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Why Ghanaian Men Will Be Negatively Affected By Prostate Cancer?

Feature Article Why Ghanaian Men Will Be Negatively Affected By Prostate Cancer?
OCT 21, 2014 LISTEN

Prostate cancer is not an equal opportunity disease. In fact, black men are at higher risk for prostate cancer than are white men, Asian men, and Hispanic men. To make matters worse, prostate cancer is more aggressive in black men as well as more deadly. Why is the picture of prostate cancer so gloomy for Ghanaian men, and more important, what can we do about it?

In this paper I will examine the factors that might influence the mortality and quality of life of Ghanaian men looking at the health service and provision in Ghana and the use of traditional medicine. I will also discuss the physical and psychological impact of definitive treatment, important of sexuality and support available. The quality of treatment received and the health related quality of life of prostate cancer patients will differ according to race and access to healthcare, even after accounting for patient and disease characteristics, type of primary treatment and other factors. Relying on traditional medicine and forsaking conventional treatment could be a calculated gamble for Ghanaian men.

Mistrust in the health sector between Herbal practitioners and medical practitioners is also a factor contributing to increased mortality amongst patient hence the need for a multi-disciplinary approach to prostate cancer management to reduce the worrying disparities in Ghana. Indigenous practitioners must submit their claims to be peer reviewed in scientific journals so that everyone can have access to it and this will also breech the gap of mistrust and this will also pave way for the traditional practitioners in the country as prostate cancer is a worldwide problem and research are going on to find better treatment options for men.

In Ghana under diagnosis of prostate cancer incidence is likely in population with health care access. Quality of the medical care systems and registries also may have substantial impact on the completeness and accuracy of the reported incidence in Ghana. Availability of pathology services reflected by percent of cases microscopically verified likely compromises the quality of cancer diagnosis. Thus the true Prostate cancer incidence in Ghanaian men is likely higher than what is reported. Whereas in the advanced countries, screening for PSA has led to early detection and management of the disease, screening has been low in Ghana, thus leading to low detection rate, poor management and increased mortality. Lack of screening facilities is also a major challenge in Ghana.

Alternative remedies
Traditional remedies have received a major patronage in Ghana due to media advertisement. Reasons why patients seek therapies is fundamental in evaluating their use– that is, distinguishing where possible the factors 'pushing' patients away from Orthodox medicine and those factors 'pulling' patients towards traditional medicine.

Orthodox medicine, Ghana – 'push' factors
Failure to produce curative treatments, adverse effect of orthodox medicine, e.g. chemotherapy side-effects; lack of time with practitioner; loss of bedside skills, dissatisfaction with the technical approach and fragmentation of care due to specialization.

Herbal Remedies Ghana–'pulls' factors
Media reports of dramatic improvements produced by herbal remedies and Massive advertisement and claiming of treatment cure.Belief that these therapies are natural and do not affect sex life.

Importance of sexuality and support available
Sex issues appear very important for men especially Ghanaian men in Prostate cancer treatment. Some treatments for Prostate cancer can have an impact on your sex life. But there are solutions and things that can help. Some men have common worries like having sex will not affect their cancer or the success of treatment. Fear of catheter insertion also scare Ghanaian men of going to the hospital leading to advanced Prostate cancer with increased mortality rates in Ghana. Sexuality is a key role since the men don't want to sleep on duty! Men must be told that erections are safe even if they have their catheter in!

Prostate Cancer Risk Factors in Black Men
Experts have come up with a few risk factors that may at least partly explain why black men are at higher risk of prostate cancer and more aggressive and deadly prostate cancer than are men of other populations. Environmental influence is another factor. Skepticism: Black men tend to be less trustful of their physicians than are white men. They also tend to be less likely to see the same doctor on return visits for care and less likely to be screened for prostate cancer.

Quality of health care: Black men are less likely to have health insurance and/or access to health care, which means they are less likely to have prostate cancer detected at an early stage.

Black Men as Patients: Blacks are often diagnosed with more advanced cancer and are more likely to have other underlying health problems

Underuse of care: Black patients are less likely to be advised about cancer screenings and less likely to receive surgery or chemotherapy

Hospital systems: Hospitals that treat primarily black patients tend to have fewer resources and offer lower quality care

Genetics: A Harvard School of Public Health study indicated that genetic differences may be important in determining prostate cancer among black men. Researchers noted that the average number of androgen (hormone) receptor gene CAG configurations was lower among black men than among white and Asians.

