YOU may be in good health now, bubbling all over the place. You may be a minister, governor, commissioner, or legislator in the federal or state House. You may be a successful businessman or a professional at the top of your career-doctor, engineer, architect, accountant, lawyer, professor, surveyor, public relations or advertising guru, IT specialist, or what have you. You may be a newscaster, editor, reporter, or a columnist, like me. You may be a farmer, tailor, bricklayer, carpenter, electrician, welder, driver, or tailor. You may even have retired after many years of service. Whatever your vocation or stage in life, please go to a doctor today and ask him or her to examine your prostate. It could be a life saver for you.

I feel compelled to give this advice for three major reasons: First, prostate cancer is the second leading cause of cancer death in men. As a rule of thumb, it is often said that men over fifty often die of prostate cancer or die with it. Over 100,000 cases of prostate cancer are reported yearly in government hospitals in Nigeria, where most official statistics are collected. Many more cases go unreported, especially in remote clinics and rural areas. Some of such cases are even often misdiagnosed.

Second, I have lost far too many relatives, friends, and acquaintances to prostate cancer, many of whom should still be alive today, if only they knew or had a doctor intervene early enough. I still have not recovered from recent losses to prostate cancer, one a relative and the other a friend of over 40 years.

Third, educating the public through informative reports and columns like this one is one of the major functions of the press. This function has been unnecessarily displaced by undue focus on politics. Yet, many citizens could have been saved if only they knew what to do and at the appropriate time.

Although the symptoms or signs of prostate cancer may not be detected for a long time, there are minor changes that should not be ignored. They include frequent urination; finding it difficult to start or stop urination; slow, weak or interrupted urinary stream; pain or burning sensation when urinating or ejaculating during sexual intercourse; and blood in urine or in semen.

Other symptoms include pain in the low back, hips, or thighs. If the pain becomes intense, it is quite possible that the cancer has spread beyond the prostate.

To be sure, these symptoms do not automatically translate to prostate cancer. They could mean that either your prostate has grown larger (technically known as Benign Prostatic Hyperplasia) or it is inflamed (Prostatitis). Enlarged prostate often comes with old age, whereas inflamed prostate often results from bacterial infection. Such an infection often follows urinary tract infection, contracted during sexual intercourse with an infected person.

Both of these non-cancerous conditions can be treated with appropriate medication, although surgery may be needed for complete treatment of an enlarged prostate. Only a qualified doctor can tell you precisely which is which and which course of treatment to follow, and only after thorough medical and laboratory examinations. It is important to emphasise that prostate cancer may also lead to the enlargement of the prostate. That’s why the best way to differentiate it from the other two conditions is by identifying cancer cells in a biopsy of the prostate itself.

However, ordering a biopsy is not going to be your doctor’s first line of action if your prostate has never been examined. First, a digital rectal exam, using a gloved and lubricated finger, will be performed to determine the size and texture of your prostate. The doctor will mover his or her finger around to feel the prostate wallIs it enlarged? Is it soft or very firm? Does it feel smooth or have bumps?

Second, depending on your doctor’s finding, you may be ordered to give a blood sample to determine the level of a particular protein produced by the prostate. This protein is known as Prostate-Specific Antigen. The PSA level, as it is called, will indicate whether or not you have a higher chance of having prostate cancer.

In order to determine your PSA baseline, it is important to see a doctor now to order a PSA test, even if you have none of the symptoms listed above. Your urologist will compare your future PSA test results over time against this baseline.

As a rule of thumb, a PSA level less than 4 nanograms per mililiter (ng/mL) of blood is considered a normal level. However, a level greater than 10 ng/mL often suggests the possibility of cancer. Mind you, individuals vary greatly on this scale. Some may have prostate cancer even when their PSA level is below 10 or even less than 4! This is the more reason to start early on your own investigation. Don’t wait until cancer is actually present in the prostate.

A further complication with PSA levels is that they can be increased by BPH and Prostatitis, leading to a false positive test result. That is, while it is true that the PSA level is elevated, it does not follow that cancer is present. Moreover, some medications may also suppress your PSA level by giving a false negative test result.

The third and most determinative test for prostate cancer is a biopsy of the prostate. A piloted needle is inserted usually through the rectum to remove small samples of tissue from the prostate. The samples will be examined for cancer tissue under a microscope by a pathologist.

Once the result gets back to your doctor, he or she will determine the course of treatment. Fortunately, recent medical advances have made a variety of treatment options possible. I will examine those options in more detail next week.

In the meantime, I cannot emphasise enough how important it is to get started early, if not immediately, by visiting your doctor and getting examined. I know a number of people who had prostate cancer over twenty years ago and are still alive today, because the cancer was detected early and they quickly underwent surgery to remove the prostate. They may develop other cancers, but prostate cancer will never be one of them.

Prof. Niyi Akinnaso