinburgh, some of the treated patients, all with advanced prostate cancer, stopped taking pain relief medication within a short time after they started taking Abiraterone.
Advanced clinical trials involving 1,200 patients around the world are currently under way.
Another medical specialist, Dr P M Ngugi, a senior lecturer at the University of Nairobi, said the current hormone related treatment is effective but has the side effect of decreasing a patient’s physical activity.
“Androgen withdrawal therapy has a significant effect on walking speed and a physical performance in men with prostate cancer,” Dr Ngugi wrote in the East African Medical Journal.
Most of the other prostate cancer treatments, including radiation and medical castration have the effect of reducing sexual potency. Considering that one of the major reasons for treating cancer patients is to improve or retain a good quality life, lose of sexual prowess can be debilitating.
According to another study by Dr D. K. Kiptoon of Meru District Hospital, some of the patients seeking treatment for prostate cancer are as young as 46 although the mean age is about 66.7 years.
A family counsellor says that erectile dysfunction, which is linked to prostate cancer, poses a great challenge for many men and sometimes undermines patients’ will to live or fight the malignancy.
Another side effect of the hormone withdrawal treatment, according to Dr Ngugi, is that it leads to a patient experiencing hot flushes.
The logic behind this form of treatment is that the cancer is driven by sex hormones such as testosterone produced in the testicles. This treatment works by stopping the testicles from producing testosterone.
However, experts have now discovered that the cancer can feed on sex hormones from other body sources, including supplies of the hormone produced by the tumour itself.
Abiraterone, on the other hand, works by blocking production of the hormones throughout the body. Of those men who received treatment, the research panel wrote: “They have very aggressive prostate cancer which is exceptionally difficult to treat and almost always proves to be fatal. We hope that abiraterone will eventually offer them real hope of an effective way of managing their condition and prolonging their lives.”
It is hoped that the drug will also aid other cancer patients, including those with breast cancer. Typical life expectancy following chemotherapy is no more than 18 months but with the new product it is hopped this will improve significantly.
Dr Ngugi and other specialists will definitely be following the progress of this product keenly. “No major breakthrough has occurred in developing news products for the treatment of prostate cancer in a long, long time now.”
However, the biggest disappointment to the Kenyan male is confirmation by researchers that Africans have the highest rates of prostate cancer in the world.
“Prostate cancer incidence and mortality is higher for Africans in the Diaspora than all other races in the world,” wrote Prof Magoha in the special supplement.
The highest rates of the disease have been recorded among people of African descent in Kingston, Jamaica. The lowest are in China and other countries in Asia.
For many years, say the local researchers, prostate cancer was thought to be rare in Africans. But recent studies indicate this was only because of lack of adequate studies in the region.
Prof Magoha indicates his interest being piqued by one study which had indicated that prostate cancer incidence in Nigeria was similar to rates reported among men of African extraction in the US or in Jamaica.
Compare experience
The urologist, then set out to compare his experience at Kenyatta National Hospital, with the Nigeria studies and found similarities in the rates. He also noted that Kenyans with the cancer presented themselves to hospitals when it was too late for effective management.
He then concludes that, prostate cancer prevalence in Kenya is comparable to the high incidence rates reported in African Americans and other men of African ancestry in the Diaspora.
Prof Magoha studied data from all parts of Africa and compiled the findings in the medical journal.
He said that most men who report with prostate cancer for treatment do so when the disease has progressed too far.
Following about 85,000 patients who were examined at KNH for one year, it emerged that 87 per cent sought treatment when the disease was at an advanced stage. Ages affected started from 50 years peaking at between 66 and 70.
Because of late presentation, the two experts said it had been difficult to reduce mortality rates. “Survival is greatly affected by stage of the disease at diagnosis.”
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