An Open Letter To President Mahama On Prostate Cancer In Ghana: Time To Take Action!

Good Morning His Excellency! I am writing you this letter from Dodowa, the best town in Ghana currently. So please, you just hear me out and withhold judgment as some may think that I am writing from Dodowa; so why should you take my words seriously.

Mr. President, as a young alternative medical practitioner, who specialized in prostate cancer, a prostate cancer researcher and a PhD student working on my thesis now and an advocate of men’s health from my Prostate Research Lab and Men’s Health Foundation Ghana; the country’s biggest men’s charity working with people affected by prostate cancer. We were established in the year 2013 with the broad aim to raise awareness, offer free screening programs and support men affected by prostate cancer through providing them with relevant information regarding prostate cancer treatments.

Mr. President, I started this concept partly because I saw how men received wrong treatment options regarding prostate cancer and how men are doing everything possible to save their manhood for good! The treatment for prostate cancer comes with lots of side effects and pensioners cannot afford it even paying for the screening using the PSA test. Do men even get the best treatment for the amount of money they pay for prostate cancer treatment in Ghana? There are more questions than answers!

Mr. President, men’s health issues have been low on the agenda, recently, Citi FM reported that the urological problems in this country are serious. According to the report, there are more than 400 men who are wearing catheters who come every three to four weeks to have it changed at Korle Bu. 1 in 5 Ghanaian and 1 in 4 black men will get prostate cancer in their lifetime (Men’s Health Foundation Ghana, 2015, Prostate Cancer UK, 2013). Close to about 1,000 men are affected by prostate cancer yearly in Ghana and the most worrying aspect is the number of deaths per year—800. Another report also revealed that Ghana has exceeded the global prostate limit and about 70% of cancer cases in Ghana are at the late stage of the disease.

Mr. President, I am writing this letter to you to consider prostate cancer and men’s health issue a key area on your agenda. I am writing to you to consider a special program on prostate cancer dubbed a “Presidential Initiative On Free Prostate Screening on the NHIS or empowering the Men’s charity to offer free screening programs in the country as we have the expert to carry the program and already have started a pilot project in Dodowa at our Research Lab. The Men’s Health Foundation Ghana have been offering free prostate screening and providing expect talk program; but the challenge has to be funding for the program as early detection and awareness is the key to save lot of Ghanaian men.

I am also writing to you to declare every Father’s Day a prostate cancer awareness day so that awareness on prostate cancer can go far starting from this year Father’s Day in June just like the Valentine Day has become the Chocolate Day in Ghana. In this case everybody will talk about prostate cancer and free screening programs will go on that day. If you speak once on prostate cancer as a man yourself we are on cause to raise awareness. I also bring your attention to also recognise September as National Prostate Cancer Awareness Month as it is recognised globally a prostate cancer month and most presidents issue statement in September to start the celebration.

Mr. President, I also bring your attention to some herbal centres misinforming the general public on prostate cancer cure and something has to be done with the Traditional and Alternative Medicine Practice Council on advertisement concerning health issues.

Mr. President, prostate cancer is one type of cancer with lots of disparities with most researches not factoring in black men; hence there need for Ghana to have a National Cancer Foundation so that we start local research into prostate cancer and other alternative ways of treating the disease. The over-reliance on foreign research is becoming too much and not beneficial to black men, especially prostate cancer and it was evident when the US Task Force called for abolishment of the PSA test for prostate cancer screening.

Mr. President, many countries are developing pragmatic measures to fight prostate cancer. In the UK, the Public Health England, with support from Prostate Cancer UK, is launching a local Be Clear on Cancer pilot in London to raise awareness on the increased risk of prostate cancer amongst Black men aged 45+. 1 in 4 Black men in the UK will be diagnosed with prostate cancer at some point in their lives compared to 1 in 8 of all men.

The campaign will target Black men from all socio-economic groups over the age of 45. It will also target their key influencers, such as wives/partners, friends and family. The campaign is using 45 as opposed to 50 as Black men have been shown to be diagnosed with prostate cancer on average five years younger than white men. So if you are a black man and 45 years above whether you have symptoms or not you are entitled to free prostate cancer screening on the NHS. Other countries are also addressing prostate cancer in black men and it is time for Ghana to rise up.

