Prostate Cancer among African American Men - Essay Example

Pro cancer is a form of cancer that affects men. It is one of the few cancers that are specifically found in one gender. The cancer cells develop in the patient's prostate gland (National Medical Association [NMA], 2008). This gland is found in the reproductive system of men. Cancer occurs when specific cells in the body of the patient start multiplying. The multiplication is abnormal and uncontrolled (NMA, 2008). The reason why these cells start acting this way is not yet well known. It is suspected that it is a result of mutation, whereby the genetic make-up of the cell is affected, making the cell "to go mad" (Rosenberg et al, 2008). The genetic coding of the cells responsible for control of multiplication is interfered with, making the cells to lose control off their multiplication activities (Thompson, 2002). In the case of prostate cancer, the cells that multiply uncontrollably are those found in the prostate gland. The danger of the cancer is that the cells might migrate to other organs of the body. This is called "metastasis" (Robbins, 2007). When they get to these other organs, they make the cells here to also multiply. This makes the organ to become cancerous also. This form of cancer has some effects on the patient. It might lead to pain and difficulty when passing urine and erectile dysfunction (Rosenberg, 2008). This paper is going to look at the issue of prostate cancer among African American men. This is because it has been noted that there are disparities between the occurrence and effects of prostate cancer between African American men and Caucasian, American men. Introduction There is a variation in reported incidences of prostate cancer around the world. Countries from the Asian continent, for example china and Japan, report fewer cases than the European or American continent (American Prostate Cancer Association [APCA], 2009). America records one of the highest rates of prostate cancer around the world. The cancer also varies from one age group to the other. It is mostly found in men aged above the age of fifty years (APCA, 2009). It is the most common form of cancer among the male population. Cancer of the prostrate develops very slowly, unlike that of breast or the colon (Arterburn 2006). As a result, it is possible for a man to live with it for a long time without been detected. Another important aspect is that it rarely has symptoms (Washburn et al, 2004). It might manifest itself in form of other complications like that of erectile dysfunction, but no direct symptoms. This, coupled with the fact that majority of those inflicted are above sixty years, makes it hard to diagnose. In fact, the patient might die from other diseases (Arterburn, 2006). African American men record the highest incidences of prostate cancer around the globe (National Cancer Institute [NCI], 2008). They make up about a quarter of all prostate cancer cases (NCI, 2008). They are also more likely to die from it than other men. In fact, they are three times more likely to die from it than their white counterparts (NMA, 2008). Prevalence of Prostate Cancer amongst African American Men This cancer is very significant to the African American man. As far as non-skin cancerous conditions are concerned, it tops the list in terms of occurrence amongst this segment (Washburn et al, 2004). It the most diagnosed cancer among these men. The American Prostate Cancer Association estimates that approximately 40,000 cases will be reported this year alone (2009). This is among the African American men. It is fact that the mortality rate from prostate cancer is dropping (APCA, 2009). But still, it occupies the second position as far as cancer mortalities amongst African American men is concerned (APCA, 2009). In 2005, more than five thousand black men in America succumbed to this cancer (Robbins, 2007). This dropped to about four thousand in 2007 (Robbins, 2007). The mortality rate has been in decline though. For instance, between the years 2000 and 2003, approximately sixty men out of 100,000 died. Compare this to about seventy men in the period 1997-2000 (APCA, 2009). This is a drop of approximately ten percent. If an African American man comes from a family that have just a single close relative with this condition, he stands a 33% risk of getting it too (Arterburn, 2006). The risk rises to approximately 80% if the number of relatives with prostate cancer doubles (Arterburn, 2006). If the relatives are three, he stands a 97% risk of contracting it. As explained earlier in this paper, this cancer has no discernible symptoms. This is especially when it is at its early stages. The only hope that is there for detecting it is through screening. This is advised to be carried out annually when the African American man turns forty years (Washburn et al, 2004). Approximately 75% of prostate cancer used to be detected at an advanced stage before the advent of new technology. Today, almost ninety percent of this cancer in African American men is detected at an early stage (American Cancer Society [ACS], 2008). This has made it possible for the condition to be managed such that the patient can live with it for more than five years. This reduces to about two years if the disease is detected at a very advanced stage (Arterburn, 2006). This explains the importance of screening for early detection. Health Dimensions of Prostate Cancer amongst African American Men Causes of Prostate Cancer Related to the Health of the Patient There is no consensus on the causes of this disease. Specific causes remain hidden. The major risk, though, is suspected to be age. This is because it rarely inflicts men below the age of forty five. As the man becomes older, the risk increases (Ablin, 2007). The average age of African American men diagnosed with this cancer is seventy years (Ablin, 2007). Risk of prostate cancer can also be associated with genetic make-up of the individual. This might explain why this condition is common among African American men, than in their Caucasian counter parts. This is because the blacks have identical gene make-up. If one identical twin develops it, it is highly likely that the other will get it too (Ablin, 2007). If a black man comes from a family with a history of prostate cancer, as seen