By Dr Peter Kumpalume

Prostate cancer is a silent killer. The majority of men who have been and are currently afflicted with the disease stated they experienced little to no symptoms before their diagnosis.

It is the second most common cancer occurring in men worldwide, and cases have continued to steadily increase since the early 2000s.

The incidence of prostate cancer also disproportionately affects Black men, who are 50% more likely to be diagnosed with an aggressive form of prostate cancer in their lifetime compared to men of any other race or ethnicity. Black men are also twice as likely to die from the disease compared to White men.

As a result, early detection of prostate cancer becomes even more crucial for men of African heritage.

Internationally, the healthcare and philanthropic communities are taking a proactive approach to improving awareness, infrastructure, and access to prostate cancer screening, in efforts to tackle what is a critical health burden for many Black men.

The African American philanthropist and entrepreneur, Robert F. Smith, is a major supporter of the Prostate Cancer Foundation. He has established and funded cancer treatment centres across the US, including the Robert Frederick Smith Precision Oncology Center of Excellence at the Jesse Brown VA Medical Center and Mount Sinai Robert F. Smith Mobile Prostate Cancer Screening.

Smith’s charitable activities place a strong emphasis on closing the health gap for African Americans, whom, in the US, are 73% more likely to develop prostate cancer than men of other races or ethnicities.

His work has enabled more African American men to quickly and affordably detect early-stage prostate cancer, thus also allowing better chances at survival or even remission with targeted treatment.

As a disease with few warning signs and has been shrouded in stigma, initiatives like Smith’s that focus on driving specialised research and development are crucial in order to improve the survival rate and standards of care for prostate cancer patients.

In a similar vein to the efforts of Smith’s mobile screening unit, the Dozy Mmobuosi Foundation has launched an initiative in Nigeria to tackle the widespread problem of prostate cancer.

Nigeria is the largest population and economy in the Western African region, where men are at the fifth highest risk for prostate cancer mortality in the world.

Prostate cancer remains the most common and most deadly cancer in the country, resulting in 32.8 cases and 16.3 deaths per 100,000 men.

Endorsed by the Nigerian Medical Association and Rotary Club, the Dozy Mmobuosi Foundation’s pilot scheme for a free Mobile Prostate Cancer Screening Service is working with 100 medical practitioners to service all 36 Nigerian states and the Federal Capital Territory.

Doctors taking part in the Foundation’s initiative have emphasised the importance of early identification to have a chance at early treatment, which has not always been accessible, or even known to be a possibility, to many.

Despite Black men being most at risk for aggressive forms of prostate cancer, the majority of data from genetics-based prostate cancer research is based on White men of European ancestry.

Statistics from the National Institutes of Health in the US indicate the negative consequences of informational deficiency for African-centred research, revealing that Black men are ultimately at a ‘substantially higher risk of developing prostate cancer’.

In 2019, The Lancet published a study where they investigated prostate cancer control in Nigeria. Their survey of prostate cancer patients and survivors revealed that family support, knowledge of family history and trust in the healthcare system all positively pressured them into seeking and participating in screening services.

Deterrents included a lack of prostate cancer knowledge, fear of medical procedures, religious beliefs, high financial costs, and a compulsion to care for other sick family members first.

With the precedent of the Patient Navigation Research Program in the US, the researchers discerned that a well-organised prostate cancer education, screening, and patient navigation initiative that targeted at-risk men would certainly improve outcomes for patients in Nigeria.

Importantly, the paper emphasised that this could certainly be managed by non-governmental organisations.

Both Smith’s and Mmobuosi’s mobile screening initiatives bring state-of-the-art equipment and specialised staff to cities, rural communities, and everyone in between, educating the public on the disease itself as well as providing a vital health service.

The screening service itself is efficient and almost completely pain free, first involving a blood test to identify levels of prostate specific antigen (PSA) that signifies one’s risk of prostate cancer. A digital rectal examination is carried out by a doctor, who accesses whether the prostate is enlarged or abnormal.

Mobile units are a way to break down barriers to education, screening services, treatment and data collection, a crucial tool in the fight against prostate cancer.

Furthermore, The Lancet’s paper demonstrates how increased medical research focusing on historically overlooked populations, such as Black people, needs to occur to resolve global health inequalities and improve treatment outcomes.

With enhanced knowledge, medical professionals and the public will be able to gain a stronger understanding of personal health and care pathways, especially important to incentivise the public to seek life-saving help.

Much more still needs to be done to address the global problem of prostate cancer, but Smith and Mmobuosi certainly show that positive action is underway.

About the author:

Dr Peter Kumpalume is Malawi’s former Minister of Heath and MP for Blantyre West where he served in Public Appointments, Public Accounts and Legal Affairs Committees of Parliament. Dr Kumpalume is also the former Head of Downstream Processing at GlaxoSmithKline where he served for over six years leading a team of scientists with expertise in downstream processing, developing medicines that are safe and efficacious. He was also Research Fellow at the University of Cambridge for over 2 years within the Department of Chemical Engineering where he developed inexpensive but effective processes for the manufacture of snake antivenom.