Vitamin D: Vitamin D helps protect against prostate cancer, but generally individuals do not get enough of this important nutrient. Black men are especially prone to having low or deficient levels of vitamin D because they have dark skin, which is less effective at producing vitamin D than is lighter skin. Therefore, they need to either spend more time in the sun or be sure to take vitamin D supplements.

Calcium absorption: You may think the ability to effectively absorb calcium is a positive characteristic, but for some black men, it is not. In fact, researchers at Wake Forest Baptist Medical Center discovered that calcium increases prostate cancer risk in African-American men who have a certain alternative form of a gene (called a genetic allele). This allele enhances the calcium-absorbing abilities in men when compared with individuals who don't have the allele. Overall, investigators found that black men who were genetically predisposed to absorb calcium poorly were 59 percent less likely to develop advanced prostate cancer than were men who had the genes that allowed them to absorb calcium well. Therefore, calcium increases prostate cancer risk in African-American men

How Ghanaian Men Can Protect Themselves
Admittedly, the news concerning black men and prostate cancer is not reassuring, but that doesn't mean wecan't take steps to reduce our risk of developing prostate cancer or dying of the disease. The following steps are suggestions for all Ghanaian men. Get screened for prostate cancer beginning at age 40. Although the typical age to begin screening for prostate cancer is 50 for men of other races, and get a prostate-specific antigen (PSA) test, ultrasound scan of the prostate and a digital rectal examination (DRE). Remember: prostate cancer is more aggressive in black men, so the sooner the disease is detected and treated, the better.

You can also supplement with vitamin D if you check and is low and you talk with your doctor.

Be careful of calcium intake and limit calcium intake to no more than 1,000 mg daily, which is the recommended daily allowance, and get calcium from food (preferably non-dairy foods such as leafy greens, sardines, almonds, and calcium-fortified orange juice) rather than supplements.

In conclusion Prostate cancer is affecting a larger proportion of Ghanaian male population with low awareness of the disease and poor treatments option information. Lack of screening centers and support groups is also a contributing factors leading to increased mortality. There must be collaboration in the health between herbal practitioners and medical practitioners needed in the fight to save lives. The illness and treatments affect patients' quality of life in multiple spheres. Issues such as sexual dysfunction, urinary incontinence, bowel changes, fatigue, pain, hot flashes, body image changes, and forced lifestyle changes lead to psychological distress. Avoidance of these issues leads to increased suffering, significant psychological distress and feelings of despair, isolation, hopelessness, and passive thoughts of wanting to die.

When you are also diagnosed with prostate cancer seeks for multiple expert opinions and plans your cancer team because the cancer journey is a long pathway because herbal practitioner will recommends herbal medicine, a surgery will also recommends surgery and it goes on like that and it is time to consider a specific policy on prostate cancer in Ghana to reduce the worrying disparities and more treatments options needed for men to make informed decision.

Multidisciplinary care also needed in Ghana, the strategy gives prostate cancer patients access to a surgeon, a medical oncologist, and a radiation oncologist, urologist, and medical imaging expert, uro -oncology nurses, social workers, nutritionist, cancer psychologist and Naturopathic Oncologist -- all in a single visit. The care team then decides as a group what's best for the patient, easing the bias for any one specialty.

Such multidisciplinary care has been common in Europe and is often used in the United States for breast and lung cancers, but it can be expensive and difficult to structure outside of large, sophisticated hospitals.

The approach may be increasingly useful as prostate cancer patients now face a complex array of treatment options, including different surgical methods, radiation therapies, and active surveillance.

RAPHAEL NYARKOTEY OBU: ND
Registered Naturopathic Doctor (TAP 00396) & Prostate Cancer expert

MSc Prostate Cancer-Sheffield Hallam University, UK

CEO DE MEN'S CLINIC & PROSTATE RESEARCH LAB, MEN'S HEALTH FOUNDATION GHANA-DODOWA, AKOTO-HOUSE. Tel : 0541090045

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