above, he is likely to get it too. African American men diagnosed with this condition have been known to share some common genetic traits (APCA, 2009). These are the genes BRCA1 and BRCA2 (APCA, 2009). These genes are also referred to as Breast Cancer 1 and 2 respectively. They have been known to be factors in ovarian and breast cancer. This can only be explained by the fact that it can be genetically inherited. Symptoms of Prostate Cancer Associated with Health At an earlier stage, it rarely causes any symptoms. But it does have some symptoms at those rare cases. However, the symptoms are identical to those of benign prostatic hypertrophy (Robbins, 2007). The latter is the enlargement of the prostate gland common amongst older men. Some of the symptoms include blood stained urine (Rosenberg et al, 2008). This is an indication of a tumor in the urinary tract of the patient (Rosenberg et al, 2008). Medically, this condition is referred to as haematuria. The condition also associated with malfunctioning of the urinary system. This is because it causes the enlargement of the prostate gland. This then will surround the prostatic urethra (Rosenberg, 2008). This pushes the wall of the bladder. Other symptoms include sexual dysfunction. This is caused by the blockage of the prostatic urethra. The patient finds it hard to achieve and maintain an erection. Painful ejaculation might also occur. When this cancer advances, it can metastise in other parts of the body. This will add to other symptoms depending on the organ affected (Rosenberg, 2008). The patient might be afflicted with painful bones especially those of the spine. The prostate cancer can spread to the spine. Here, it compresses the spinal cord and this may lead to other complications (Washburn et al, 2004). This will lead to weakness of the legs. It will further lead to "urinary and fecal incontinence" (Washburn et al, 2004). Behavioral Etiology of Prostate Cancer amongst African American Men Some behaviors and lifestyle of African American men have been known to put them at risk of developing prostate cancer. One of them is diet (Washburn et al, 2004). This includes deficiency or below optimal intake of vitamin D & E (Washburn et al, 2004). Another deficiency is that of selenium, a very important mineral in the formation of enzymes used to counteract free radicals in the body (Arterburn, 2006). Processed dairy products, for example low fat milk, has been known to be a contributing factor (Arterburn, 2006). This is especially so if it contains vitamin A palmitate, a synthetic form of the natural vitamin A. Palmitate combines with zinc and protein found in the body. The end product is an unabsorbable complex product. Obesity is another behavioral risk factor. It raises the level of hormone testosterone in the blood. This increases the risk of this condition. Sexually transmitted diseases, such as gonorrhea, syphilis and Chlamydia might also increase the probability of prostate cancer (Ablin, 2007). This is because they have been known to infect and inflame the prostate gland. This condition is called prostatitis. Any inflammation and infection to the prostate gland leads to risk of this cancer. Behavioral Expression of Prostate Cancer The behavior of the person with prostate cancer does change. This is indicated by frequent urge to urinate, especially at night (Thompson, 2002). The patient will also have a difficulty in passing a steady stream of urine. The urine passes out in form of trickle. The patient might also experience pain when passing urine. Other behavioral expression is the dipping of the man's libido. He has less urge for sex and cannot perform satisfactorily as far as sex is concerned. The physical activity of the man is reduced, especially strenuous activities like aerobics. This is because of the discomfort associated with cancer, especially at an advanced stage (Thompson, 2002). Psychosocial Etiology of Prostate Cancer Some psychosocial factors among African American men have been shown to be associated with prostate cancer. As men get older, they develop some psychological complications like depression and anxiety. To cope with this, they might resort to alcohol and tobacco. Tobacco and alcohol can also be viewed as part of their social lifestyle. These have been known to be risk factors as far as prostate cancer is concerned (Thompson, 2002). The men also decrease their physical activities due to these psychological complications. They also start eating junky food to cope. This may lead to obesity, a risk factor. They also suffer from deficiency of the afore-mentioned minerals and vitamins and this increases their risk to prostate cancer. Psychosocial Expression of Prostate Cancer Men with prostate cancer experience unique psychosocial complications. This is after they have been diagnosed with the disease or before diagnosis. These conditions are in addition to the normal psychosocial complications of old men and women. They suffer from a sense of threatened masculinity (Robbins, 2007). This is attributed to the fact that prostrate cancer leads to sexual dysfunction. They cannot function sexually. This makes them feel as if they are not real men. They also suffer from depression and anxiety (Arterburn, 2006). This might be in part from sexual dysfunction or from the normal reaction to a terminal illness. He is also embarrassed by the condition. This is because every person in the society knows that prostate cancer might lead to sexual dysfunction. Socially, the man suffers from problems of adjusting to the disease (Rosenberg, 2008). The depression might lead to him been easily provoked to anger. He fails to live well socially with those people around him. The social activity of the man with prostate cancer is also curtailed (Rosenberg, 2008). This is because his mobility is affected as it becomes impossible to move from one place to the other due to fatigue and pain. As such, he is unable to attend to his social activities like visiting friends. Environmental Etiology of Prostate Cancer There have been documented environmental factors that increase the risk of the African American man to develop prostate cancer. This cancer seems to afflict men who relocated from regions of low incidences to those of high incidences. African men who are in the African continent are