Prostate cancer is a disease in which abnormal cells grow uncontrollably in the prostate, a small gland found only in male reproductive system that sits below the bladder and plays a key role in producing semen.
The cancer often develops slowly and may remain confined to the prostate for years without causing noticeable symptoms.
However, in some cases, it becomes aggressive, spreading to nearby tissues and distant organs such as the bones, where it can cause severe pain, disability, and eventually death if untreated.
Speaking with PT Health Watch, Sefiu Eniola, a Urologist, warned that it has become the most commonly diagnosed cancer among Nigerian men, quietly advancing as a major public health challenge amid low screening rates, late presentation, and limited awareness.
According to the Global Cancer Observatory (GLOBOCAN), 2022, it estimates that Nigeria records over 18,000 new prostate cancer cases annually, accounting for the highest cancer burden among men in the country.
The report also estimated that 11,443 deaths were recorded each year, largely due to late diagnosis and advanced disease at presentation.
Unlike some cancers that present with early warning signs, prostate cancer often develops silently, making early detection difficult without routine screening.
Why it is common among Nigerian men
Mr Eniola explained that prostate cancer is not only common globally but disproportionately affects men of African descent.
He noted that worldwide, prostate cancer is the second most common cancer in men, but in Nigeria, it is the commonest.
He added that age remains the strongest risk factor and the likelihood of developing prostate cancer increases significantly as men grow older, with the average age of diagnosis around 68 years.
Studies also show that microscopic prostate cancer can be found in up to 80 per cent of men aged 80 and above during post-mortem examinations, even when it was not the cause of death.
Beyond age, the urologist noted that family history and race play a significant role.
He added that men with close relatives who had prostate cancer are at higher risk, while African and black men are more likely to develop aggressive forms of the disease compared to Caucasians.
No early symptoms
Mr Eniola said one of the biggest challenges in tackling prostate cancer is that it often shows no symptoms in its early stages.
He explained that when prostate cancer is still localised within the prostate, there are usually no symptoms and the only way to detect it early is through regular screening.
“Symptoms typically appear only when the cancer has advanced or spread beyond the prostate. These may include difficulty urinating, blood in the urine, bone pain, lower back pain, erectile dysfunction, weakness of the legs, and, in severe cases, urinary incontinence,” he explained.
Screening, the most effective defence
Mr Eniola added that because early prostate cancer is usually silent, routine screening is crucial. He recommended that African men begin prostate cancer screening between the ages of 40 and 45.
He explained that screening typically involves a Prostate-Specific Antigen (PSA) blood test, sometimes combined with a digital rectal examination.
While not all prostate enlargement is cancerous, he noted that screening helps differentiate between benign enlargement and malignant disease.
“It is important to note that not every enlarged prostate is cancer. Some men have enlargement without symptoms, some have symptoms without cancer, and some have cancer. Screening helps us identify which is which,” he said.
Treatment options
The urologist noted that treatment for prostate cancer depends largely on how early the disease is detected.
He explained that early-stage, localised cancer, curative treatment options include radical prostatectomy, the complete surgical removal of the prostate, and radiotherapy, which uses targeted radiation to destroy cancer cells.
Another option, brachytherapy, he said, involves implanting radioactive seeds directly into the prostate.
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“In selected low-risk cases, doctors may recommend active surveillance, where the cancer is closely monitored without immediate treatment to avoid unnecessary complications.”
He, however, noted that when prostate cancer spreads beyond the prostate, treatment focuses on slowing progression and improving quality of life.
Advanced disease and survival outlook
Mr Eniola further explained that advanced prostate cancer often depends on hormonal therapy, aimed at reducing testosterone levels, since prostate cancer cells rely on the hormone to grow.
This, he said, can be achieved through periodic injections or surgical removal of the testes.
“If prostate cancer is not treated, it will continue to progress. Even before it leads to death, it can severely affect quality of life, causing intense bone pain, paralysis, and inability to walk,” he said.
He added that prostate cancer among African men tends to be more aggressive, contributing to poorer survival outcomes compared to high-income countries where early detection is common.
