Experts in cancer medicine have linked prostate cancer to several factors including age, family history, race, and diet. Studies done on the disease show that a man’s risk of developing prostate cancer increases if he has a close relative, such as a father or brother, who a history of the disease.
For Timothy Lwanga, a music programmer at a local radio station, the disease is rooted in his family. And sadly it has claimed three family members: his father, his father’s twin brother and another uncle.
Lwanga’s greatest fear is waking up one day to be told that he also has a disease that he hopes should never claim another family member.
“In fact for me I fear cancer more than I fear HIV, because with HIV, there are drugs that prolong life for more than 30 years. Cancer can get you even when you are the healthiest person, you eat healthy, you exercise, you donnot drink alcohol, and you do not smoke. And for me, that is the most scary thing,” he says.
Cancer ambassador
The 41-year- old has now become a self-appointed ambassador and activist, creating awareness of the disease, which he says is still a silent killer in the country.
He uses every opportunity he gets to urge colleagues, friends and family to test for prostate cancer.
Tracing the disease in the family
His father’s twin brother became the first victim of prostate cancer, which Lwanga suspects could have been inherited from his great grandparents.
That was in 2004. Unfortunately, it was too late because the disease had spread beyond the prostate. To make matters worse, Lwanga’s uncle also suffered from cancer of the barin which complicated his treatment process.
He passed on a few months after the initial diagnosis. And so did his other uncle.And his dad’s troubles began in November 2006. He remembers his father as a very strong man despite having suffered ulcers for many years.
“He had suffered ulcers as a young man even before he married my mum but he always knew how to take care of his health. He always watched what he ate, exercised, and performed several medical checkups,” Lwanga recounts.
Ironically, his father never did any tests for prostate cancer until he went on holiday in Nairobi, following an accident that dislocated a part of his spinal cord.
It is during this short time in Nairobi that his younger sister advised him to do a comprehensive medical checkup. The test results showed he was positive for cancer of the prostate.
Fortunately, it was early to be treated – at least that’s what the doctors told him.
Cancer surgery
Lwanga’s father went on to have his prostate removed through surgery in 2007, with hope that the disease would cure.
“But you see, cancer is like fungi. You cut one, two others develop. Sometimes removing cancer worsens the situation and doctors, in most cases do not explain this to patients,” says Lwanga.
“Leaving it and containing it using drugs can prevent further spread in some cases. So it requires doctors to study each individual case, and then explain the options that a patient may have,” adds Lwanga, who has become a very passionate advocate on prostate cancer awareness.
“As a matter of fact, there are people who have had cancer of the prostate and are still living on drugs. Often, when a patient is diagnosed with cancer they get scared and they want the prostate removed immediately not knowing that this may increase further spread. I am not blaming the doctors but they need to be more open to patients about their options.”
Lwanga’s father lived a normal life for three years after his prostate was removed.He did not have any reason to worry because he knew he been cured after the removal of the prostate.
Unfortunately this was not to last for a long time. The cancer was slowly returning and this time, it was more aggressive. Doctors said it had spread.
Costly treatment
“My dad had a very interesting body immunity. He responded very well to medication and every time he got treatment, his cancer receded. The only problem is that the drugs were very expensive,” explains Lwanga.Nevertheless, his family stood with him and paid for all the necessary treatments. He took his medication religiously, and he went for chemotherapy without complaints. But most importantly, he lived his life in sickness positively which made it easier for those who cared for him to endure being with him despite the seemingly unbearable pain he suffered.
“During his final days, I was planning to get married. We almost cancelled the event but my father wanted to witness the wedding. We pushed on reluctantly, but somehow God blessed us, and the wedding took place,”says Lwanga.
But three days after Lwanga’s wedding, his father passed on. That was on July 3, 2012.
Today, apart from raising awareness about the disease, Lwanga does routine cancer screening tests. He says he does not want to be caught by surprise, and only learn of it when the disease has progressed.
“I do not want people to come for another funeral in our family because of prostate cancer. I do not want it to be the curse of the family. I keep telling my relatives to test so that if it is found, they can be treated early,” Lwanga notes. His message to fellow men is to test. For those who have had some family members who have died or been diagnosed with prostate cancer, he says going for tests at least once every year is recommended.
“Every man has a prostate gland, anytime the cancer can develop. It does not matter what age they are in. Every man is a potential candidate for prostate cancer,”he concludes.
What doctors say
In Uganda, there are no clear statistics on how big the problem of prostate cancer is, but Jackson Orem, the director of the Uganda Cancer Institute, says that for the past 10 years, there has been an upward trend in the number of Ugandan men being diagnosed with this type of cancer.
Data obtained from the institute show that there are at least 39 cases for every 100,000 men in the over 50 age bracket who present with prostate cancer.
Even though doctors say 90 per cent of prostate cancer cases can be cured if detected early, most patients show up in hospital when the disease has advanced.
Dr Frank Asiimwe, a urologist in the department of Urology at Mulago, prostate cancer is one of the fast growing cancers in Uganda and the challenge is that fewer men will check for cancer status especially if they are not feeling sick. Even those who are sick will first test for everything else except cancer, and by the time they consider to test, it already too late,” Dr Asiimwe says.
He says surgical procedure is the cheapest mode of treatment for men who present late. However, the method is less preferred because most men do not want to be known to have no testicles.
“Most of our patients go for the surgical procedure which involves the removal of the entire testis because they present late,” Dr Asiimwe says.
He adds that when all the other forms of treatment have failed, a patient will be put on chemotherapy – a standard treatment of cancer using different drug combinations. Men who get sexual infections, according to Dr Asiimwe are also at risk. Family history also plays a key role in the development of prostate cancer. “If your father, grandfather, brother, or uncle has had prostate cancer, you are at higher risk,” Dr Asiimwe.
Every year, over 543,000 new cases of prostate cancer are reported worldwide with 75 per cent of these in advanced stages.
The commissioner for non-communicable diseases at the ministry of health, Dr Gerald Mutungi says that they are yet to train specialists to do prostate cancer screening at lower facilities.
He also says that the prostate cancer tests are expensive and may not be rolled out to all facilities. It costs Shs80,000 to do a PSA test, which he says may also not be specific and requires specialised equipment, including MRI and CT scans.
According to Dr Siraji Obayo, an oncologist at the Uganda Cancer Institute, prostate cancer is hidden by nature and a patient may not feel pain until it is in advanced stage when the majority of patients in Uganda present.
“The challenge is that prostate cancer does not show any signs until it is in advanced stage, where unfortunately, it is hard to treat and mortality rate is higher.”