not affected so much by this condition, but when they migrate to high incidence areas like America, they seem to increase their risk (APCA, 2009). Exposure to industrial chemicals like cadmium has also been shown to increase the risk of prostrate cancer (Washburn et al, 2004). This exposure might occur when the person is working in those industries. Mostly, African American men are the workers in these factories and are thus exposed to those chemicals. Other factors environmental may be exposure to radiation. Chemicals used in commercial agriculture are also known to be risk factors (Arterburn, 2006). These are chemicals like dioxin. Most of the workers in these farms are black men. Exposure to Agent Orange, a chemical used in the Vietnam War, has also been seen to increase the probability of war veterans exposed to it to develop prostate cancer (APCA, 2009). This discovery was made in May of 2007. Environmental expression of Prostate Cancer The men with prostate cancer are unable to interact fully with the environment. This may be due to incapacitation of the patient. He can not exercise or enjoy the environment. Another expression is the increased ingestion of drugs to counteract the condition (NMA, 2008). Also, the men cannot take care of the environment, like mowing the lawn and tending to the garden. This is because of pain and fatigue. The environment is neglected. Prevention and Intervention Technique to Counter Prostate Cancer in African American Men This is divided into primary, secondary and tertiary intervention measures (NCI, 2008). Primary Intervention This takes the place before the onset of the condition. It can be referred to as the preventive measures (Thompson, 2002). Some simple interventions have been shown to avert the risk of developing prostrate cancer. This involves the change of lifestyle on the part of African American men as they turn forty. They should increase the intake of vitamins A and E to avert this cancer. Vitamin E can be ingested via supplements or the diet while vitamin D can only be achieved through exposure to sunlight (American Cancer Society [ACS], 2008). Increased frequency in ejaculation is also beneficial (ACS, 2008). Ejaculation can be achieved through intercourse or masturbation. Others include intake of oils and fats, especially omega-3 fatty acids also helps (APCA, 2009). Secondary Intervention This is the intervention that takes place at the earlier stages of the onset of this condition. They include screening for early detection (NCI, 2008). African American men aged forty years and above should be screened at least once after every year. Another intervention is the treatment and chemotherapy of the patient. It has been noted that patients who have had their cancer detected at an early stage stood a better chance of surviving for more than five years. This might also include surgery to remove the prostrate gland. Tertiary Intervention This is the intervention that takes place after the disease has progressed past a certain stage (Thompson, 2002). This includes the post-operation care that the patient needs. The aim is to let the patient live as comfortably as possible with the disease. Medicine given is not for treating the disease but for easing the discomfort (Rosenberg, 2008). Patients with this disease experience a lot of discomfort, especially if the disease spread to other parts of the body. Tertiary intervention might also include counseling the patient to live comfortably with the condition (NMA, 2008). Public Health Implications of this Study Prostate cancer has serious implications on public health. As indicated in this study, it affects a disproportionately large number of African American men. This is as compared to their Caucasian counterparts. This is a very important aspect as far as public health policy making is concerned. The findings of this study will help the public health policy makers in drafting policies to deal with this condition as a public health issue. African American men will be encouraged to go for prostrate cancer screening after turning forty years (Arterburn, 2006). This should be done at least once every year. This is because studies have shown that when this condition is detected early, the patient stands a higher chance of surviving than when detected late (NCI, 2008). African American men should be encouraged to change their lifestyle to reduce their chances of developing this condition (APCA, 2009). They should reduce their exposure to the carcinogenic agents related with this condition. This will include the public policy makers drafting policies that will require employees in a factory to have protective gear to avoid exposure to some chemicals found to increase risk of this cancer. Counseling should be integrated in the public health policy of dealing with prostate cancer patient. This is because they have been known to suffer from psychological conditions that should be dealt with through counseling (NMA, 2008). Conclusion Prostate cancer is a dorm of cancer that has been known to affect men only. The risk of developing this condition increases as the man gets older. It is a threat to men who are above the age of forty years (Rosenberg, 2008). This cancer has also been known to affect men of African American extraction more than their Caucasian counterparts. This has been attributed to some conditions unique to the African American man, including his genetic make-up (Rosenberg, 2008). The cause of this cancer is not yet well known. But some conditions and environment have been associated with it. These include the race of the person, age and lifestyle. It manifests itself variously, sometimes taking the form of health, psychosocial and even behavioral manifestations. Men who are above the age of forty have been advised to go for screening at least once after every year. References Ablin, D. (2007). Prostate cancer in African American men. Cengen Publishers. Houston. Arterburn. G. (2006). Prostate cancer and sexual dysfunction in men. Oxford Publishers. Oxford. Atkins, R. T., Mitchell, S. B., Ablin, H. O. (2008). Prostate cancer mortalities amongst African American men. American Cancer Society Journal, vol. 10 (26), 23-29. Irwin, P. (2009). Risk factors associated with prostate cancer. 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