Mr. President, The Men’s Charity is also appealing to you to help us with a mobile van to enable us go to the rural areas to raise awareness and offer screening programs. I know you are really proud to see young professionals doing charitable programs to help Mother Ghana. You even paid a cocoa farmer a visit on his farm and I know you can even pay us a visit at Dodowa or probably invite us to discuss prostate cancer and the way forward in Ghana because we believe men deserve better treatment for prostate cancer.

Mr. President, there is no single thing that causes prostate cancer; it is a spectrum of diseases and not a single entity! In my PhD in prostate cancer journey, I realised that for one, our cells don’t get cancer. They can’t have cancer. They cancer. Coupled with the overwhelming resignation many Ghanaians have regarding the certainty of cancer, little efforts seem to go into the ultimate cancer cure: its prevention.

By looking at the body as a complex system, whether or not we fully comprehend the system, we may very well be able to notice causal relationships between body systems that were never seen before. Things like regular inflammation, even from wearing high-heeled shoes, can have a hand in causing a person’s cells to “cancer.”

I have realised that cancer is often misunderstood by even the most respected medical professionals in the world. Part 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.

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!

But while one-size-fits-all “magic bullet” pharmaceuticals have found ways to cure diseases caused by invader stimuli: the answer to a disease caused by our own wayward cells may require a very different approach. If the problem is within our system, the solution can only come from understanding how our own body works-black men!

I know readers may be wondering and asking if cancer is unavoidable? No. The choice to die without disease is ours to make, right now. And I don’t know about you readers. But trying to live my entire life cancer-free seems like a pretty formidable goal as I embark on because of my research work.

Mr. President, prostate cancer is not an equal opportunity disease and I believe that unless we tackle the primary prevention of cancer i.e. stopping cancer before it starts, we are unlikely to see any improvement in the cancer situation in Ghana. There are many barriers to action on the primary prevention of cancer; cancer is also caused by lack of political will power to fight it. In my view, the biggest barrier to addressing cancer services is the lack of action on primary prevention which necessitates greater resources into services in the first place.

I sincerely hope this is a great opportunity to include the environmental and occupational risk factors for cancer into new cancer plans…without addressing these confounding risk factors we can only look forward to a cancer forever future.

There are many risk factors to consider—race, family history, physical health and lifestyle—even geographic location, bio-chemical difference—are all factors that can increase the likelihood of developing prostate cancer. Most of these risk factors are not necessary cancer casing agent.

Mr. President, some of the reasons why men of African ethnicity are more prone to prostate cancer include the lack of health workers, the quality of our healthcare system, distrust in the medical sector, lack of screening programs and centres across the country, few charities fighting against men’s prostate issues, our tertiary institutions not running courses in prostate cancers to train expert in the management of the disease, cancer registries and misinformation regarding right treatment option in the media.

Although the PSA is not tumour-specific but organ-specific it is still the best marker for prostate screening programs and it can be improved upon by smart screening as the Prostate Cancer risk management program in the UK. The US Task Force did a disservice to black men. Cancer disparities exit and it is time we take men’s health issues in Ghana seriously and start the campaign and free screening program to reduce high mortality rates in the county.

Mr. President, although it appears most men diagnosed with prostate cancer are pensioners and cannot even afford the treatment and some have called for the inclusion of prostate cancer treatment on the NHIS, it is a good thing. But my only challenge with this is that if it is included will men make their informed decision on the type of treatment choice they deem it right for them or they will be subjected to the one that the NHIS can afford? I am asking this question because prostate cancer treatment comes with lot of side effects.

So if men will be allowed to make their informed decision and choices on the treatment they think it is good for them we will be on course.

Thank you, Mr. President and hope to hear from you.

God bless Ghana
God bless Mr. President
God bless Men’s Health
God bless our health care system
God bless our Manhood for Good!
We don’t have to sleep on duty as men because of prostate cancer treatment!

Thank you Mr. President and hoping to hear from you as Father’s Day approaches.

Dr. Raphael Nyarkotey Obu is a registered alternative medical practitioner who specializes in Prostate cancer and studied the Masters program in prostate cancer –Sheffield Hallam University, UK and a PhD student, Indian Board of Alternative Medicines Academy, Kolkata, India and the founder of Men’s Health Foundation Ghana and De Men’s clinic and Prostate Research Lab in Dodowa, Akoto House. Tel: 0541090045, 0500106570. E.mail:[email protected].