Unlike other types of cancer, Prostate cancer could be prevented if the entire male fork above 50 years underwent medical check- up.

Robert Zulu consultant surgeon at the University Teaching Hospital (UTH) said of the 60 per cent urology patients received at the Hospital, 20 per cent have prostate cancer.

Mr Zulu said urological services for prevention of prostate cancer in Men were readily available at UTH and Men above 50 years should take advantage of them.

“American Urological Association and the American Cancer Society have published guidelines advocating annual Digital Rectal Examination and Prostate Specific Antigen testing for men over the age of 50.These guide lines are available from your doctor and every male above 50 years should visit his doctor to discuss this,” he said.

Genetic studies suggest that a strong familial predisposition may be responsible for as many as 5-10 per cent of prostate cancer cases. Dr Zulu who is also Zambia Medical Association (ZMA) spokesperson said Men with a family history of prostate cancer have a higher risk ofdeveloping prostate cancer and are also likely to present it 6-7 years earlier.

He added that Epidemiological studies which is the study of people in the community that has had prostate cancer, have shown that diet also played a role in the development of prostate cancer.

He said studies have identified a variety of dietary factors, particularly fat intake and obesity as causes of prostate cancer and Hormonal causes.

It has been observed that in the era before testing of the blood to diagnose cancer (Prostate Specific Antigen) by clinics, patients with prostate cancer commonly showed symptoms confirmed to the urinary system.

Inability to pass urine developed in 20-25% of these patients, back or leg pain developed in 20-40 per cent, and blood in urine developed in 10-15percent.

Dr Zulu said with the current Prostate Specific Antigen screening, Urinary, Decreased urine stream, Urinary urgency and Blood in urine has proved to be the typical symptoms of prostate cancer.

“The typical symptoms of prostate cancer and their frequency are Urinary with 38 percent) frequency, Decreased urine stream with (23percent), Urinary urgency (10percent) and blood in urine at (1.4percent),” he said.

He said manifestations of advanced prostate cancer may include weight loss and loss of appetite, anaemia with or without fracture and lower extremity pain and oedema. Dr Zulu said initial work-up for prostate cancer involves testing of the blood (Serum Prostate-Specific Antigen),examining the extent of cancer using fingers (Digital Rectal Examination) and  rostate Biopsy which is the test done to ascertain the problem by the of the affected flesh.

He added that further workup depends on how far the disease has progressed. “A higher clinical stage of cancer determined by Digital Rectal Examination (DRE) findings, Prostate-Specific Antigen (PSA) level, correlates with an increased risk of spread to distant organs, andthese tests are considered key factors in determining the staging, work-up and predicting patient prognosis,” he said.

He said standard treatments for clinically early prostate cancer include radical prostatectomy or removing the prostate, radiation therapy, or active surveillance.

He said for locally advanced prostate cancer, radiation therapy along with androgen ablation which is the blocking of the male sex hormone on which prostate cancer rely upon for its growth in order to treat it, was generally recommended, although radical prostatectomy may beappropriate as an alternative to radiation therapy in some cases.

Bowel cancer was misdiagnosed as constipation by GPs at Sale practice

11:20am Thursday 6th January 2011

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a PENSIONER from Sale died just days after an operation to remove a massive tumour from her colon which had gone undiagnosed for months, an inquest heard.

Roselie Smith, 71, first went to Firsway Medical Centre in November 2008 complaining of constipation and lower abdomen pain, and was prescribed laxatives.

the court heard around a year later Ms Smith, who lived on the town’s Granary way, presented again at the surgery with similar symptoms, then in February 2010, and was then seen a further four times in March by doctors at the practice as her symptoms became increasingly worse.

she was eventually admitted as an emergency on March 31 where a CT scan at Trafford General identified a large obstruction in her colon.

But after surgery in May surgeons discovered she had advanced bowel cancer which had spread in to her stomach and was inoperable. she died on May 19 of multi-organ failure.

“I think it had been present for a while,” said consultant surgeon Felix Mazarelo, who performed the operation on Ms Smith, and who told told the court he’d found a “mass” of cancer cells near her pancreas and spleen.

the inquest also heard evidence from Firsway GP, Dr Michael Holloway, who explained how the practice had been amalgamated with two others in 2008 to create a single super surgery, and that Ms Smith had not seen the same doctor twice. “It is a weakness of bigger groups,” he said. “In practice there’s a continuity problem that smaller surgeries don’t suffer with as much.”

But he also said Ms Smith’s symptoms had not been consistent with bowel cancer, and said consitipation, which was what she had been diagnosed with, was “very common” amongst the elderley.

“With old people we see this a lot,” he said. “And with large bowel cancers it’s unusual for them to present with only constipation. There’s usually rectal bleeding, loose stools and a change of bowel habits. she had none of these things.”

Verdict: Natural causes.

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