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Surveys have shown that a large percentage of men aged over 45 years had never been tested for prostate cancer despite being a common infection among older men/CFM

Kenya

Demystifying perspectives of prostate cancer screening, to encourage early diagnosis

NAIROBI, Kenya, April 23 – Prostate cancer is the most commonly diagnosed non-skin cancer in men that occurs in the prostate.

In its early stages, there might be no symptoms whatsoever, therefore, early detection is key in prevention of spread to other parts of the body, and better chances of successful treatment.

Screening for prostate cancer is widely accepted but few opt for it. For men to carry out the prostate cancer screening, they need to mentally overcome fears of losing their masculinity and accept the intrusiveness of screening.

The Nairobi Hospitals’ Urologist Dr Maina Kanyi expounds more on the Prostrate Brachytherapy treatment option, on Capital Health.

-What is Prostate Brachytherapy ?-

Brachytherapy is a cancer treatment in which radioactive material i.e. iodine, is permanently implanted in the prostate using a needle or catheter. The radiation given off by this source damages the DNA of nearby cancer cells.

“This method is said to none intrusive as the process does not involve surgery hence leaving the patient whole and able to carry out his functions,” noted Dr. Kanyi.

The therapy can be used on its own, usually to treat low-risk prostate cancer, before or after external beam radiotherapy to make treatment work better, usually for medium-risk to high-risk prostate cancer or with hormonal therapy, or with hormonal therapy and external radiotherapy.

This mode of treatment is not only limited to Prostate cancer but can also be used in the treatment Cancer of the Cervix.

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 – At what stage of cancer can one use the Prostate Brachytherapy treatment option?-

Many factors will determine the best treatment plan, including the stage of the cancer, PSA level, grade of the tumor (i.e., Gleason score), age of the patient, and the patient’s other health issues.

“The Brachytherapy treatment is commonly used on patients who have displayed early symptom of Prostate cancer, meaning that the cancer is still contained within the prostate and has not spread out of the prostate referred to as stage 3,”explained Dr. Kanyi.

Dr. Kanyi further notes that for the Prostate Brachytherapy treatment to be effective, early diagnosis is key. Over the years men have shied from seeking the Prostate cancer diagnosis due to the intrusive nature of the test. This however, can be achieved through the Prostate Specific Antigen (PSA).

Prostate-specific antigen is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in a man’s blood.

The blood level of PSA is often elevated in men with prostate cancer.

Men who report prostate symptoms often undergo PSA testing to help doctors determine the nature of the problem, monitoring its treatment, or assessing its recurrence.

According to Dr. Kanyi, the PSA test is available in both public and private health facilities in the country.

 “Men are willing to participate in prostate cancer screening to prevent cancer and gain reassurance about their health, particularly when supported or prompted by their social networks or healthcare providers,” Dr. Kanyi explained. “Addressing the concerns and priorities of men may facilitate informed decisions about prostate cancer screening and improve patient satisfaction and outcomes.”

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Which are some of the side effects of the prostate brachytherapy to the patient?-

Brachytherapy is associated with a reduced risk of side effects compared to other treatment options for prostate cancer.

It is worth noting that all treatments for prostate cancer carry a risk of side effects and people respond to treatments in different ways. The type of side effects that may be experienced depends on a number of factors, such as the stage of the prostate cancer and whether there are any confounding health problems.

Side effects may appear in the short-term (known as acute side effects), which typically resolve soon after treatment. Other side effects may appear several months later (long-term side effects).

Immediately after the brachytherapy procedure, you may experience some of the following:

Soreness or localized bruising around perineum (the area between the scrotum and anus where the needles are inserted to deliver the brachytherapy).

Blood in urine or semen.

Discomfort when passing urine (may include needing to pass urine urgently or frequently).

“These side effects are typically mild in nature and typically resolve soon after treatment,” noted Dr. Kanyi.

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-What are the clinical benefits and success rate of the Prostate Brachytherapy?-

“Brachytherapy treatment is the best treatment for prostate cancer, because once the radioactive iodine is deposited in the prostate, the burning of all cancer cells begins. And the patient is able to lead a normal life not to mention that no surgery procedure is involved,” Dr.Kanyi expounded.

Brachytherapy has been used extensively to treat earlier stage prostate cancer and is also used to augment EBRT for patients with advanced localized prostate cancer. Research suggests that the use of brachytherapy in addition to external beam radiation therapy (EBRT) may be more effective treatment than EBRT alone for patients with advanced localized prostate cancer. 

Research by Cancer Connect evaluated the effectiveness of brachytherapy plus EBRT in the treatment of over 300 patients with advanced localized prostate cancer.

Five years following treatment, high PSA levels existed in only 33% of patients that had received the combination of brachytherapy.

“Since high PSA levels are an indication of the presence of cancer, these results suggest that brachytherapy plus EBRT may be more effective in the treatment of advanced localized prostate cancer,” stated the report.

-Where can one access the prostate brachytherapy treatment in Kenya-

In Africa, the brachytherapy treatment is available in South Africa, Egypt, and in Ghana.

In Central and East Africa region, the treatment is only available at the Nairobi Hospital.

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“Since the brachytherapy treatment was introduced in Kenya in 2017, over 100 patients have undergone the procedure successfully with a handful reporting mild side effects which were consequently addressed,” explained Dr Kanyi.

 Dr Kanyi noted that the treatment is supported by the National Hospital Insurance Fund (NHIF) paying up to half a million shillings.

The total sum that the Nairobi Hospital has charged for the treatment in entirety is Sh850,000.

https://youtu.be/9_xDAJvr_k0
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