9 January 2013

Ghana: Cancer Versus Man, Who's Winning?


Due to the copious means of information in the entire world, and also the increasing number of medical personnel in numerous fields in every society, there is an increasing mode of anxiety to get to know what may be said to be wrong with mankind health-wise, and more so, with the notion that, something could be done about what might afflict us, by way of innate diseases.

One doesn't spare any moment, when the chance to be informed seems to be "within grabbing." We just went through a period in the Gregorian calendar, where the 'Holy feast of Christmas is spent, and billions of people participate.

A man of about 68 years of age sat about ten meters from a table which I had been ushered unto, and I was enjoying a meal not any longer so common on a Ghanaian menu, but, when available, it is quite delicious. It is called "Aprapransa." Its base is corn, but a dozen of other ingredients come together to give it the irresistible appeal, -smell, appearance, taste, and the property that, it such fills you, and you regret nothing. It was after enjoying something of that nature, that someone from the nearby table approached me. He was very polite, and from the very first sentence, he managed to have cleared all doubts of his high presumed standard of education.

He was tipped by a friend as to what I do for a living, and that being the case, he felt he could top up with some information, on some problem, "at heart." He had undergone surgery for PROSTATE CANCER, not quite three months before he and his wife for thirty years had embarked on the visit to his home, a visit he had only once undertaken, since getting married, and they had grandchildren. He told me that it was a tough decision for him and his family to go along with the advice of their Urologist, (the Specialist for the type of cancer the gentleman is supposed to have been afflicted with). It was after six weeks of discussion, and opinion tussle, that he finally decided to go for it.

It was surgery, (a kind of prostatectomy, with addition of a special type of radiation, and a series of Chemotherapy). Prominent personalities in America who haven't kept their "prostate cancer" a secret, include the "IRAQ-WAR FAMED" General Norman Schwarzkopf. All men above the age of 45 run the risk of contracting a tumor of the prostate, benign or malignant. A lot is being recently written by "SPECIALISTS" on Prostate Cancer. Patients like General Schwarzkopf contribute to increasing awareness.

Urologists should know best about it, but Neurological Surgeons are increasingly being forced to getting more and more "inquisitive", because of this tumor's propensity of sneaking into the Neurosurgeon's domain of anatomy, and the function thereof. The inquisitiveness is, therefore, not out of arrogance, but this type of cancer "carries the trend" of encroaching upon the nervous system, i.e. "the brain, and the spinal cord, with some appendages called "plexuses", or you could say, bundles of nerve-fibers, the lumbar, and brachial, whereby the lumbo-sacral tends to be more often entangled. It destroys bones: the spine, and the skull-base.

The noble gentleman was advised to approach me, at a "yuletide function", because, I have penned a couple of general newspaper articles, in an attempt to educate the general public of this sensitive topic, which so concerns a lot of men, and invariably, "their spouses" as well. The spouses, usually getting into their late fifties, but frequently early sixties, "get so concerned", because, eventually sexual satisfaction sooner or later might suffer, and oftentimes, not temporarily, but for ever.

The erudite wealthy man, near his seventies, from an advanced society, had heard almost everything there would be to hear from men and women in the fields that handle the victims of this "sensitive and readily, slowly devastating and fatal malignancy". Who would not cling to even the smallest morsel of hope? So, you would, as a patient be eager to ask questions, and questions again, in the hope of stumbling onto a useful tip, and for free!

You would be obliged, for the "neat gathering, and truly debated", none would be offended with a genteel surprise. You could one day be taken by surprise through a late afternoon call, and the caller could be from a close relation, who may announce from the emergency-admission of a male relation, around the age of mid-fifties, or late sixties. In each case, the message would add that, he all of a sudden complained of not being able to pass urine, and he was in excruciating spasmodic pain.

If you could rush to the scene, you would find your "male loved one" not in such a dignified state, -and a rubber-catheter inserted in his male organ. The story will continue with administration of medications, none of them so cheap. The pain may ease, and he might be able again to pass urine spontaneously, so there might be the wish of the patient first, but of the Doctor too, to go home. There would be a second or third episode, and the prostate will finally be taken out. The Neurosurgeon may come in, when in some situations, the patients may complain of numbness in the legs, or dragging of a foot. In some other situations, he may convulse, and might be unable to understand, or let out speech appropriately. Neurological investigations, with adjuvant imaging might disclose lesions along segments of the vertebral column, with pelvic involvement, and cranio-cerebral lesions as well, called metastases.

The Neurosurgeon is stretched to the extreme, because, try as he might, his knife would not restitute much of a function. It seems true though that, detected early, (early listening and interpretation of the patient's complaints, and inception of imaging, preceded by PSA-assessment, oncological care would promote the executive's life, both qualitatively, and for the length of survival.

The question posed by an erudite sufferer, early-detected prostatic cancer sufferer dared ash; "just how useful is the prostate gland? Would it make a difference in the executive's life, if at some stage, the prostate could be "excised?" Much as it ought to have been the Urologist to be asked this question, it may not be a scientific enough question, but it has been asked. Remember the German saying, "There are no stupid questions, only stupid answers."

Kofi Dankyi Beeko, MD, Consultant Neurosurgeon

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